Evidence-based practice: a critical appraisal by Liz Trinder, Shirley Reynolds

By Liz Trinder, Shirley Reynolds

Evidence-based perform is an idea whose time has come. Few suggestions may have accomplished the prestige of unchallengeable good judgment in this type of brief house of time, and throughout this type of extensive diversity task. As but there were few possibilities to take inventory and consider the facts for evidence-based perform, or the results of its adoption. How powerful or possible is it in drugs? Is it relatively assorted? What are the implications of now not basing perform on examine? Can evidence-based perform be utilized in non-clinical settings, the place practitioners needs to care for the complexity of multi-problem members, households and enterprises? this article introduces the major thought of Evidence-Based perform and debts for its emergence and speedy enlargement inside and past medication. It then is going directly to describe how evidence-based perform is being translated in key parts (medicine, nursing, psychological health and wellbeing schooling and social welfare) whereas severely appraising the strengths and weaknesses of evidence-based perform because it applies in various fields perform.

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During the late nineteenth to early twentieth centuries, general practice had gradually evolved into a form which we would recognise today, although the distinction between general practitioners and specialists was not formalised until the formation of the NHS in 1948. Before this, general practitioners often also held hospital posts and consultants often dabbled in general practice. The founders of the College aimed to improve standards in general practice and to raise its status. This was an uphill task, as medical schools were (and largely remain) attached to teaching hospitals, whose consultants dominated the medical curriculum, often speaking in disparaging terms of general practice and general practitioners.

1995). This body of research also has a subtext about the status and competence of general practice as compared to hospital medicine. For instance it is often assumed that the appropriateness of referrals to hospitals should be measured against standards set by hospital doctors. ’ (Reynolds et al. 1991); or a study of open access gastroscopy which starts by pointing out specialist unit concerns that the referral threshold might be lowered by open access (Hungin 1987). tw’ yields 41 865 references.

Fig. 1 The audit cycle. When combined with ideas from the business world such as quality assurance and management, audit seemed to offer a way forward to improve the quality of care in general practice (Irvine 1990). This was in keeping with the zeitgeist of the Thatcher era, in which business methodology, as well as the inherent virtues of the market, was supposed to be applicable to and beneficial for all human activities. 6). ’Quality in Practice’ bulletins were henceforth issued in the Journal of the Royal College ofGenerul Practitioners.

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