Evidence for practice, epistemology, and critical reflection

Nursing Philosophy (Impact Factor: 0.64). 09/2006; 7(4):216 - 224. DOI: 10.1111/j.1466-769X.2006.00267.x
Source: PubMed

ABSTRACT Abstract  Evidence-based practice (EBP) has become a critical concept for ethical, accountable professional nursing practice. However, critical analysis of the concept suggests that EBP overemphasizes the value of scientific evidence while underplaying the role of clinical judgement and individual nursing expertise. This paper explores the empiricist position that valid evidence is the basis for all knowledge claims. We argue against the positivist idea that science should be regarded as the only credible means for generating evidence on which to base knowledge claims. We propose that the process of critically reflecting on evidence is a fundamental feature of empirical epistemology. We suggest that critical reflection on evidence derived from science, arts and humanities and, in particular, nursing practice experience can provide a sound basis for knowledge claims. While we do not attempt to define what counts as evidence, it is argued that there is much to be gained by making the processes of critical reflection explicit, and that it can make a valid contribution to expert nursing practice, without recourse to irreducible concepts such as intuition.

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Available from: Dawn Freshwater, Jul 27, 2015
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    • "Its ascendancy in the field of research and practice is related to the Cochrane Collaboration in 1993 [2], and also to the efforts of Hargreaves [3] who purported that research in medicine was a model to which educational researchers should aspire. Indeed since that time evidence-based practice (EDP) has become equated with accountable, professional nursing practice [4]. Essentially, the term evidence-based practice refers to the utilization of knowledge, derived primarily from research, in practice. "
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    ABSTRACT: The term evidence-based practice refers to the utilization of knowledge derived from research. Nursing practice, however, is not limited to clinical practice but also encompasses nursing education. It is, therefore, equally important that teaching preparation is derived from evidence also. The purpose of this study was to examine whether an evidence-based approach to preceptor preparation influenced preceptors in a assuming that role. A qualitative method using semistructured interviews was used to collect data. A total of 29 preceptors were interviewed. Constant comparative analysis facilitated examination of the data. Findings indicate that preceptors were afforded an opportunity to participate in a preparatory process that was engaging, enriching, and critically reflective/reflexive. This study has generated empirical evidence that can (a) contribute substantively to effective preceptor preparation, (b) promote best teaching practices in the clinical setting, and (c) enhance the preceptorship experience for nursing students.
    07/2012; 2012:948593. DOI:10.1155/2012/948593
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    • "To minimize challenges of implementation, social workers must remain conscientiously aware of the seduction of the positivist-empirical element of the EBP model in deference to the practice wisdom and client preference elements. The former is an easy lure, since the scientific method is viewed and advocated as the most important means of evidence generation by some (Avis and Freshwater 2006), even as this power differential among the elements of the model continues to be questioned by others (Hall 2008). Similarly, with regard to social work policy concerns, the E in EBP needs to be well-defined, especially where non-scientific ideological concerns come into play (Tannenbaum 2003). "
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    • "Eventually, Paley concludes that best evidence is what the system presents as being (probably) true. On the other hand, Avis & Freshwater (2006) commence by pointing out that valid evidences for practice are those emerging from the critical reflection of individual practitioners. They continue to provide their counter-thesis by denoting that empiricism in the form of objective, value-free, and true evidence can undervalue and distort knowledge for practice. "
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    ABSTRACT: This paper puts forward the argument that there are various, competing, and antithetical evidence-based practice (EBP) definitions and acknowledges that the different EBP definitions are based on different epistemological perspectives. However, this is not enough to understand the way in which nurse professionals choose between the various EBP formations and consequently facilitate them in choosing the most appropriate for their needs. Therefore, the current article goes beyond and behind the various EBP epistemologies to identify how individuals choose an epistemology, which consequently will assist our understanding as to how an individual chooses a specific EBP formation. Individuals choose an epistemology on the mere belief that the specific epistemology offers the ideals or ideas of best explaining or interpreting daily reality. These ideals or ideas are termed by science, history, and politics as ideology. Similarly, individual practitioners choose or should choose between the different EBP formations based on their own personal ideology. Consequently, this article proceeds to analyse the various ideologies behind different EBP definitions as to conclude that there are two broad ideologies that inform the various EBP formations, namely the ideology of truth and the ideology of individual emancipation. These two ideologies are analysed and their connections to the various EBP formations are depicted. Eventually, the article concludes that the in-depth, critical, and intentional analysis by individual nurses of their own ideology will allow them to choose the EBP formation that is most appropriate and fitting for them, and their specific situation. Hence, the conscious analysis of individual ideology becomes the criterion for choosing between competing EBP formations and allows for best evidence to be implemented in practice. Therefore, the best way to teach EBP courses is by facilitating students to analyse their own ideology.
    Nursing Philosophy 11/2007; 8(4):244-55. DOI:10.1111/j.1466-769X.2007.00321.x · 0.64 Impact Factor
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