This book challenges the evidence-based practice movement to re-think its assumptions. Firmly rooted in real practice while drawing lucidly on a great breadth of theoretical frameworks, it examines ...afresh how clinicians use knowledge.
Evidence-based practice has recently become a key part of the training of all health professionals. Yet despite its ‘gold-standard’ status, it is faltering because too much effort has gone into insisting on an idealised model of how clinicians ought to use the best evidence, while not enough has been done to understand why they so often don’t.
Practice-based Evidence for Healthcare is a groundbreaking attempt to redress that imbalance. Examining how clinicians actually develop and use clinical knowledge day-to-day, the authors conclude that they use ‘mindlines’– internalised, collectively reinforced, tacit guidelines. Mindlines embody the composite and flexible knowledge that clinicians need in practice. They are built up during training and continually updated from a wide range of formal and informal sources. Before new evidence becomes part of practitioners’ mindlines, it is transformed by their interactions with colleagues and patients via their communities of practice and networks of trusted colleagues.
To explore how mindlines work Gabbay and le May draw on a wide range of disciplines to analyse their detailed observations of clinical practice in the UK and the US. Their conclusions and provocative recommendations will be of value to all practitioners, health service managers, policymakers, researchers, educators and students involved in the promotion of evidence-based practice.
1. Introduction: evidence in practice; 2. From formal knowledge guided complexity; 3.Clinical thinking and knowledge in practice; 4. Growing mindlines: laying the foundations; 5. Growing mindlines: cultivating contextual adroitness; 6. The place of storytelling in knowledge sharing; 7. A community of clinical practice?; 8. Co-constructing collective mindlines; 9. Co-constructing clinical reality; 10; Conclusions and implications
John Gabbay is Emeritus Professor at the Wessex Institute for Health Research and Development, University of Southampton, UK.
Andrée le May is Professor of Nursing at the University of Southampton, UK.
'This book is one of the most important publications about clinical practice in general and evidence based medicine in particular to appear in the last 20 years. Those who consider themselves to be working at the ‘cutting edge’ in these fields should make time to read it.' - Trisha Greenhalgh, University College London, UK
'This amazing book, which will revolutionize the way we think about clinical practice as well as the way we teach practitioners, should push the whole field forward by a quantum leap. Practice-based Evidence will come as a big relief to thinking practitioners who have felt oppressed by the evidence-based practice movement, and should be on the 'must read' list for anyone involved with meeting continuing competency requirements in both nursing and medicine.' - Lesley Degner, University of Manitoba, Canada
'This is a fascinating analysis that rings true with my own clinical experience. It will doubtless be eagerly devoured by those who study clinical decision-making but anyone concerned with clinical practice and policy, however busy, will gain by reading it. This valuable book addresses issues that are of crucial importance and from which we all need to learn.' - Joel Howell, University of Michigan, USA
'The actors who speak at the beginning of each chapter remind me of people I have met and worked with all through my career; they describe my behaviours at various stages of my life as a clinician. So, I felt very comfortable reading this book, which is filled with wisdom distilled from many disciplines and raises major issues about professional development. It will have a significant and lasting impact on how I view a number of concepts. Very few books have such a powerful influence.' - John Balla , Centre for Evidence Based Medicine, University of Oxford, UK and University of Melbourne, Australia
'This important book makes a major contribution to our understanding about the everyday problems of making sense of clinical knowledge in practice. Grounded in real world research that gives a unique insight into the real world of health professionals, John Gabbay and Andrée le May will not only inform the implementation of evidence-based practice, but also help to shape future studies of this key problem of contemporary health care, which has never been more politically contentious' - Carl May, Newcastle University, UK
Literature reviews are undertaken by students, researchers, clinicians and educationalists - that is, almost all nurses.
Despite much excellent work, exploring the assumptions and practices that ...constitute searching for and reviewing literature has merit, and prompting those who undertake these activities to think critically about what it is that they are doing should be encouraged. Widely adopted approaches to structuring reviews (the "standard model") can detrimentally limit the scope or range of literature that is accessed and appraised. It is further proposed that a lack of professional ambition or confidence invests aspects of the way some nurses engage with the sources that are available to them. Across the book, parochialism is challenged. The crucial roles that values and judgement play in reviews are highlighted. It is argued that humanities and arts texts deserve, potentially, a bigger or more assured place in reviews undertaken by nurses. Difficulties in appraising quantitative and qualitative research reports are identified, and benefits linked with taking a contemplative line through the review process are considered.
This book contributes to debates around evidence-based practice and literature reviews more generally. It will appeal to anyone with an interest in professional issues, research, and the philosophy and sociology of nursing.
"Identifying Perinatal Depression and Anxiety brings together the very latest research and clinical practice on this topic from around the world in one valuable resource. Examines current screening ...and management models, particularly those in Australia, England and Wales, Scotland, and the United States. Discusses the evidence, accuracy, and limitations of screening methods in the context of challenges, policy issues, and questions that require further research. Up to date practical guidance of how to screen, assess, diagnose and manage is provided. Considers the importance of screening processes that involve infants and fathers, additional training for health professionals, pathways to care following screening, and the economics of screening. Offers forward-thinking synthesis and analysis of the current state of the field by leading international experts, with the goal of sketching out areas in need of future research"--Provided by publisher.
This paper examines the unregulated approach to video evidence in U.S. courts. It provides an overview of three key factors that contribute to the inconsistent treatment of video as evidence: the ...shifting and uncertain categories under which video is admitted as evidence, the discrepancies in how video is perceived and interpreted, and the lack of widespread legal training in visual literacy. Together, these factors exacerbate the challenges that visual perception and interpretation pose in court, as illustrated by the analysis of the varied use of video by district and appellate courts at summary judgment in McDowell v. Sherrer, a case involving an Eight Amendment excessive force claim. By discussing these challenges, the paper argues for the necessity of archival legal standards, which could facilitate research into uniform guidance and applications for treating video as evidence. Otherwise, civil rights and human rights may be disparately recognized and upheld.
Evidence-Based Clinical Supervisioncritiques and summarises the best available psychological evidence relating to clinical supervision, clarifying the key principles, setting out the related practice ...guidelines and specifying the research and practice implications.A best-practice guide to clinical supervision, an approach used across psychotherapy and health services where professionals meet regularly with each other to discuss casework and training issues Summarises the best available clinical evidence relating to clinical supervision, and relates this information to key principles with a strong applied focus, drawing out practice guidelines and implications Aims to motivate health professionals to practice supervision with greater enthusiasm and proficiency Represents the culmination of two years' intensive research on supervision and twenty years of involvement in supporting and developing supervisors
Developing and Delivering Practice-based Evidencepromotes a range of methodological approaches to complement traditional evidence-based practice in the field of psychological therapies. Represents ...the first UK text to offer a coherent and programmatic approach to expand traditional trials methodology in the field of psychological therapies by utilizing evidence gained by practitioners Includes contributions from UK and US scientist-practitioners who are leaders in their fieldFeatures content appropriate for practitioners working alone, in groups, and for psychological therapy services
Systematic reviews have been considered as the pillar on which evidence-based healthcare rests. Systematic review methodology has evolved and been modified over the years to accommodate the range of ...questions that may arise in the health and medical sciences. This paper explores a concept still rarely considered by novice authors and in the literature: determining the type of systematic review to undertake based on a research question or priority.
Within the framework of the evidence-based healthcare paradigm, defining the question and type of systematic review to conduct is a pivotal first step that will guide the rest of the process and has the potential to impact on other aspects of the evidence-based healthcare cycle (evidence generation, transfer and implementation). It is something that novice reviewers (and others not familiar with the range of review types available) need to take account of but frequently overlook. Our aim is to provide a typology of review types and describe key elements that need to be addressed during question development for each type.
In this paper a typology is proposed of various systematic review methodologies. The review types are defined and situated with regard to establishing corresponding questions and inclusion criteria. The ultimate objective is to provide clarified guidance for both novice and experienced reviewers and a unified typology with respect to review types.
Evidence-based psychotherapies have been shown to be efficacious and cost-effective for a wide range of psychiatric conditions. Psychiatric disorders are prevalent worldwide and associated with high ...rates of disease burden, as well as elevated rates of co-occurrence with medical disorders, which has led to an increased focus on the need for evidence-based psychotherapies. This chapter focuses on the current state of evidence-based psychotherapy. The strengths and challenges of evidence-based psychotherapy are discussed, as well as misperceptions regarding the approach that may discourage and limit its use. In addition, we review various factors associated with the optimal implementation and application of evidence-based psychotherapies. Lastly, suggestions are provided on ways to advance the evidence-based psychotherapy movement to become truly integrated into practice.
Context: This article describes the historical context and current developments in evidence-based practice (EBP) for medicine, nursing, psychology, social work, and public health, as well as the ...evolution of the seminal "three circles" model of evidence-based medicine, highlighting changes in EBP content, processes, and philosophies across disciplines. Methods: The core issues and challenges in EBP are identified by comparing and contrasting EBP models across various health disciplines. Then a unified, transdisciplinary EBP model is presented, drawing on the strengths and compensating for the weaknesses of each discipline. Findings: Common challenges across disciplines include (1) how "evidence" should be defined and comparatively weighted; (2) how and when the patient's and/or other contextual factors should enter the clinical decision-making process; (3) the definition and role of the "expert"; and (4) what other variables should be considered when selecting an evidence-based practice, such as age, social class, community resources, and local expertise. Conclusions: A unified, transdisciplinary EBP model would address historical shortcomings by redefining the contents of each model circle, clarifying the practitioner's expertise and competencies, emphasizing shared decision making, and adding both environmental and organizational contexts. Implications for academia, practice, and policy also are discussed.
Law on Display Feigenson, Neal; Spiesel, Christina
10/2009, Letnik:
3
eBook
Experience the multimedia and view the links featured in the book at lawondisplay.comVisual and multimedia digital technologies are transforming the practice of law: how lawyers construct and argue ...their cases, present evidence to juries, and communicate with each other. They are also changing how law is disseminated throughout and used by the general public. What are these technologies, how are they used and perceived in the courtroom and in wider culture, and how do they affect legal decision making?In this comprehensive survey and analysis of how new visual technologies are transforming both the practice and culture of American law, Neal Feigenson and Christina Spiesel explain how, when, and why legal practice moved from a largely words-only environment to one more dependent on and driven by images, and how rapidly developing technologies have further accelerated this change. They discuss older visual technologies, such as videotape evidence, and then current and future uses of visual and multimedia digital technologies, including trial presentation software and interactive multimedia. They also describe how law itself is going online, in the form of virtual courts, cyberjuries, and more, and explore the implications of law's movement to computer screens. Throughout Law on Display, the authors illustrate their analysis with examples from a wide range of actual trials.
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