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Evidence Based Medicine

The most commonly used definition for EBM is that "Evidence-based medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence-based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research." provided by David Sackett et al in the 1996 article, " Evidence-Based Medicine: What it is and what it isn't" for BMJ. Contact your librarian for full text.



The 5 "A's" will help you to remember the EBP process:

  1. ASK:  Information needs from practice are converted into focused, structured questions.
  2. ACCESS / ACQUIRE:  The focused questions are used as a basis for literature searching in order to identify relevant external  evidence from research.
  3. APPRAISE:  The research evidence is critically appraised for validity.
  4. APPLY: The best available evidence is used alongside clinical expertise and the patient's perspective to plan care.
  5. ASSESS / AUDIT:  Performance is evaluated through a process of self reflection, audit, or peer assessment.

Please note, there are several models for EBP with various named and numbered steps.  This guide will detail the first three steps ASK, ACCESS/ACQUIRE, APPRAISE.  Some models include a 6th step for DISSEMINATE.

* This box and graphic was created by Diane Giebink-Skoglind of ThedaCare. Used by permission.  The graphic is adapted from Melnyk, BM & Fineout-Overholt, E. (2011). Evidence-based practice in nursing & healthcare: A guide to best pracatice. (2nd ed.)  Philadephia: Wolters-Kluwer/Lippincott Williams & Wilkins.

Recommended Readings: Contact your librarian for full text copy

Series from the Arizona State University College of Nursing and Health Innovation's Center for the Advancement of Evidence-Based Practice

Authors: Ellen Fineout-Overhold, Bernadette Mazurek Melnyk, Susan B Stillwell & Kathleen m Williamson

{Titles are live links to article summary}

  1. Evidence-based practice step by step: Critical appraisal of the evidence: part I
  2. Evidence-based practice, step by step: Critical appraisal of the evidence: Part 2
  3. Evidence-based practice, step step Critical appraisal of the evidence: part 3