What is evidence-based practice? |
The meaning of evidence-based practice (EBP) has evolved over time, in response to legitimate criticisms. Contemporary EBP is best understood as a client-centred, question-in-context driven process of information seeking, collaboration, and critical reasoning to facilitate defensible healthcare decisions (Dawes et al., 2005; Hoffmann, Bennett, & Del Mar, 2017; Murphy, Guisard, Curtin, Biles, Thomas, & Parnell, 2019; Sackett, Rosenberg, Gray, Haynes, & Richardson, 1996). ‘Evidence’ can be thought of as any information that increases confidence in a particular answer to a question. In healthcare, practitioners ask various types of questions. In EBP, evidence is not just information about intervention effectiveness. Different kinds of information can be relevant, depending on the kind of question being asked. Context is a central consideration in high-quality EBP. Decisions should always be made cognisant of the resourcing constraints that apply and the socio-cultural and geographical context. Regardless of the nature of the question or the context, EBP is a conscientiously considered, systematic process involving five steps: asking, acquiring, appraising, applying, and analysing.
EBP and mastery development
Done well, EBP supports clinical reasoning and development of clinical mastery within a practitioner’s scope of practice. Early in their professional development, students and practitioners will need, and should be expected, to ask lots of questions and work through EBP processes in order to build their clinical practice knowledge, understandings and capabilities. As mastery develops, much of this underpinning knowledge, understanding and capability becomes ‘second nature’ and more automatically applied, and variants from typical presentations and care contexts will more likely trigger EBP processes. At more advanced stages of mastery, EBP processes may be used to stay abreast of new developments and emerging knowledge in the practitioner’s field, to challenge assumptions, and to fine-tune clinical reasoning, as well as to determine how best to respond to variants from typical presentations and care contexts. Thus, EBP is relevant at every stage in the journey of clinical mastery. The guidance provided in this framework is intended to assist students to develop an EBP habit that will serve them well throughout that whole journey.
EBP and mastery development
Done well, EBP supports clinical reasoning and development of clinical mastery within a practitioner’s scope of practice. Early in their professional development, students and practitioners will need, and should be expected, to ask lots of questions and work through EBP processes in order to build their clinical practice knowledge, understandings and capabilities. As mastery develops, much of this underpinning knowledge, understanding and capability becomes ‘second nature’ and more automatically applied, and variants from typical presentations and care contexts will more likely trigger EBP processes. At more advanced stages of mastery, EBP processes may be used to stay abreast of new developments and emerging knowledge in the practitioner’s field, to challenge assumptions, and to fine-tune clinical reasoning, as well as to determine how best to respond to variants from typical presentations and care contexts. Thus, EBP is relevant at every stage in the journey of clinical mastery. The guidance provided in this framework is intended to assist students to develop an EBP habit that will serve them well throughout that whole journey.