Reflective practice provides a systematic way for nurses to ask questions about their practice that leads to better understanding and sense-making as they sift evidence for situated practice contexts . Research questions derive from practice; clinicians become partners with nurse educators in preparing nurses with the myriad skills critical for developing and cultivating knowledge guiding practice . Knowledge development is a key foundation for guiding the science underpinning evidence-informed nursing practice. By developing a growth mindset for continuous improvement of their practice, nurses engage in the ongoing search for evidence informed practice. Technical, objective knowledge development is more dominant than knowledge development for delivering holistic, person-centered care.
1.3. Excluded studies
Clinicians can evaluate their progress at each stage by asking whether their questions were answerable, by asking if good evidence was found quickly, by asking if evidence was effectively appraised, and by asking whether the integration of the appraisal with clinical expertise and the patient’s unique features left them with a rational, acceptable management strategy. To complete the cycle of practising evidence based medicine clinicians should evaluate their own performance. Only after these things have been considered can we then decide whether and how to incorporate the evidence into the care of a particular patient. One way to do this is to prepare a one page summary that includes information on the patient, the evidence, and the clinical bottom line organised as a critically appraised topic (CAT).12 CATmakers (for constructing, storing, and printing information on critically appraised topics, and for calculating likelihood ratios and numbers needed to treat) are becoming more widely available, as are websites where they can be stored or retrieved (see the NHS site described earlier). If the foregoing strategies for gaining rapid access to evidence based medicine fail clinicians can resort to the time honoured and increasingly user friendly systems for accessing the current literature via Medline and Embase, employing methodological quality filters to maximise the yield of high quality evidence. This paper focuses on what evidence based medicine is and how it can be practised by busy clinicians.
In addition, we aimed to assess the impact of evidence‐informed practice and/or evidence‐based practice educational programs on patient outcomes. Our review reveals extensive research work conducted on the effectiveness of evidence‐based practice educational interventions (see the Summary of findings table). We anticipated that the content, manner of delivery, and length of the educational program may differ in eligible studies as there is no standard evidence‐informed practice/evidence‐based practice educational program.
While there are challenges to implementing research-informed practice, these can be overcome through strategies such as providing training and support, improving access to research evidence, and encouraging a culture of research-informed practice. Research-informed practice is a critical component of effective social work, particularly when working with vulnerable populations such as children and families. This involves critically appraising the research studies to determine their validity, reliability, and relevance to the practice question or issue. This involves searching for research studies that are relevant to the practice question or issue.
Walking the talk: Reflective practice in developing an inclusive and balanced professional learning curriculum
Relatively simple prompting and reminder systems can improve clinicians’ performance11; the price of useful databases such as Best Evidence (which comprises Evidence-Based Medicine and the American College of Physicians Journal Club on CD ROM) and The Cochrane Library is little more than the cost of subscribing to a journal. Many health professionals already feel overburdened, and therefore a radical change in approach is required so that they can manage change rather than feel like its victims. This is the first in a series of eight articles analysing the gap between research and practice
5. Agreements and disagreements with other studies or reviews
Practitioners reported that they rely primarily on clinical experiences to inform treatment decisions, although they often consult EST literature. This informed continuing discussions by the Council for Higher Education in Art & Design (CHEAD) and the AHRC resulting in an evolved notion of practice as research in art, design and architecture, media, and creative writing. The UK’s Arts and Humanities Research Council had a steering committee devoted to practice-led research and its report was completed in September 2007, titled AHRC Research Review in Practice-Led Research in Art, Design and Architecture. Rather than seeing the relationship between practice and theory as a dichotomy, as has sometimes traditionally been the case, there is a growing body of practice research National Academies report on mental health academics across a number of disciplines who use practice as part of their research. The notes below the graph explain how the data was collected and which school districts were involved in the study. To make sense of them, take it slow and read through the notes and descriptions carefully.
- Technical, objective knowledge development is more dominant than knowledge development for delivering holistic, person-centered care.
- A total of 45 full‐text articles on evidence‐based practice educational interventions and one full‐text article on evidence‐informed practice educational intervention were screened for their eligibility for inclusion.
- Fundamental to the transfer of evidence into policy and practice is diffusion, the process by which an innovation is communicated over time among members of a social system (classical diffusion) .
- Moreover, the outcome criteria (e.g., knowledge, skills, attitudes, practices, and health outcomes) were described narratively as improved or not, with the use of vote counting.
- The characterizations of the processes involved in implementing evidence‐informed practice and evidence‐based practice given in this systematic review offer intervention designs based on existing empirical and theoretical literature, which could be considered in the design of evidence‐informed practice and evidence‐based practice educational interventions.
Contextual relevance is particularly important in studies of the organisation and delivery of services,27 such as stroke units, hospital at home schemes, and schemes for improving hospital discharge procedures to reduce readmissions among elderly patients. The choice of key players—those people in the organisation who will have to implement change or who can influence change—will depend on the processes to be changed; in primary care, for example, nurses and administrative staff should be involved in many cases, in addition to general practitioners, since their cooperation will be essential for organisational change to be effective. Although different people can promote the uptake of research findings—including policymakers, commissioning authorities, educators, and provider managers—it is largely clinicians and their patients who will implement findings. However, in health care the challenge is to promote the uptake of innovations that have been shown to be effective, to delay the spread of those that have not yet been shown to be effective, and to prevent the uptake of ineffective innovations.24 Furthermore, health professionals have their own experiences, beliefs, and perceptions about appropriate practice; attempts to change practice which ignore these factors are unlikely to succeed.