How to cite:

Fitroh Asriyadi, Arief Budiman (2021). Relationship of Competence

(Knowledge, Attitude and Behavior) With Readiness to Apply

Evidence-Based Practice in Nurse Profession Students. Journal

Eduvest. 1(11): 1329-1340

E-ISSN:

2775-3727

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Eduvest – Journal of Universal Studies

Volume 1 Number 11, November 2021

p- ISSN 2775-3735 e-ISSN 2775-3727

RELATIONSHIP OF COMPETENCE (KNOWLEDGE, ATTITUDE

AND BEHAVIOR) WITH READINESS TO APPLY EVIDENCE-BASED

PRACTICE IN NURSE PROFESSION STUDENTS

Fitroh Asriyadi, Arief Budiman

Muhammadiyah University of East Kalimantan, Indonesia

E-mail: [email protected], [email protected]

ARTICLE INFO ABSTRACT

Received:

October, 26

2021

Revised:

November, 17

2021

Approved:

November, 19

2021

Indonesia is currently in the 21st century where the

learning process is developing, education is expected to be

able to produce human resources capable of

implementing programs and solving problems together in

a wise, peaceful, and intelligent way. ). This research is a

type of quantitative research with a correlational analytic

design and uses a cross-sectional design where in this

design the researcher wants to reveal the relationship

between readiness to apply Evidence-Based Practice with

knowledge, attitudes, and behavior in Nursing

Professional Students, Muhammadiyah University of East

Kalimantan. The population in this study is all students

who will complete the academic program of S1 Nursing

Science at the University of Muhammadiyah East

Kalimantan and who will continue the profession of Ners

at the University of Muhammadiyah East Kalimantan, and

the number of samples in this researcher as many as 115,

using the Non Probability Sampling method with sampling

techniques used total sampling. This research will be

carried out by the UMKT campus and Wahana learning of

Ners professional practice. The conclusion of this study is

the characteristics of respondents based on semester i.e.

students are undergoing semester I education (one), the

majority of respondents aged 17-25 years as many as 92

Fitroh Asriyadi, Arief Budiman

Relationship of Competence (Knowledge, Attitude and Behavior) With Readiness to

Apply Evidence-Based Practice in Nurse Profession Students 1330

respondents, gender is mostly female as many as 76

respondents.

KEYWORDS

Competence, Readiness, Preparation, Evidence-Based Paractice,

NERS Students

This work is licensed under a Creative Commons

Attribution-ShareAlike 4.0 International

INTRODUCTION

This development of education is by the goal of the sustainable development goal

(SDG'S) in goal 4 which ensures a fair and inclusive quality of education and increases

lifelong learning opportunities for all. The strategy that has been set by SDG at point 8 is

to improve the quality of higher education. The efforts made in updating and improving

science and technology are by the Minister of Education and Culture, No. 49 of 2014

article 11 concerning national standards of higher education, by the regulations of the

Minister of Education and Culture, the characteristics of the learning process are expected

to consist of interactive, integrative, holistic, contextual, collaborative, effective and

scientific, what is meant by scientific is the learning process carried out based on

approaches scientific.

The scientific approach taken in health education institutions aims to realize

professional services based on ability through student curiosity during the educational

process and students are expected to be able to provide evidence-based services

(Simamora & Kep, 2009). Evidence-based practice is a competency that must be

possessed by health workers to be able to provide services in health actions so that they

remain up to date so that evidence-based practice must be integrated into the nursing

curriculum and can assist in making clinical action decisions effectively.

The Faculty of Health and Pharmacy Sciences at the Muhammadiyah University of

East Kalimantan, which was formerly known as the Muhammadiyah Samarinda College

of Health Sciences, is one of the educational institutions that has been registered as a

member of AIPNI, where UMKT has developed an evidence-based practice in the

nursing professional nursing program so that students can apply articles or journal that is

evidence-based when in clinical practice. This can be seen in one of the missions of the

Muhammadiyah University of East Kalimantan, namely, developing research with

priority on social issues, especially unemployment and poverty as well as the

environment.

The Muhammadiyah University of East Kalimantan has collaborated with several

hospitals in Samarinda in the implementation of clinical practice for the nursing

profession. Clinical practice is said to be key in building nurse student competencies

because nurse students can apply theoretical knowledge and develop skills to provide care

to their patients directly (Yang, 2013).

Preliminary study of researcher interviews with 8th-semester students at the

Muhammadiyah University of East Kalimantan, as many as 10 respondents obtained

information that they know what is meant by evidence-based practice, in the process of

searching for journals they usually use Google Scholar, PubMed but they still do not

understand how to determine an evidence-based practice journal. 8 out of 10 respondents

said that they would apply articles that are evidence-based practice in practice.

Based on the description of the phenomenon above, there are several factors related

to the readiness to apply evidence-based practice to nursing students. Therefore,

researchers are interested in researching "Factors related to Readiness to Apply Evidence-

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Volume 1 Number 11, November 2021

1331 http://eduvest.greenvest.co.id

Based Practice in Nursing Professional Students, University of Muhammadiyah East

Kalimantan in 2020"

The purpose of this study was to analyze factors related to the readiness to apply

evidence-based practice to nursing professional students in 2019 at Muhammadiyah

University of East Kalimantan. By identifying the characteristics of respondents

(semester, age, and gender) in nursing professional students at the Muhammadiyah

University of East Kalimantan. Identifying knowledge, attitudes, behavior in nursing

professional students in 2019 at Muhammadiyah University of East Kalimantan.

Identifying readiness for application to nursing professional students in 2019 at

Muhammadiyah University of East Kalimantan and analyzing the relationship between

knowledge and readiness to apply evidence-based practice to nursing professional

students in 2019 at Muhammadiyah University of East Kalimantan.

Research urgency: Evidence-based practice is a strategy to acquire knowledge and

skills to increase positive behavior by combining the best research evidence so that

evidence-based practice can be applied to nursing practice and make better health care

decisions (Bostwick, 2003).

Knowledge of the concept of evidence-based practice is an important thing that

nursing students must have later, this is because knowledge is a factor that can affect the

quality of service to patients. Nursing students need to be aware of what evidence-based

practice means and what attitude they must take so that the concept can be applied

correctly in the field of practice (Oktiayuliandri, 2015). Nugraha (2015) attitude is needed

by students to be able to behave according to the inclination of their heart. Behavior in the

use of evidence-based practice where students systematically find, assess, and use the

latest valid research findings as a basis for determining clinical decisions to be given to

patients.

(Slameto, 2010) although nursing students show a positive attitude in applying

evidence-based, the ability to search scientific literature is still lacking. Some literature

shows that evidence-based practice is still a new thing for nursing students, therefore the

integration of evidence-based into the nursing curriculum and how to integrate evidence-

based into clinical practice is very important (Ashktorab, Pashaeypoor, Rassouli, &

Alavi-Majd, 2015).

RESEARCH METHOD

This research is a type of quantitative research with a correlational analytic design

and uses a cross-sectional design where in this design the researcher wants to reveal the

relationship between readiness to implement Evidence-Based Practice with knowledge,

attitudes, and behavior in Nursing Professional Students, Muhammadiyah University,

East Kalimantan. The population in this study are all students who will complete their

undergraduate nursing education at the Muhammadiyah University of East Kalimantan

and who will continue the nursing profession at the Muhammadiyah University of East

Kalimantan, and the number of samples in this researcher is 115, using the Non-

Probability Sampling method with the technique of sampling used total sampling. This

research will be carried out by the UMKT campus and the Nurses' Professional Practice

Learning Center. Univariate Analysis This study aims to analyze in the form of

explaining or describing the characteristics of each variable being studied. The course of

the research that has been carried out is divided into several stages, namely: Research

Fitroh Asriyadi, Arief Budiman

Relationship of Competence (Knowledge, Attitude and Behavior) With Readiness to

Apply Evidence-Based Practice in Nurse Profession Students 1332

Preparation Stage by submitting a research proposal. Prepared the Evidence-based

practice Questionnaire from Upton and Readiness from Melnyk. Taking care of licensing,

conducting a preliminary study to obtain primary data in the form of interviews with 10

students and secondary data obtained through the UMKT Academic Administration

Section (BAA) which is used as reference material. Implementation Phase This research

was conducted at the UMKT campus and the nurse's student practice area adjusted the

schedule that had been set. The research was carried out by the researcher with the help of

several fellow students. Before the questionnaire was given, informed consent was given.

After the time limit has been set, the researcher collects data for further editing (data

editing) where the researcher checks the correctness of the data that has been collected.

Next, the researcher coding sheet (code sheet) on the questionnaire sheet that has been

filled out by the respondent.

The final stage is compiling a report on the results of the entry researcher (entering

data) that has been collected into a table in Microsoft Office and analysis applications.

enter research data and do the cleaning. Discussion of research results based on existing

data is connected with related theories and presents research results.

RESULT AND DISCUSSION

A. Characteristics of Respondents

Data processing that has been carried out using computerization has the following

results:

Table 1 Characteristics of respondents by semester, age, and gender.

Characteristics

Frequency

Percentage %

Semester

Semester 1

113

100.0

Age

17 – 25

81.4

26 – 35

14.2

36 – 45

4.4

Gender

Woman

67.3

Man

32.7

In the presentation of table 1 above, it shows that based on the respondent's

semester, the semester that was taken was Semester 1 as many as 113 respondents

(100%). based on the age of the respondents, namely the majority aged 17-25 years as

many as 92 respondents (81.4%). the majority of respondents' gender is female as many

as 76 respondents (67.3%). Based on the results of the characteristics of respondents in

the form of semesters According to the Ministry of Health (2018) semester is the length

of effective learning activities for 6 months both in the form of theory and laboratory

practice in professional education, nurses apply all their learning in clinical practice and

in the community in improving technical, intellectual skills, based on real theory and able

to implement a nursing process approach that is supported by the practical basics of

evidence-based nursing practice to achieve the goal of successful care to be provided to

patients (Indonesia, 2016).

The researcher argues that based on the description and data results since the

beginning of the semester, nurses' professional education has targeted students to improve

problem-solving skills in nursing actions and involve EBP in it to achieve the best

nursing actions and in the future become partners who can respond to the growth and

development of science and technology. to achieve the best health care. Based on the

Eduvest – Journal of Universal Studies

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results of the characteristics of the respondents in the form of age. Age is often associated

with a person's level of maturity in thinking and behaving, this is usually associated with

increasing age, the experience and responsibility in carrying out tasks increases, then the

older the person will increase the ability to make decisions, control emotions, think

rationally and tolerance for the views of others so that it also affects the increase in

motivation.

Based on the description and results of the data, the researcher argues that age

affects a person to continue to find out, understand, and accept scientific developments so

that the ability to analyze will be better and then be able to apply the latest sciences.

Based on the results of the characteristics of the respondents in the form of gender. In the

research of Yanti & Warsito (2013) and Lippa (2010), the nature of women is more

patient, gentle, and caring. The nature of men is more competitive, dominant, responsible,

independent, and unemotional, although gender will provide different motivations, the

male sex has a greater desire than women because the male responsibility is greater.

Based on the description and results of the data, researchers argue that gender differences

influence individual behavior in implementing something in their lives regardless of other

factors such as education, environment, or experience.

B. Univariate Analysis

Student Behavior Variables

Table 2 Frequency Distribution by Behavior

Behavior

Frequency

Percentage %

Good

58.4

Not Good

41.6

Total

113

100.0

Source: Primary Data 2020

The presentation of the data in the table above shows that based on the behavior of

respondents who have good behavior as many as 66 respondents (58.4%). Research by

Ammori, Raddaha, Dsouza, et al., (2014) shows that respondents have a positive response

to the behavior of using EBP with years of experience having better practice behavior.

The behavior in implementing real evidence-based practice is when health practitioners

are able to assess the situation around or the environment around the patient, the

appearance of the patient, and the actions of the clinician to be given to the patient in

accordance with the focus of clinical questions that will be answered in relation to the

patient's condition (Tilson et al., 2011) (Legita, 2012). The results of research by

(AbuRuz, Hayeah, Al-Dweik, & Al-Akash, 2017) reveal that respondents with best

practice behavior values are always followed by good attitudes and knowledge values as

well. The holistic learning process is divided into three learning domains, namely the

cognitive, affective, and psychomotor domains through these domains enable individuals

to develop abilities. In nursing professional education, clinical learning provides

opportunities for students to develop attitudes, psychomotor skills, knowledge, time

management, and problem-solving skills (Rahyubi, 2014. Reilly, 2002. Desvitasari,

2016). Based on the description and results of the data above, the researcher argues that

positive behavior can be seen in terms of expertise or skills in carrying out clinical actions

against patients, this is a reflection of the cognitive and affective domains obtained from

formal education or previous clinical practice learning.

Attitude Variable The results obtained in the univariate analysis are the majority of

students have a positive attitude as many as 62 respondents (54.9%) and based on the

readiness to apply the evidence-based practice, respondents have good readiness, namely

as many as 57 respondents (50.4%). which consists of thinking, feeling, behaving, and

Fitroh Asriyadi, Arief Budiman

Relationship of Competence (Knowledge, Attitude and Behavior) With Readiness to

Apply Evidence-Based Practice in Nurse Profession Students 1334

responding to a command or cognitive object as well as attitude is something that can be

learned, determines how individuals react to situations, and determines what individuals

are looking for in life. Attitudes are related to affection (deep feelings) that are positive or

negative and relate to certain objects. A negative attitude is an attitude that does not

support or oppose the object. Similar to positive attitudes, negative attitudes are also

influenced by individual personal experiences, cultural influences, mass media religious

institutions, educational institutions, emotional factors, and the influence of other people

who are considered important (Yusvanita, 2019). The results of research by AbuRuz,

Hayeah, Al-Dweik, and Al-Akash (2017) say that attitudes towards evidence-based

practice have the highest average score, which means that respondents have a positive

attitude. However, they do not put their positive attitude and evidence-based practice into

daily practice. Based on the results of the study and the description above, the researcher

assumes that a person's attitude can change according to his heart's desires and what he

learns in his life. Based on the readiness of the implementation of evidence-based

practice, most of the respondents have good readiness, readiness for the application of

evidence-based practice is an attitude that can support nursing professional students to be

able to participate creatively towards organizational goals in the field of practice. The

readiness of nursing professional students in implementing evidence-based practice may

include several factors related to their attitudes towards beliefs about evidence-based

practice, namely workplace culture and the need for information (Makki, Salleh, Memon

& Harun, 2015; Saunders & Vehvilainen-Julkunen , 2015). Harun, Herliani & Setyawati

(2019), which states that the readiness to implement evidence-based practice in question

is looking for research results, evaluating research results, and applying them. Research

results can be found through scientific magazines or also called journals both online and

offline. Based on the results of the study and the description above, the researchers

assume that the readiness to apply evidence-based practice can be seen from how often

they seek and read the best research results. The more they get used to finding and

reading the best research results, the better prepared they will be to apply them.

C. Knowledge Variable

Table 3. Knowledge and Readiness of Evidence-based Practice for Nurse Profession

Students at Muhammadiyah University of East Kalimantan.

Variable

Frequency

Percentage (%)

Knowledge

Well

44.2

Pretty good

43.4

Not good

12.4

Total

113

100.0

Source: Primary Data for 2020.

The presentation of data for the knowledge of nursing professional students shows

that most of them have good knowledge as many as 50 respondents (44.2%), 49

respondents have good knowledge (43.4%), and 14 respondents (12.4%) have poor

knowledge. The presentation of the data in table 2 shows that most of them have good

knowledge as many as 50 respondents (44.2%), knowledge is quite good as many as 49

respondents (43.4%), and poor knowledge as many as 14 respondents (12.4%).

Eduvest – Journal of Universal Studies

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Knowledge is a competency that must be possessed by nursing professional students in

providing quality care to patients. Nurse profession students' knowledge of evidence-

based practice is not only based on concepts, but also requires knowledge of how to apply

evidence-based practice directly to patients (Melnyk, Ford, Long, & Overholt, 2014.

Harun, Herliani, & Setyawati, 2019 ).

According to Melnyk, Overholt, & Mays (2008), knowledge in applying evidence-

based practice to students before looking for journals to apply to patients, they must make

PICO questions (P: problem, I: intervention, C: comparison or control, O: results),

discusses evidence-based practice from research studies with colleagues informally, is

able to evaluate the results of the given intervention, reads and critically assesses

research, is able to search for evidence-based practice guidelines on the internet

(Cochrane Library, NCBI, Google Scholar, etc.) ) in determining the intervention to be

given.

In the data presentation, table 2 shows that most of them have good readiness to

implement evidence-based practice as many as 57 respondents (50.4%), poor readiness as

many as 56 respondents (49.6%). Readiness in applying evidence-based practice is the

condition of a person who makes himself ready to provide nursing actions with the

knowledge and skills he has such as conducting a literature search and evaluating

evidence, knowledge is one of the keys in implementing evidence-based practice when in

practice so that he can help contribute productively to achieve goals in providing nursing

actions to patients while in practice (Makki, Salleh, Memon, & Harun, 2015. Slameto,

2010. AbuRuz, Hayeah, Al-Dweik and Al-Akash 2017).

Based on the description above, the researcher argues that in applying evidence-

based practice students already have the skills to conduct a literature search and when in

clinical practice they are required to have the knowledge and readiness to apply the best

research evidence from previous research findings directly to patients so that students

able to contribute productively in providing nursing care and can evaluate it directly in

order to achieve the desired goals.

Variables of Readiness to Implement Evidence-Based Practice

Table 4. Distribution of Frequency Based on Readiness to Implement Evidence-Based

Practice.

Deployment Readiness

Frequency

Percentage %

Good

50.4

Not Good

49.6

Total

113

100.0

Source: Primary Data for 2020.

The presentation of the data in the table above shows that based on the readiness

to implement evidence-based practice, respondents with good readiness were 57

respondents (50.4%). The readiness of nursing professional students in implementing

evidence-based practice includes behavior in their skills related to evidence-based

practice such as searching for research results both online and through scientific

magazines (journals), evaluating research results, and applying them. Learning-related to

evidence-based practice in students can encourage behavior and readiness in carrying out

nursing care related to previous findings (Saunders & Vehvilainen-Julkunen, 2015.

Harun, Herliani, & Setyawati, 2019. Hart et al., 2008. AbuRuz, Hayeah, Al-Dweik, and

Al-Akash, 2017. Damayanti & Bachtiar, 2020. ).

Based on the description and data results, the researcher argues that the readiness

to apply evidence-based practice to students begins with positive behavior in seeking the

best research results which are then applied and evaluated so that they can be taken into

Fitroh Asriyadi, Arief Budiman

Relationship of Competence (Knowledge, Attitude and Behavior) With Readiness to

Apply Evidence-Based Practice in Nurse Profession Students 1336

consideration in determining the best course of action for patients. It also allows students

to connect theory with practice in treating patients directly.

Bivariate Analysis

Relationship between Behavior and Readiness to Apply Evidence-Based Practice.

Table 5. Relationship between Behavior and Readiness to Apply Evidence-Based Practice

Source: Primary Data for 2020

The results of the research above on the relationship between behavior and

readiness for the application of evidence-based practice at the Muhammadiyah University

of East Kalimantan with a total of 113 respondents obtained the majority have good

behavior with readiness to implement EBP obtained 39 respondents (34.5%). The results

of the statistical test showed a p-value 0.047 < from the alpha value of 0.05 which means

Ha failed to reject that there is a significant relationship between behavior and readiness

to implement evidence-based practice in nursing professional students at Muhammadiyah

University of East Kalimantan.

According to Zan PH, (2010). Notoadmodjo S, (2010). Reilly & Oermann, (2002),

behavior arises as a result of several things, including because of the reciprocal

relationship between stimulus and response which is better known as response stimulus.

The relationship between stimulus and response will form new behavior patterns, but all

responses are highly dependent on individual characteristics. Before someone adopts a

new behavior, the person must go through a sequential process including one awareness

(awareness), two interests (feeling interested), third evaluation (evaluating), fourth trial

(trial), and fifth adoption (adaptation). The results of research by Perez-Campos et al.,

(2014) and research by Brown et al., (2008) state that positive knowledge and attitudes

shape good behavior and skills as well. However, this is different from the research of

Manjula et al., (2018) and Zhou (2016) in this study, respondents with positive attitudes

but lack knowledge and behavior towards the application of evidence-based practice.

Based on the description and results of the data, the researcher argues that the

behavior of implementing good evidence-based practice is the result of good knowledge

and positive attitudes, this is by three learning domains, namely cognitive, affective, and

psychomotor which are interrelated. The formation of the behavior itself starts from how

the student perceives an object, prepares physically and emotionally, and learns skills or

actions that will be carried out through standardized procedures and mechanisms, and can

work and innovate in acting. Unfavorable behavior with good readiness obtained 18

respondents (15.9%) while those who had poor readiness were 29 respondents (25.9%).

In the study, Ez Elarab et al., (2012) stated that nurses with low clinical skills had

little EBP application, this was due to a lack of information sources and overcrowded

working hours as for other factors such as age, experience, and education level. Ez Elarab

Variable

EBP Implementation

Readiness

Total

P value

Good

Not Good

Behavior

Good

34.5

23.9

58.4

0.047

2.327

(1.082 –

5.006)

Not Good

15.9

25.7

41.6

Total

50.4

49.6

113

100.0

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et al., (2012) also conveyed that nursing education believes by applying evidence-based

practice will update or strengthen research, theory, and clinical skills. Unfortunately,

many nurses in practice do not understand the concept of evidence-based practice or how

to apply the EBP approach to clinical activities in general. Meanwhile, according to Ryan

in Herliani et al., (2018), it is stated that graduates of nursing education have fewer

opportunities to practice EBP and so are less confident in using EBP independently.

According to Ligita (2012), that the lack of learning methods about the evidence-

based practice at the time of undergraduate nursing college so that the ability of nursing

professional students in search for scientific literature is still very low or it can be said

that they do not have sufficient knowledge and readiness so that in applying evidence-

based practice is still lacking. Based on the description and results of the data above, the

researcher believes that poor behavior is caused by several factors, namely lack of

opportunity, lack of understanding regarding the application of EBP in clinical action, or

lack of confidence. Readiness to apply the good evidence-based practice, researchers

argue that there is motivation from individuals to develop their abilities related to the

field of interest.

Relationship between attitude and readiness to implement evidence-based practice

Table 6. Relationship between attitudes and readiness to implement evidence-based

practice at Muhammadiyah University of East Kalimantan

Variable

EBP Implementation Readiness

Total

P Value

Good

Not Good

Attitude

Positive

33.6

21.2

54.9

0.019

2.667

(1.242-

5.724)

Negative

16.8

28.3

45.1

Total

50.4

49.6

113

100

Source: Primary Data for 2020

Based on table 3, the results of the bivariate analysis above are positive attitudes

and good EBP implementation readiness, namely, there are 38 respondents (33.6%).

From table 3 based on the results of bivariate analysis, the results of statistical tests show

a p-value of 0.019 which is smaller than the alpha value of 0.05 which means rejecting

the null hypothesis (H0), which can be concluded that there is a significant relationship

between attitudes and readiness to apply evidence-based practice to students. nurse

profession at the Muhammadiyah University of East Kalimantan.

Hart, Eaton, Buckner, et al., (2008) explained that the attitude of nurses is one of

the most important factors in implementing EBP. Nurses with positive attitudes are more

likely to use evidence-based research (EBP) in clinical practice. Nurses who believe that

EBP can provide the best outcomes for patients will improve their clinical practice

inpatient care. Respondents in the study of Campos et al., (2014) got the highest score on

the EBPQ attitude subscale with a mean value of 5.35, indicating a good tendency to use

research evidence and belief in EBP.

Several studies (Nagy et al. 2001, Sanzero-Eller et al. 2003, Wallin et al. 2003,

Milner et al. 2006) show that nurses' positive attitudes towards evidence-based practice

are relevant to the application of evidence-based practice in daily clinical practice. them

(Eizenberg, 2011). Based on the results of the study and the description above, the

Fitroh Asriyadi, Arief Budiman

Relationship of Competence (Knowledge, Attitude and Behavior) With Readiness to

Apply Evidence-Based Practice in Nurse Profession Students 1338

researcher assumes that knowledge and experience must be supported by a positive

attitude so that when a person has sufficient knowledge and experience, his attitude will

be receptive to applying evidence-based studies.

Harun, Herliani, and Setyawati (2019) explain that nurses have a negative attitude

towards research and are the lowest compared to other health workers. Based on the

description above, the researcher assumes that there are still nurses who have negative

attitudes towards research because nurses are still not exposed to the best research and

have not gotten used to using it. This study is also in line with research by Hart et al

(2008) and Knops et al (2009) in Ligita (2012) which states that almost all respondents

have a positive attitude towards the implementation of EBP because respondents believe

that EBP can improve the quality of care for patients and research (scientific evidence).

assist them in making clinical decisions. By applying the concept of EBP, clinicians

realize that the results of the research carried out are useful in everyday clinical practice.

There are many reasons for failure to implement evidence-based practice or EBP

including, lack of knowledge about evidence-based strategies, misperceptions or negative

attitudes about evidence-based research and care, lack of knowledge about how to find

and assess evidence, demanding patient workloads, organizational constraints (lack of

administrative support or incentives). Based on the description above, the researcher

assumes that in the application of EBP the respondents are not ready because of many

things, one of which is a misperception of the research so that it raises a negative attitude

and the respondent has a positive attitude but the readiness for the application of EBP is

not good due to obstacles in the institution such as the lack of support for nurses towards

current evidence-based practices (Ez elarab et al., 2012).

Relationship between knowledge and readiness to implement evidence-based

practice

Table 7. The relationship between knowledge and readiness for the application of

evidence-based practice in nursing professional students at Muhammadiyah University of

East Kalimantan

Variable

EBP Implementation Readiness

Total

P value

Good

Not Good

Knowledge

Well

28.3

15.9

44.2

0.024

Pretty good

18.6

24.8

43.4

Not good

3.5

8.8

12.4

Total

50.4

49.6

113

100.0

Source: Primary Data for 2020.

The results of the Chi-Square test analysis showed that the p-value was 0.024

<0.05, which means Ho was rejected, it can be concluded that there is a significant

relationship between knowledge and readiness to implement evidence-based practice in

nursing professional students at Muhammadiyah University of East Kalimantan.

Based on the results of table 3 cross-tabulation conducted between knowledge and

readiness for the application of evidence-based practice, it was obtained that from 113

respondents, who had good knowledge with readiness to implement good evidence-based

practice were 32 respondents (28.3%) while those who had good knowledge with the

readiness of the implementation of evidence-based practice is not good as many as 8

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respondents (15.9%). Based on the results of the analysis using the Chi-Square test, the

results obtained p-value = 0.024 < 0.05, which means Ho is rejected, meaning that there

is a significant relationship between knowledge and readiness to apply evidence-based

practice to nursing professional students at Muhammadiyah University of East

Kalimantan.

This research is in line with the research that has been conducted by Harun,

Herliani, & Setyawati (2018), where the results of the analysis of the knowledge

relationship between nurses' professional program students in the application of evidence-

based practice in managed patients obtained a significant relationship between student

knowledge in applying evidence-based practice with p-value = 0.01 < 0.05.

Knowledge, experience in applying evidence-based practice, level of education,

and age indicate a positive influence on the readiness to apply evidence-based practice to

a person. The higher a person's education level, the higher the knowledge about the

concept of evidence-based practice that one has so that in applying evidence-based

practice the better (Azmoude, Farkhondeh, Ahour, & Kabirian, 2017) (Saunders &

Vehviläinen-Julkunen, 2016).

This is supported by research by Elysabeth et al. (2014), which states that

knowledge greatly influences a person in critically assessing scientific work. This is

because education acts as something that influences a person's behavior in making

changes to the knowledge, attitudes, values , and skills possessed in assessing scientific

work.

Based on the description above, the researcher believes that knowledge about the

concept of evidence-based practice is the result of the level of education and behavior of

students who continue to update their knowledge so that students are able to prepare

themselves in providing nursing care to patients based on the latest research evidence so

that later these students are expected to become a professional nurse and able to apply the

latest sciences.

The conclusion of this study is the characteristics of respondents based on

semesters, namely students who are studying in the semester I (one), the majority of

respondents aged 17-25 years are 92 respondents, gender is mostly female as many as 76

respondents. The behavioral variables of nursing profession students at the

Muhammadiyah University of East Kalimantan have good behavior as many as 66

respondents and based on readiness for the application of evidence-based practice have

good readiness as many as 57 respondents. There is a significant relationship between

behavior and readiness for the application of evidence-based practice in nursing

professional students with a p-value = 0.047 <0.05 Variable The attitude of the

respondents is positive with a total of 62 respondents, the readiness to apply evidence-

based practice respondents is good, as many as 57 respondents. There is a significant

relationship between attitude and readiness to implement evidence-based practice with p-

value = 0.019 < 0.05. Variable Knowledge of nursing professional students at the

Muhammadiyah University of East Kalimantan from 113 respondents mostly had good

knowledge as many as 50 respondents (44.2%) and for readiness to apply evidence-based

practice to nursing profession students, most of them had good readiness, namely 57

respondents (50.4%). The results of the chi-square test obtained p-value = 0.024 < 0.05,

there is a significant relationship between knowledge and readiness to implement

evidence-based practice in nursing professional students.

CONCLUSION

Based on the results of this study, it can be concluded that reticuline compounds

Fitroh Asriyadi, Arief Budiman

Relationship of Competence (Knowledge, Attitude and Behavior) With Readiness to

Apply Evidence-Based Practice in Nurse Profession Students 1340

have good stability, followed by geranyl-caproate which is seen from the value of binding

energy (∆G). Good secondary metabolite compounds of Annona muricata plant were

shown by reticuline with a value (∆G) of -9.91 kcal/mol. Furthermore, the observation of

hydrogen bonding and amino acid scyllitol showed the similarity of 1 of 2 residues

possessed by celecoxib, which previously had known anticancer activity. It can be

concluded that curcumin and its analogues have potential as anticancer, and can be used

for further drug development related to anticancer.

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