Article

Association between nurses’

education about research
q
and their research use
Lynn McCleary and G. Ted Brown

Knowledge about research methods, skills for critical appraisal of research reports, and a
positive attitude towards research have been identified as means to potentially overcome
barriers to individual nurses’ research utilization, and ultimately improve nursing practice.
The objective of this study was to examine independent relationships between nurses’
education about research and research use and their attitudes towards research, knowledge
about research and research utilization. Research utilization and attitude towards research
were measured using the Edmonton Research Orientation Scale. One hundred and
seventy-five nurses working in a pediatric hospital responded to the survey. Higher levels of
education were associated with both (1) positive attitudes towards research and (2) higher
Lynn McCleary RN
PhD, levels of self-reported research utilization. Whether or not nurses had university education,
Social Work Scientist, completing a course about research design or a course about how to read and use research
Kunin-Lunenfeld
Applied Research was associated with positive attitudes towards research. Having completed a course about
Unit, Baycrest Centre how to read and use research was not associated with self-reported research utilization. The
for Geriatric Care,
3560 Bathurst St., association between having completed a course about research design and self-reported
Toronto, Ontario, research utilization was not independent of the association between level of education and
Canada M6A 2E1.
Tel.: +416 785-2500
research utilization. The findings indicate that education about research may be one way to
ext. 3416; Fax: +416 overcome negative attitudes towards research as a barrier to research utilization.
785-4230
ª 2003 Elsevier Ltd. All rights reserved.
E-mail: lmccleary@
klaru-baycrest.on.ca
G. Ted Brown PhD
MSc MPA BSc OT(C)
OTR,
Postdoctoral Research
Fellow, School of
Introduction practice being more broadly defined as the
Occupational integration of research evidence and clinical
Therapy, Faculty of
Evidence-based practice is promoted as a expertise in clinical decision making (Sackett
Health Sciences, La way to improve nursing practice and patient et al. 1996). Knowledge about research
Trobe University, outcomes; a way to overcome the gap between methods, skills for critical appraisal of research
Bundoora, Victoria,
3086, Australia
the generation of research evidence and its use reports, and a positive attitude towards
Occupational in clinical practice. Research utilization, research have been identified as means to
Therapist, Uncle Bob’s defined as the use of research evidence to potentially overcome barriers to individual
Child Development
Centre, Royal
guide practice (Estabrooks 1999a), is a part of nurses’ research utilization, and ultimately
Children’s Hospital, evidence-based practice; evidence-based improve nursing practice (French 1998;
Parkville, Victoria,
3052, Australia q
Maljanian 2000; Melnyk 2002). The study
This research was funded by the Children’s Hospital described here asked: ‘‘Is education about
(Requests for offprints of Eastern Ontario Research Institute and data collection
was conducted by the Chalmer’s Research Group. The research independently associated with nurses’
to LM)
Manuscript accepted: authors thank the clinical staff of the Children’s Hospital research use, knowledge about research, and
21 May 2003 of Eastern Ontario, for their contributions to the research. attitudes towards research?’’

556 Nurse Education Today (2003) 23, 556–565 0260-6917/$ - see front matter ª 2003 Elsevier Ltd. All rights reserved.
doi:10.1016/S0260-6917(03)00084-4

Background
Research utilization
Inquiry and knowledge about research
utilization grew out of the field of diffusion of
innovations (Rogers 1995). According to
diffusion of innovations theory, an innovation,
such as a research finding, is adopted by an
individual or a group in a five-stage process:
1. Knowledge or awareness of an innovation.
2. Persuasion – the forming of a favorable
attitude towards the innovation.
3. Decision to adopt or reject the innovation.
4. Implementation of the innovation, and
5. Confirmation – the decision to use the
innovation again (Rogers 1995).
The process of diffusion is influenced by
characteristics of the adopters, characteristics
of the innovation, and the way the innovation
is communicated (Rogers 1995). Diffusion of
innovations theory places considerable weight
on the decision making autonomy of the
individual adopter. Contemporary models of
research utilization by nurses emphasize, in
addition, the influence of the context within
which nurses work (Estabrooks 1999b; Kitson
1999).
Results of a systematic review of
investigations of research utilization indicate
that three kinds of factors influence research
utilization in health care:
1. Individual characteristics of the nurse, such
as education and critical appraisal skills.
2. Organizational characteristics, such as
decision-making processes and research
climate, and
3. Environmental characteristics, such as
professional regulation and population
density (Dobbins et al. 1998).
Nurses’ lack of knowledge about research
Much of the relevant nursing research has
focussed on barriers to research utilization. The
Barriers Scale (Funk et al. 1991) has been
widely used in this research. Nurses rate the
degree to which potential barriers are
perceived to be a barrier to their use of research
in clinical practice. The 28 items represent four
kinds of barriers: (1) the nurse/adopter of the
ª 2003 Elsevier Ltd. All rights reserved.
Education about research and research use
research; (2) the organization where the nurse
works; (3) the research itself; and (4)
communication of research findings. The
results of this research are congruent with
theory that multiple kinds of factors influence
research utilization. Although individual
characteristics of the nurse tend to be endorsed
as barriers less frequently than characteristics
of the organization where the nurse works,
insufficient knowledge about research is
consistently among the top ten barriers to
research use (Carroll et al. 1997; Dunn et al.
1998; Kajermo et al. 1998; Parahoo 2001).
One item on the Barriers Scale (Funk et al.
1991) specifically pertains to the individual
nurse’s lack of knowledge about research. This
item, ‘‘The nurse does not feel capable of
evaluating the quality of the research’’, has
been endorsed by between 35% and 69% of
nurses surveyed in a variety of settings (Dunn
et al. 1998; Funk et al. 1991; Kajermo et al.
1998,2000; Parahoo 2001; Retsas 2000). These
findings suggest that improving nurses’
understanding of research methods and skills
for critiquing research might improve research
utilization.
Nurses’ attitudes towards research
Positive attitudes towards research are
associated with self-reported research
utilization (e.g., Champion & Leach 1989;
Lacey 1994). Earlier research identified
multiple correlates of research utilization but
did not clarify whether attitude towards
research is an independent predictor of
research utilization. In a more recent survey of
600 nurses, Estabrooks (1999c) found that
positive attitude towards research was one of
three independent predictors of research
utilization. The other independent predictors
were attending in-service training sessions and
belief suspension. Belief suspension was an
indicator of the nurse’s ‘‘willingness to and
frequency of using research when it contradicts
information acquired prior to, in, or after
nursing school’’ (Estabrooks 1999c). A survey
of Canadian rehabilitation professionals, using
a published measure of attitudes towards
research, found that research utilization was
associated with positive attitudes towards
research and with graduate education (Waine
Nurse Education Today (2003) 23, 556–565 557
Education about research and research use
et al. 1997). These findings indicate that
improving attitudes towards research may be a
method to increase nurses’ research utilization.
Education about research as a method to
overcome barriers to nurses’ research
utilization
Associations between education about
research and both attitudes towards research
and self-reported research utilization have, for
the most part, been tested in surveys and
to a limited extent in formal evaluations of
research education. Interpretation of the
results of this research is challenging because
nurses’ education about research has been
confounded with level of education, and
because of the wide variability in research
curricula in undergraduate and graduate
nursing education. This means that it has not
been possible to sort out whether positive
effects of education are due specific effects of
education about research.
Historically, education about research was
obtained as part of undergraduate and
graduate education, with a more recent
availability of continuing education courses
and workshops about critical appraisal of the
research literature. In Canada, at the entry to
practice level, diploma programs at
community colleges are less likely to provide
research methods or critical appraisal courses
than are university based programs. At the
baccalaureate level, research curricula vary.
Traditionally these programs included
introductory research methods courses. Some
baccalaureate programs now focus, instead, on
teaching skills for evidenced-based practice
and critical appraisal of research literature.
Students have positively evaluated such
courses (Kessenich et al. 1997), but it is not
clear whether the courses have effects on
nurses’ research utilization after graduation.
Graduate nursing education commonly
includes coursework about research methods,
the opportunity to conduct thesis research, and
recently, additional courses about the research
utilization process (Quinn 2001).
There are conflicting results of tests of the
association between level of education and
research utilization. Several earlier studies did
558 Nurse Education Today (2003) 23, 556–565
not find that education and research utilization
were associated (Champion & Leach 1989; Coyle
& Sokop 1990; Varcoe & Hilton 1995). These
studies may not have had sufficient statistical
power to detect an association. An association
between higher level of education and higher
levels of research utilization has been reported
in more recent research (Michel & Sneed 1995;
Rogers 2000). Rogers (2000) surveyed hospital
based nurses in Scotland, finding that both
higher qualification and having studied
research were associated with higher research
utilization but the extent to which studying
research had an effect over and above the effect
of higher qualification was not tested.
Rogers (2000) found that one of the effects of
education about research was improved
attitude towards research. This is consistent
with Pearcey’s (1995) finding that nurses who
had taken courses in which research skills
information was presented were more likely to
believe that research could improve their
patient care. Evaluation of research courses
(Dyson 1997) and workshops (Mulhall et al.
2000), using pre-post designs, indicates that an
effect of the courses is improved attitudes
towards research. This research is limited by
inadequately tested measures of attitudes
towards research.
With the current emphasis on critical
appraisal skills and evidence-based practice,
continuing education courses and workshops
about research and the use of research are
increasingly available to nurses who might not
otherwise have learned about research,
including nurses who did not take research
courses as part of their basic education. Level
of education and studying research are no
longer completely confounded and it may now
be possible to use survey designs to test for
independent effects of level of education and
studying about research.
Research questions
The objective of the study reported here was
to examine independent relationships between
nurses’ education about research and
education about research use, and their
attitudes towards research, knowledge about
research, and research utilization. The research
questions were:
ª 2003 Elsevier Ltd. All rights reserved.

1. Is education about research design
associated with knowledge about research
and research utilization, attitudes towards
research, and research use? and
2. Is education about reading and using
research associated with knowledge about
research and research utilization, attitudes
towards research, and research use?
It was predicted that education about
research design or reading and using research
would be associated with higher levels of
research utilization, higher levels of knowledge
and skills for research utilization, and positive
attitudes towards research. This study was part
of a larger investigation of research utilization
among pediatric health professionals
(McCleary & Brown 2002).
Methods
Procedures
All 528 registered nurses in an acute care
pediatric teaching hospital in Ontario, Canada
were surveyed. The hospital research ethics
committee approved the study prior to the
survey and procedures to protect
confidentiality and ensure that participation
was voluntary were implemented. The survey
was explained and publicized at staff and
management meetings. Questionnaires with an
explanatory cover letter were distributed by
hospital mail. One week later, a reminder letter
was sent to all non-respondents and a general
email reminder was sent to all nurses. A second
reminder letter, with a duplicate copy of the
questionnaire, was sent to non-respondents
two weeks later. The researchers visited the
clinical areas to answer questions and remind
staff to complete the survey. Completed
questionnaires were returned to the research
assistant in pre-addressed envelopes, via
hospital mail or via collection boxes located
on the clinical units.
Measures
Demographic variables included age, years of
clinical experience, and level of education. The
survey included the Edmonton Research
Orientation Survey (EROS) (Pain et al. 1996), a
ª 2003 Elsevier Ltd. All rights reserved.
Education about research and research use
two-part measure of research involvement,
research utilization, and attitudes towards
research. The research orientation section
consists of 38 items rated from 1 (strongly
disagree) to 5 (strongly agree). Two EROS
subscales were used in this study. The EROS
Valuing Research subscale was the indicator of
attitudes towards research; it is made up of 8
items, including, for example, ‘‘Even when
funds are severely limited, it is important to
support research activities’’ and ‘‘Research can
improve the cost-effectiveness of patient care’’.
The EROS Evidence-Based Practice/Using
Research subscale, the indicator of research
utilization, is made up of 10 items, including,
for example, ‘‘Research articles provide
information which helps me in my day-to-day
work’’ and ‘‘Hearing research presentations
has changed the way I practice’’. The authors
report high internal consistency of the
EROS total score (Cronbach’s a ¼ :93) and
evidence of construct validity in a sample of
rehabilitation professionals, including
nurses (Pain et al. 1996). In the current
study, internal consistency and construct
validity of the subscales were good
(McCleary & Brown 2003).
Additional items from the EROS were used
to measure knowledge about research and
research utilization. Understanding of six
topics pertaining to conducting and using
research was rated on a 4-point scale (very
poor, poor, good, and very good
understanding). The six topics were: research
design, statistics, reading research, using
research in clinical practice, conducting a
literature search, and using the library.
Participants were asked whether they had ever
completed a course in research design and
whether they had completed a course about
how to read and use research.
Data analysis
Parametric or non-parametric statistics were
used, as appropriate. Differences in knowledge
were tested using the Mann–Whitney U test.
Independence of associations between the
knowledge variables and each of level of
education and completion of specific courses
about research design or reading/using
research were tested by a series of logistic
Nurse Education Today (2003) 23, 556–565 559
Education about research and research use
regression analyses. Correlations involving
ordinal variables were tested using the non-
parametric Kendall’s tau. Differences in EROS
subscale scores were tested using t tests and
regression analyses.
Findings
Sample
One hundred and seventy-five participants
returned survey questionnaires with complete
data; a response rate of 33.3%. Mean age of the
respondents was 40.5 years (SD 9.5, minimum
22 years, maximum 61 years). Mean work
experience was 18.2 years (SD 9.5, minimum
<1 year, maximum 38 years). Half of the
participants had community college education
(n ¼ 92, 52.6%), 76 had Bachelor’s degrees
(43.4%), and a minority had Master’s degrees
(n ¼ 7, 4%). Of the 171 participants who
reported their work unit, there was fairly even
distribution among the specialty settings except
mental health: (1) Emergency department
(n ¼ 25, 14.7%); (2) Neonatal ICU (n ¼ 33,
19.4%); (3) Pediatric ICU (n ¼ 26, 15.3%); (4)
Mental health (n ¼ 3, 1.8%); (5) Oncology
(n ¼ 23, 13.5%); (6) Surgery (n ¼ 29, 17.1%); and
(7) Pediatric medicine (n ¼ 31, 18.2%).
Education about research
Seventy-three participants had completed a
course about research design (41.7%). Of
those, the majority had completed one course
(n ¼ 44, 61.1%), 19 (25.4%) had completed two
courses, and 9 (11.5%) had completed between
3 and 5 courses. It had been 7.1 years, on
average, since completing a course about
research design (SD 6.2, range less than 1 year
to 25 years). Seventy-six participants had
completed a course about how to read and use
research (43.4%). Of these, a majority had
completed one course (n ¼ 56, 74.7%), 14 had
completed two courses (18.7%), and 5 had
completed three or four courses (6.6%). It had
been 6.7 years, on average, since last
completing a course about how to read and use
research (SD 6.2, range less than one year to
25 years). History of completing a course about
research was associated with a higher level
of education. Eleven participants with
560 Nurse Education Today (2003) 23, 556–565
community college education had completed a
course about research design (12%), while
56 (73.7%) of those with a Bachelor’s degree
and 6 (85.7%) of those with Master’s degrees
had completed such a course. Sixteen (17.4%)
of the participants with community college
education had completed a course about how
to read and use research, while 54 (71.1%) of
those with a Bachelor’s degree and 6 (85.7%) of
those with a Master’s degree had completed
such a course.
Knowledge for research utilization
Self-reported knowledge and skills for research
utilization are summarized in Table 1, with
topics listed in order from those that were well
understood to those that were poorly
understood. A majority of nurses reported
good or very good understanding of research
articles, how to use research in practice, and
how to use the library. Participants were less
likely to report good understanding of research
design and statistics.
Research utilization and attitudes towards
research
Mean EROS Valuing Research was 3.87 (SD .62);
significantly higher than mean EROS Using
Research, at 3.57 (SD .59; paired t test, p < :01).
Research education and knowledge for
research utilization
Self-reported knowledge and skills for research
utilization are summarized according to
whether the participant had taken a course in
reading/using research (see Table 1) and
whether the participant had taken a course in
research design (see Table 2). Nurses who had
taken courses in either research design or
reading/using research had higher levels of
self-reported knowledge (all Mann–Whitney U
tests, p < :01). Knowledge about research
topics was also associated with level of
education. As compared to nurses with
community college education, nurses who had
University education reported higher levels of
understanding of each topic except
understanding of how to use the library
ª 2003 Elsevier Ltd. All rights reserved.
 Education about research and research use

Table 1 Differences in self-reported understanding of research and research utilization by education about
reading/using research

Topic Education about Level of understanding

reading/using
Very poor Poor Good Very good
research
a
1. Research articles in journals Yes 2 (2.7) 4 (5.4) 54 (73.0) 14 (18.9)
No 16 (16.3) 26 (26.5) 52 (54.1) 3 (3.1)
Total 18 (10.5) 30 (17.4) 107 (62.2) 17 (9.9)
2. Using research in clinical practicea Yes 0 12 (16.0) 57 (76.0) 6 (8.0)
No 11 (11.3) 30 (30.9) 53 (54.6) 3 (3.1)
Total 11 (6.4) 42 (24.4) 110 (64.0) 9 (5.2)
3. Using the librarya Yes 1 (1.4) 8 (10.8) 44 (59.5) 21 (28.4)
No 5 (5.2) 19 (19.6) 60 (61.4) 13 (13.4)
Total 6 (3.5) 27 (15.8) 104 (60.8) 34 (19.9)
4. Conducting a literature searcha Yes 4 (5.4) 12 (16.2) 42 (56.8) 16 (21.6)
No 22 (22.4) 39 (39.8) 33 (33.7) 4 (4.1)
Total 26 (15.1) 51 (29.7) 75 (43.6) 20 (11.6)
5. Research designa Yes 4 (5.5) 17 (23.3) 50 (68.5) 2 (2.7)
No 32 (32.7) 53 (54.1) 13 (13.3) 0
Total 36 (21.1) 70 (40.9) 63 (36.8) 2 (1.2)
6. Statisticsa Yes 4 (5.4) 27 (36.5) 41 (55.4) 2 (2.7)
No 23 (23.5) 44 (44.9) 28 (28.6) 3 (3.1)
Total 27 (15.7) 71 (41.3) 69 (40.1) 5 (2.9)

Note. Topics listed in order from best understood to least understood. Figures indicate number and (%) within
response to education about reading/using research. Total n = 175.
a
Mann–Whitney U test, p < .01.

(results not shown, Mann–Whitney U tests,
p < :01).
In order to test for independence of
associations between self-reported knowledge
and each of level of education and
completing courses about to research design
or reading/using research, a series of logistic
regression analyses were conducted. For the
logistic regression analyses, the knowledge
variables were collapsed into two categories:
very poor or poor understanding vs. good or
very good understanding. The adjusted Odds
ratios presented in Table 3 are the odds of
reporting good or very good understanding of
a topic, depending on whether or not the nurse
had completed a course in either reading/
using research or research design, adjusted
for university education vs. community
college education. For example, after
adjusting for the effect of level of education,
nurses who had completed a course in
reading/using research design were 9.4 times
more likely than those who had not completed
such a course to report at least good
understanding of research design.
Among the 73 nurses who had completed
a course in research design, those who
completed a course more recently reported
better understanding of how to conduct a
literature search (correlation coefficient ¼ .26,
Kendall’s tau, p < :01) and a better
understanding of how to use the library
(correlation coefficient ¼ .25, Kendall’s tau,
p < :01). Time since completing the research
design course was not associated with the
other indicators of knowledge. Among
the 76 nurses who had completed a
course in reading/using research, time
since completing the course was not
associated with any of the indicators of
knowledge.
Research education, research utilization and
attitudes towards research
Nurses who had completed a course about
research design scored higher than those who
had not completed such a course on EROS
Valuing Research (mean ¼ 4.1, SD .55 vs.
mean ¼ 3.7, SD .63, t ¼ 3:8, df 173, p < :01) and

ª 2003 Elsevier Ltd. All rights reserved. Nurse Education Today (2003) 23, 556–565 561
Education about research and research use

Table 2 Differences in self-reported understanding of research and research utilization by education about
research design

Topic Education about Level of understanding

research design Very poor Poor Good Very good
a
1. Research articles in journals Yes 1 (1.4) 6 (8.3) 51 (70.8) 14 (19.4)
No 17 (17.0) 24 (24.0) 56 (56.0) 3 (3.0)
Total 18 (10.5) 30 (17.4) 107 (62.2) 17 (9.9)
2. Using research in clinical practicea Yes 1 (1.4) 11 (15.5) 54 (76.1) 5 (7.0)
No 10 (9.9) 31 (30.7) 56 (55.4) 4 (4.0)
Total 11 (6.4) 42 (24.4) 110 (64.0) 9 (5.2)
3. Using the librarya Yes 1 (1.4) 6 (8.3) 45 (62.5) 20 (27.8)
No 5 (5.1) 21 (21.2) 59 (59.6) 14 (14.1)
Total 6 (3.5) 27 (15.8) 104 (60.8) 34 (19.9)
4. Conducting a literature searcha Yes 2 (2.8) 11 (15.3) 44 (61.1) 15 (20.8)
No 24 (24.0) 40 (40.0) 31 (31.0) 5 (5.0)
Total 26 (15.1) 51 (29.7) 75 (43.6) 20 (11.6)
5. Research designa Yes 1 (1.4) 15 (21.2) 53 (74.6) 2 (2.8)
No 35 (35.0) 55 (55.0) 10 (10.0) 0
Total 36 (21.1) 70 (40.9) 63 (36.8) 2 (1.2)
6. Statisticsa Yes 4 (5.6) 27 (35.6) 38 (52.8) 3 (4.2)
No 23 (23.0) 44 (44.0) 31 (31.0) 2 (2.0)
Total 27 (15.7) 71 (41.3) 69 (40.1) 5 (2.9)

Note. Topics listed in order from best understood to least understood. Figures indicate number and (%) within
response to education about reading/using research. Total n = 175.
a
Mann–Whitney U test, p < .01.

Table 3 Association between education about research design or reading/using research and understanding of
research-related topics, adjusted for the effect of level of education

Adjusted odds ratio

Education about reading/using research and understanding of:
Using the library 1.8
Research articles in journals 5.2


Using research in clinical practice 3.2


Conducting a literature search 4.2


Statistics 2.2

Research design 9.4


Education about research design and understanding of:
Using the library 3.0

Research articles in journals 3.5

Using research in clinical practice 2.7

Conducting a literature search 6.6


Statistics 1.8
Research design 22.9

Note. Odds ratios indicate odds of good or very good understanding of a research topic depending on whether
nurses had taken courses about reading/using research or research design, adjusted for the effect of University
Education.
*
p < .05.
**
p < .01.

EROS Using Research (mean ¼ 3.7, SD .51 vs. reading/using research scored higher than
mean ¼ 3.4, sd .60, t ¼ 3:5, df 173, p < :01). those who had not completed such a course on
Nurses who had completed a course about EROS Valuing Research (mean ¼ 4.1, SD .56 vs.

562 Nurse Education Today (2003) 23, 556–565 ª 2003 Elsevier Ltd. All rights reserved.

mean ¼ 3.7, SD .62, t ¼ 4:2, df 173, p < :01) but
not on EROS Using Research (mean ¼ 3.7, SD
.56 vs. mean ¼ 3.5, SD .58, t ¼ 2:9, df 173, ns).
In order to test whether these differences
were independent of the effect of level of
education, three regression analyses were
conducted. Controlling for the effect of level
of education, completing a course about
research design was an independent predictor
of EROS Valuing Research (F Change ¼ 4.2, df
1172, p < :05) but not of EROS Using Research
(F Change ¼ 2.2, df 1172, ns). Completing a
course about reading/using research was an
independent predictor of EROS Valuing
Research (F Change ¼ 6.8, df 1172, p ¼ :01).
Discussion
These findings indicate that education about
research is valuable. However, the low
response rate means that the findings should
be interpreted with caution. While the response
rate is similar to previous research about
barriers to research utilization (e.g., Carroll
et al. 1997; Dunn et al. 1998; Funk et al. 1991), at
33%, the response rate was low, despite our
efforts to maximize response. The sampling
frame, the Human Resources list of staff,
included names of some nurses who were no
longer actively working or were on leave but
this would explain only a small portion of the
non-response. Five questionnaires were
returned blank, three with notes that the nurses
did ‘not wish to complete’ the questionnaire,
and one with a note that it was ‘too time
consuming’. Other reasons for non-response
are not known. Nurses who valued research
may have been more inclined to respond to the
survey. The participants were compared to
participants in another survey about nursing
retention and recruitment completed shortly
before this study with an 85% response rate.
Participants in the two surveys had similar
years of experience. However, there were
proportionately more nurses with
baccalaureate education in our sample (47% vs.
33%). Thus, this sample may not be
representative of pediatric nurses and the
results require replication with other samples.
Among the pediatric nurses surveyed,
having completed a course in research design
and having completed a course in reading/
ª 2003 Elsevier Ltd. All rights reserved.
Education about research and research use
using research were both independently
associated with a positive attitude towards
research. A limitation of previous research is
that it has not been possible to tell whether it
was education about research per se or
education in general, that contributed to
positive attitudes towards research (Dyson
1997; Mulhall et al. 2000; Pearcey 1995; Rogers
2000). Our research adds to previous research
by demonstrating that the effect of education
about research on attitude towards research
was independent of level of education.
Whether or not nurses had completed a
university degree, those who had completed
such courses had a more positive attitude
towards research.
The impact of having completed
research-related courses on research use is
less clear. Nurses who had completed either
a course about research design or a course
about reading/using research reported better
research literacy and the associations between
completing research-related courses and
self-reported knowledge were, for the most
part, independent of level of education.
However, knowledge did not necessarily
translate into actual research use. Completing
research-related courses was not
independently associated with higher levels of
research utilization.
There are a number of possible
interpretations of these findings. First,
research-related courses may not have an effect
on skills for using research. However, the
findings that research-related education was
associated with better understanding of topics
fundamental to research use, refute this
interpretation.
Second, the EROS may not be a sufficiently
sensitive measure of research use. There are
few published measures of research utilization.
The EROS has undergone psychometric
testing, including tests of construct validity,
but its validity in relation to actual research
utilization has not been tested (Pain et al. 1996).
Direct observation of research use might
provide a more valid measure than the EROS
self-report questionnaire. However, the
feasibility of direct observation is questionable.
Third, the impact that education about
research has on the practice of research use
may vary, depending on the intensity and
Nurse Education Today (2003) 23, 556–565 563
Education about research and research use
quality of that education. Quinn (2001)
suggests that graduate courses about the
theory and practice of research utilization in
clinical practice will better prepare advanced
practice nurses for research utilization. This
study did not include details about what kind
of courses the nurses had completed and it was
not possible to test for the effect of kind of
course. It may be that some approaches to
education about research utilization do have an
impact on research utilization.
Fourth, this finding is congruent with
research about barriers to research utilization
and research about the effectiveness of efforts
to disseminate and implement research
findings. Where strategies to disseminate and
implement research findings among nurses
and physicians have been tested, the evidence
indicates that multiple interventions, targeting
different barriers to adoption of a particular
research finding are required (Grimshaw et al.
2001). Barriers within the nurse, such as
knowledge about research are less likely to be
cited as important by nurses, than are barriers
in the workplace and barriers associated with
how research findings are communicated
(Carroll et al. 1997; Funk et al. 1991; Kajermo
et al. 1998; Parahoo 2001). Education about
research may be insufficient to overcome
other barriers to research utilization.
Conclusion
Nurses’ understanding of research and
positive attitudes towards research may
contribute to nurses’ research utilization. Our
findings add to evidence that education about
research, either as part of formal nursing
education or through continuing education and
workshop, is associated with better attitudes
towards research and better knowledge of
research. The findings support educating
nurses about research. However, positive
attitudes and knowledge about research are
not enough. It is unlikely, given the
complexities of using research in nursing
practice, that educating every nurse about
research would be sufficient to ensure
evidence-based nursing practice. In addition to
ensuring nurses’ access to education about
research, successful efforts to improve research
utilization would need to attend to other
564 Nurse Education Today (2003) 23, 556–565
factors that influence nurses’ ability to put
research into practice.
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