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Evidence-Based Practice: Intro

Introduction

Healthcare providers of today and tomorrow must understand and apply the concepts of Evidence-Based Practice (EBP)/Evidence-Based Medicine (EBM) to cope with the current state of healtcare. The basic concept of EBP is simple -- use the best available information to take care of patients. Yet, mastery of all the skills necessary to practice EBP is difficult.

Keck School of Medicine - EBP Video Catalog

Pre-recorded expanded and comprehensive lectures on EBP topics and corresponding presentation on medical library resources. These lectures are a part of the Year II Medical Student Evidence-Based Medicine Curriculum

EBP Tutorials

Introduction to Evidence Based Medicine from Duke and University of North Carolina

Evidence-Based Practice: Improving Patient Care from University of California, Irvine, Grunigen Library

Evidence-Based Medicine Tutorials from University of Massachusetts Medical School, Lamar Soutter Library

Definition and Steps of the EBP process

Whether you call it EBP (Practice), EBM (Medicine) or something else (e.g., EBN for Nursing, EBHC for Health Care), the principles are the same. Depending on your field of healthcare, the specific steps below might be slightly different. For this Library Guide we will use EBP to mean all of the above.

DEFINITIONS vary:

EBP is "the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence based medicine means integrating individual clinical expertise with the best available external evidence from systematic research."

--Sackett, D.L., Rosenberg, W.C., and Gray, J.A.M. (1996). Evidence based medicine: what it is and what it isn't. BMJ, 312, 71-72.

Evidence-based medicine is the use of mathematical estimates of the risk of benefit and harm, derived from high-quality research on population samples, to inform clinical decision making in the diagnosis, investigation or management of individual patients.

--Greenhalgh, T. (2006). How to read a paper: the basics of evidence-based medicine (3rd ed.). Malden, MA: Blackwell, pp. 12.

 “EBM encourages a healthy skepticism of every practice in medicine and promotes a culture of inquiry.”  

--Sloane, P.D., Slatt, L.M., Ebell, M.H., Jacques, L.B., Smith, M.A. (2008). Essentials of family medicine (5th ed.). Philadelphia: Wolters, pp. 40.

Next...Step 1: Asking a searchable question.

Steps of EBP

STEPS OF Evidence-Based Practice

  1. ASK. Create a focused, searchable clinical question.
  2. ACQUIRE or ACCESS. Search for the information.
  3. APPRAISE your results critically.
  4. APPLY results to your patient.
  5. ASSESS. Evaluate the effects of Step 4, reformulate and repeat process if necessary. Also look at your process and correct/improve as necessary.
  6. Design research, based on gaps identified in healthcare evidence.