Skip to Main Content

NURS 4610: Translating Evidence for Nursing Practice

This LibGuide is designed to assist students in the online RN-to-BSN program with EBP-related competencies in NURS 4610.

Levels of Evidence

What are Levels of Evidence? 

  • In evidence-based practice, individual research studies are ranked and assigned levels of evidence based on their methodological rigor and strength
  • Study designs with the least potential risk for bias are at the top of the evidence hierarchy
  • Study designs with greater risk for bias are ranked lower
  • There are several variations of evidence hierarchy models. In most of these hierarchies, systematic reviews of randomized controlled trials are ranked highest, with expert opinion ranked lowest. 
  • Evidence levels are primarily an indicator of potential risk for bias being present in the study results, with the least risk for bias at the top and higher risk for bias at the bottom


Guyatt G. Rennie D. Meade M. Cook D. & American Medical Association. (2015). Users' guides to the medical literature: A manual for evidence-based clinical practice (3rd ed.). McGraw-Hill Education.

Levels of Evidence in Your Textbook (Schmidt & Brown, 2022)

Levels of evidence may vary slightly depending on which nursing research/EBP textbook you are using in your nursing program. 

The RN-to-BSN program utilizes the following text by Schmidt & Brown (2022) in the NURS 4610 course. A print copy is on reserve in the Mulford Library for student use. A few copies are also available to request and borrow from OhioLINK

See pp. 14-24 for a thorough explanation of the evidence hierarchy and levels, including corresponding study designs.