University Of Tasmania
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Factors affecting paramedicine students' learning about evidence-based practice: a phenomenographic study

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journal contribution
posted on 2023-05-20, 22:00 authored by Wilson, A, Howitt, S, Adele HollowayAdele Holloway, Anne-Marie WilliamsAnne-Marie Williams, Higgins, D

Background: Evidence-based practice is an important component of pre-service professional learning in medicine and allied health degrees, including new programmes in paramedicine. Despite substantial interest in this area, there is still a lack of clear understanding of how the skills and understandings needed to develop the capacity to apply evidence-based practice can best be learned. Evidence-based practice is often described as consisting of five steps: ask, acquire, appraise, apply and assess. This study focuses on paramedicine students’ learning about the first three steps in a final year unit which explicitly aims to develop their skills in relation to these.

Methods: We conducted a qualitative study of learning journals recorded by 101 of 121 students in a final year unit of a paramedicine degree (20 students either withheld consent for their journals to be used in the research or did not complete their journal entries). We used phenomenographic approaches to the data analysis in order to identify both variation in students’ learning and the factors affecting this variation.

Results: We observed variation in students’ understanding of the purpose of literature analysis, the nature of medical research and its relationship to practice. In all three, we identify two main factors contributing to the variation in student learning outcomes: epistemological stance, and opportunities for metacognitive learning generated through peer interactions and self-reflection. We also found that as students begin to grapple with the complexity of medical research, this sometimes produced negative attitudes towards its value; such unintended outcomes need to be recognised and addressed.

Conclusions: We suggest key factors that should be considered in developing coursework intended to enhance students’ understandings about the processes and application of evidence-based practice. Providing collaborative learning opportunities that address the architecture of variation we observed may be useful in overcoming epistemological and metacognitive barriers experienced by students.


Office for Learning & Teaching


Publication title

BMC Medical Education








Tasmanian School of Medicine


BioMed Central

Place of publication

United Kingdom

Rights statement

Copyright 2021 the authors. Licensed under Creative Commons Attribution 4.0 International (CC BY 4.0)

Repository Status

  • Open

Socio-economic Objectives

Higher education; Assessment, development and evaluation of curriculum