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Evidence Based Practice: 5 A's

What is Evidence-based practice?

"The integration of the best research evidence with our clinical expertise and our patient's unique values and circumstances" (Albarqouni et al, 2018)

The Purpose of Evidence based practice

Evidence based practice provides a structured guide to: 

  1. Assist the practitioner with a method to stay current with relevant medical treatment trends despite an overwhelming influx of research. 
  2. Inform the practitioner with the best available evidence to guide practice. 
  3. Promote an attitude of inquiry. 
  4. Substantiate clinical decision making in combination with clinical experience.
  5. Ensure the incorporation of patient values and circumstances. 

 

Three elements of Evidence Based practice are evidence, clinical experience and patient values

Image source: https://www.library.ucdavis.edu/guide/ebp-resources/

The 5 A's of Evidence based practice

ASK: 

  1. Identify knowledge gaps
  2. Differentiate between background & foreground questions (General vs. clinically specific)
  3. Develop an answerable & searchable question structured with the PICO format
  4. Determine PICO question domain (therapy/treatment, prevention, diagnosis, prognosis, etiology, meaning)

ACQUIRE:

  1. Understand the levels of evidence provided from various types of research.
  2. Differentiate between the sources of information (primary research/unfiltered vs. pre-appraised/filtered).
  3. Understand the difference between databases and how to navigate databases in the search for evidence. 
  4. Develop search strategies utilizing search terms/key words/controlled vocabularies, Boolean operators and search limiters. 

APPRAISE: 

  1. Understand the anatomy of a scientific paper and identify the key components
  2. Critically appraise the validity, reliability & value of the evidence in relation to the clinical question (CASP)
  3. Apply the Critically Appraised Tools (CAT)

APPLY: 

  1. Synthesize the best available evidence with all elements of EBP 

ASSESS: 

  1. Self-evaluation of the EBP process.