Evidence-Based Practice

Since the Evidence-Based Medicine Working Group introduced the process of evidence-based practice (EBP) into the literature in 1992, this model has drawn a considerable amount of attention from both the research and practice communities. Although EBP has been defined in a variety of ways, some of which are frankly misleading, there exists a fair consensus regarding the meaning of the term when we turn to the primary source documents in the field. One such definition is as follows:

Readers will note that this definition describes a process of inquiry, of laying out a method to obtain credible information that can be used to guide practice decisions. These definitions provide equal weight to the best available research evidence, clinical expertise, and client values and circumstances and require that judicious consideration be given to each of the decision elements, with no one being given more weight over another. It is mistaken to contend that EBP somehow consists of lists of treatments that meet some evidentiary standard. In fact, this process model of EBP does not rely upon or endorse any particular method of assessment or treatment. The five steps that make up the process of EBP as it applies to direct practice are as follows:

• 1.
  Convert the need for information into an answerable question.
• 2.
  Track down the best available evidence to answer that question.
• 3.
  Critically evaluate the validity, impact, and applicability of that evidence.
• 4.
  Integrate relevant evidence with our own clinical expertise and client values and circumstances.
• 5.
  Evaluate our expertise in conducting Steps 1 through 4 above, and evaluating how we might improve them in the future.

Each of these steps is described below.