Beginning with the patient and/or clinical scenario:
–Ask: Carefully define your clinical question(s).
–Acquire: Search for and assemble the research evidence that best addresses your question(s).
–Appraise: Evaluate and assess the credibility and applicability of the evidence.
–Apply: Integrate the research findings with your clinical experience and the patient’s values and preferences.
–Assess: Track patient outcomes, and also the effectiveness/efficiency of the EIP process as a clinical tool.
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The article linked above uses a musical analogy to discuss the importance of keeping the components of evidence-informed practice (EIP) in balance. As you read the article... What questions arise for you? Be prepared to discuss them in class.
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Based on image by R Evans, Northwestern Health Sciences University; in turn based on Shaughnessy, AF et al. (1998) Clinical jazz: harmonizing clinical experience and evidence-based medicine. J of Fam Prac; 47(6):425-428. |
Since the mid 90s, Evidence Based Medicine (EBM) has been at the center of medical education and practice.
In the ND program, we use the term Evidence Informed Practice, (EIP) as this language better reflects the focus of the ND approach.
So, what is - and isn't - EBM/EIP? The oft-cited work by David Sacket describes what the EBM approach is, and acknowledges the limitations. It's a short article and a good one to know as it set the foundation for medical education.
Sackett, D. L., Rosenberg, W. M., Gray, J. A., Haynes, R. B., & Richardson, W. S. (1996). Evidence based medicine: what it is and what it isn't. BMJ (Clinical research ed.), 312(7023), 71–72. https://doi.org/10.1136/bmj.312.7023.716
And what has developed in EBM since 1996? If you're interested in how the field has developed in the last 20 years, this review brings you quickly up to speed on the criticisms/responses, and development of the EBM approach. It also teases what is still to come in the next 25 years - read on to see the state of the field as you embark on your education, and what the field may develop into through the course of your careers:
Djulbegovic, B., & Guyatt, G. H. (2017). Progress in evidence-based medicine: A quarter century on. The Lancet, 390(10092), 415-423. doi:http://dx.doi.org.buproxy.bastyr.edu:2048/10.1016/S0140-6736(16)31592-
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