# Effectiveness of an online training course to improve evidence-based leadership practices among unit leaders: study protocol for a cluster randomised two-arm controlled trial (EVILEAD)

## TL;DR

This study will test if an online course helps nurse leaders use evidence-based practices, improving their skills, team outcomes, and hospital care quality.

## Contribution

This is the first cluster randomized trial to evaluate an online course for improving evidence-based leadership among nurse leaders.

## Key findings

- The study will assess the impact of the online course on evidence-based practice and related outcomes.
- Feasibility data will be analyzed separately to evaluate the study's implementation.
- The trial is registered on ClinicalTrials.gov with the identifier NCT06886581.

## Abstract

A substantial knowledge base exists on how nurse leaders can support clinical staff in implementing evidence-based knowledge into practice. However, fewer studies are available on how leaders themselves learn and use evidence in their daily work. This study aims to evaluate the effectiveness of an online training course designed to improve the skills of unit leaders by enhancing individual outcomes through evidence-based practice (EBP), team-based outcomes through EBP implementation, and organisational outcomes through the quality of care.

The effectiveness of the online training course will be evaluated using a cluster randomised two-arm controlled trial. Participants will be unit leaders recruited from hospitals in the Helsinki and Uusimaa Hospital District in Finland. At least 12 units will be represented, with approximately 25 participants in each unit (6 units in each arm). The sample for analysis will consist of at least 300 staff members. In the intervention arm, participants will be invited to join the online leadership course, while participants in the control group will continue practice as usual. The primary outcome is evidence-based practice, while the secondary outcomes are self-esteem, self-efficacy, implementation of EBP, quality of care, as well as work absence and intention to leave. The effectiveness of the intervention on the primary and secondary outcomes will be assessed based on the intention-to-treat principle. Feasibility data will be analysed separately. Sample size calculations are based on preliminary power analyses.

To the best of our knowledge, this is the first study to evaluate the effectiveness of an online course on evidence-based knowledge using a full cluster randomised study. By applying evidence-based practices, unit leaders can ensure that clinical decisions are grounded in the latest study results, which will lead to more effective decision-making.

Trial registration

ClinicalTrials.gov, NCT06886581. Registered on 14 March 2025, https://clinicaltrials.gov/study/NCT06886581

The online version contains supplementary material available at 10.1186/s13063-025-09207-9.