1. Asking

Encourage students to acknowledge uncertainty and ask practice-relevant questions

EBP starts with ‘asking’ questions in situations where there is uncertainty about how best to proceed. Such situations are opportunities – indeed imperatives – for EBP. Questions suggesting a poor grasp of basic facts (for example, definitions) are not EBP questions; students sometimes simply need to strengthen their understanding of foundational concepts. Questions based on curiosity alone are also not EBP questions, but may be a starting point. EBP questions are questions asked so that practitioners and clients can make healthcare decisions that are well founded on relevant information. EBP depends on practitioners raising questions, and also encouraging their colleagues and clients to ask questions, to ensure healthcare decisions are well informed. For example, a client has the right to be informed about their healthcare options (e.g., the pros and cons of a diagnostic test, or the odds of recovery with versus without a certain treatment) and factors affecting their prognosis. To enable efficient information gathering (in the second step of ‘acquiring’), practitioners must be proficient in formulating questions that target the precise information needed. In summary, EBP begins with asking questions that are relevant to decisions that need to be made in relation to specific clinical scenarios. EBP flourishes when a questioning approach to practice is encouraged.

Prompts for facilitating 'Asking'

• What is it you are unsure about in this situation?
• Does this uncertainty affect your (client’s) decision-making? Why?
• Is it possible that helpful information exists?
• What precisely do you need to find out to make the best decision?
• What is the specific question you need to answer?
  

Prompts for assessing 'Asking'

• What situations of uncertainty have you encountered?
• What specific EBP questions have you asked?
• Take one example: Why did you need to answer that EBP question? How was it important for your decision making?
  

General tips & strategies for 'Asking'

• Most EBP questions refer to a relevant health condition, desired outcome, and population group. There may or may not be a particular intervention or diagnostic test of interest. For example, the question may instead be about whether any intervention is effective in particular circumstances, or the challenges and concerns experienced by people living with a particular condition, or the likely progression of an illness without intervention, or the cultural beliefs and expectations of a person.
• If answering a question will not affect decision-making, it is not an EBP question in that context.
• During busy periods, EBP questions can be easily forgotten and never followed up. A log of questions can be kept for later follow-up.
• Questions can be collated by clinical teams, for follow-up during quieter periods or as suggestions for student presentations.