Evidence for development
Charlotte L. Clarke and John Unsworth
In this chapter we propose to explore the issues around the identification of evidence to support the development of practice. It is not our aim to rehearse the arguments around evidence-based practice, as this has been more than adequately covered in other texts (see for example Muir Gray 1997). Rather, we intend to explore the relationship between sources of knowledge for practitioners and the type of evidence available to the practitioner who intends to develop their practice. Much of the literature exploring evidence-based practice has contrived to make it synonymous with not only 'research-based practice', but research based upon the 'gold standard' randomized controlied trial (RCT). This has resulted in practitioners being bombarded with workshops and courses to equip them with critical appraisal skills and the exhortation from policymakers to enhance research capacity within health organizations. However, it needs to be questioned as to whether all these edicts address the important issues for practitioners wishing to improve patient care. Within this chapter, we will also discuss the sources and types of knowledge practitioners may draw upon to develop their practice.
The move towards evidence-based practice is undeniably long overdue. However the issue central to the debate for practitioners is not just how to critique this evidence, but where the evidence comes from, and then how it might be relevant within the context of their own practice.