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Evidence-Based Practice: Understanding Evidence

What is Evidence-Based Practice (EBP)?

Evidence-based practice (EBP) was first defined as "...the integration of best research evidence with clinical expertise and patient values". Sackett, David L. BMJ 1996;312:71-72
Most recent definition -"integrating the best available research evidence with clinical expertise and the patient's unique values and circumstances" (Straus, Glasziou, Richardson, & Haynes, 2011).


Image taken from : Curtin Universi‚Äčty Evidence Based Health Sciences page

Evidence-Based Practice vs Evidence-Informed Practice

Evidence-Informed Practice is a term that might sometimes be used, especially in nursing research.   According to Woodbury and Kuhnke (2014), this term is used instead of, or as well as, evidence-based practice. They suggest that the term seems to give more flexibility regarding the nature of evidence and its use, “i.e., it implies that many different levels of evidence and types of evidence are needed and used to support decisions in clinical practice.” (p. 29)

They also suggest that the terminology is less significant than the approach. “At the level of individual patients/ clients, it is important that clinicians know the unique values, preferences and circumstances of their clients in addition to the scientific evidence that supports and informs their practice”. (p. 29)

Hoffmann, T., Bennett, S., & Del Mar, C. (2017). Evidence-based practice across the health professions (3rd ed.). Elsevier Australia.

Straus, S. E., Glasziou, P., Richardson, W. S., & Haynes, R. B. (2011). Evidence-based medicine: How to practice and teach it (4th ed.). Churchill Livingstone Elsevier.

Woodbury, M. G., & Kuhnke, J. L. (2014). Evidence-based practice vs. Evidence-Informed Practice: What's the difference? Wound Care Canada12(1), 26-29.



The EBP Cycle

Finding the best evidence requires a systematic cycle of process


Taken from:
Duke University Medical Center Library, & Health Sciences Library. UNC-Chapel Hill.  Retrieved from:

The five 'A's of the evidence: 

Ask:  Clinical question development - construct a well-built clinical question derived from the patient dilemma

Acquire: Searching for the evidence - select the appropriate resources and conduct a search in order to acquire the evidence

Appraise:  Critical appraisal of the evidence - the validity and applicability of the evidence

Apply:  Applying evidence to patient within context - Integrate evidence with clinical expertise and patient preferences and apply to practice

Act :  Evaluate the performance and success of the change in practice.  Ask new questions


Why EBP?

·     Health and medicine is dynamic and changing

·     Accessing quality health information at any one time is an enormous task

·     Evidence-based practice means using the best, research-proven assessments & treatments in day-to-day client care & service delivery

·     Health professionals have a responsibility to stay in touch with the research literature & to implement best practice as a part of clinical decision-making     

·     Implementing EBP means a real commitment to lifelong learning

Viva La Evidence