Is informed consent necessary for EBQI?

No. There is excessive focus on the distinction between research, which has a set of regulatory conventions, and quality improvement (QI), which does not. This misdirection arises because the boundaries between research and QI create confusion, which may grow along with the pragmatic research of “learning health systems” in which every patient encounter offers the opportunity to treat the next patient better. All activity aims to generate reusable knowledge, the important distinction is not whether an activity is research, but whether it risks harming people or their rights. The Institutional Review Board (IRB) has not made a ruling on the inconsistencies of informed consent on EBQI, as the focus of quality improvement is not human testing but evaluating whether or not there was improvement. It is a reassessment of an intervention which is the last step of the nursing process - evaluation.

Reference:

Asch, D. A., Ziolek, T. A., & Mehta, S. J. (2017). Misdirections in Informed Consent - Impediments to Health Care Innovation. New England Journal Of Medicine, 377(15), 1412-1414. doi:10.1056/NEJMp1707991

Melnyk, B. M., & Fineout-Overholt, E. (2015). Evidence-based practice in nursing & healthcare (3rd Ed.). Philadelphia, PA: Lippincott Williams & Wilkins.

There are several problems with the belief of learning styles. First, there is a difference in the way someone prefers to learn and the way which leads to effective and efficient learning. Second, a preference of how a person likes to study is not a learning style. Thirdly, there is little support from objective studies that show the “assumption” that people cluster into distinct groups to classify them by learning styles. Lastly, the evidence for learning styles do not satisfy all the criteria for validity (Kirschner, 2017).

There is also no scientific basis for the belief that learners have a certain optimal learning styles, as we see with our class many of us are multimodal. People need to be aware of their personal learning style, and is there a reliable and valid way to determine that specific learning style? Learning and instructing first require determining the learning style and then instructing according to the learning style. This is an attempt to pigeon-hole learners (Kirschner, 2017).

There are also many assumptions in respects to learning styles. It assumes that learners know best how to deal with new technologies for learning. It assumes that learners adapt to learning based on preferred learning styles. Finally, it assumes that learners select and order learning contents as self-educators (Kirschner & Van Merriënboer, 2013).

Is what learners say they prefer good for them? The most productive way of learning may not be the learners preferred way. Some studies indicate that learner preference was uncorrelated or even negatively correlated to learning and learning outcomes. Learners who reported having a preferred instructional technique did not get instruction benefit from the experience. Learning outcomes are a tool used to measure learning, so if there is no benefit does preference matter (Kirschner & Van Merriënboer, 2013)?

It is also not possible to teach complex concepts with only one learning style. It is not feasible to teach nursing students to recognize heart sounds using visual methods or skin rashes for auditory learners. Utilizing only one type of learning style could harm the learner by not using all available resources to help the learning succeed (Newton, Philip, & Miah, 2017).

References

Kirschner, P. (2017). Stop propagating the learning styles myth. Computers & Education, 106, 166-171.

Kirschner, P., & Van Merriënboer, J. (2013). Do Learners Really Know Best? Urban Legends in Education. Educational Psychologist, 48(3), 169-183.

Newton, Philip M., & Miah, Mahallad. (2017). Evidence-Based Higher Education - Is the Learning Styles 'Myth' Important? Frontiers in Psychology, 8, 444.