Abstract

Background Evidence-Based Practice (EBP) is essential for healthcare quality, yet a gap between research and clinical application persists. University education plays a central role in developing EBP competence among nursing students and helping to bridge this gap. However, comparative evidence on how these competencies vary across institutions with different curricular and regulatory contexts remains limited. Aims To determine overall EBP competence and its dimensions —knowledge, skills, and attitudes— among nursing students at three public universities in Spain and Chile, examining differences across institutional contexts. Methods A multicentre cross-sectional study was conducted during the 2024/2025 academic year at the Universidad de Alicante (Spain), Universitat Jaume I (Spain), and the Universidad de Valparaíso (Chile). EBP competence was assessed using the validated EBP-COQ questionnaire via the REDCap platform. Statistical analysis included bivariate inferential tests and multiple linear regression analysis. Results Of 1,788 eligible students, 1,035 were included in the final analysis (response rate: 57.9%). The mean overall score for EBP competence was 3.75 ± 0.43. The attitude dimension showed the highest mean score among the dimensions, followed by skills and knowledge. EBP competence increased significantly across academic years (p < 0.001). In multivariable analysis, academic year, university, clinical work experience, and academic engagement were independently associated with higher EBP competence, whereas age, previous health sciences education, and prior EBP training were not significant predictors. Conclusion Undergraduate nursing students showed moderate overall EBP competence, with methodological knowledge and skills representing the most challenging components. Higher scores observed among students in later academic years and those reporting greater academic engagement, together with differences between universities contexts highlight the potential relevance of sustained curricular exposure and active learning. Nursing curricula should therefore integrate EBP progressively across academic years and provide repeated, active, and clinically applied training in evidence searching, critical appraisal, interpretation of research findings, and evidence-informed decision-making. Longitudinal research is needed to evaluate how these competencies evolve and which educational approaches are most effective.