Evaluating Evidence-Based Practice

Evidence-based practice (EBP) has emerged as a paradigm of clinical practice to improve healthcare quality by shifting emphasis from unsystematic clinical experience and pathophysiologic rationale to critical examination of scientific evidence from empirical patient-relevant clinical research. EBP provides a framework for “the integration of the best research evidence with patients’ values and clinical expertise and circumstances in clinical decision making.”4 Authors working in EBP now prefer the term evidence-based practice over evidence-based medicine to “reflect wider adoption of these concepts among other healthcare disciplines and the benefits of entire healthcare teams and organizations adopting a shared evidence-based approach.”5 Competency-based medical education (CBME) is an outcomes-based framework for design, implementation, assessment, and evaluation of clinical training programs (see Chapter 1). Core competencies have been defined as the essential minimal set of a combination of attributes, such as applied knowledge, skills, and attitudes, that enable clinicians to perform a set of tasks to an appropriate standard efficiently and effectively. A consensus-based, contemporary set of 86 core competencies in EBP have been identified that should inform the development of entry-level EBP teaching by faculty, curricular programs for learners, and programmatic assessment. In this chapter we review the assessment and psychometric properties of instruments and strategies to evaluate these core competencies and steps of EBP and offer recommendations for current educational practice, assessment, and future research..