Evidence-Based Practice Essay

Ebm

Evidence-based practice is a fairly recent paradigm in medicine that places emphasis on applying new skills for healthcare workers such as nurses and physicians that include performing efficient literature searches and applying formal rules of evidence in examining the clinical literature in order to find the best answer to a problem (Evidence-Based Medicine Working Group, 1992). These skills are in addition to traditional clinical skills and understanding patients' emotional needs. The evidence-based practice represented a shift from old processes used by health care workers such as intuition, unsystematic clinical experience, and pathophysiologic rationale in applying diagnoses or treatments to consumers of healthcare services (Evidence-Based Medicine Working Group, 1992).

This particular paradigm shifts in medicine developed due to the increasing use of randomized controlled trials (RCTs) in medicine which were rare up until 1960s and 1970s. RCTs became standard practice for the development of treatments such as medications (Hoffmann, Bennett, & Del Mar, 2010). If we compare the methods used to diagnosis and treat clinical conditions prior to the evidence-based methods we see that practitioners that the previous approach was characterized by: (1) using unsystematic clinical observations to build knowledge, (2) believing that understanding the basic pathology of disease is a guide for practice, (3) medical training and common sense were believed to allow one to evaluate the efficacy of medical treatments, (4) clinical experience and content expertise were considered sufficient to generate valid guidelines for clinical practice, and (5) a reliance on authority and expert opinions (Evidence-Based Medicine Working Group, 1992). These techniques are certainly helpful, but evidence-based practice adds: (1) the understanding of the value of clinical experience, but experiences and observations should be recorded systematically and evaluated for biases and be replicable in other settings; (2) studying pathophysiology and disease are necessary but not sufficient to guides and predictions made without empirical evidence and understanding the rules of evidence is required to…