Evidence-based practice in the context of health professional education

The evidence-based medicine paradigm came to prominence in the early 1990s with a medical group in Ontario, Canada, using scientific evidence to support history taking, physical assessment and diagnostic tests in the patient management decision process. There are two main approaches to research: (1) quantitative studies, which use numerical analysis of the results, and (2) qualitative studies, which attempt to understand more about the events, situations, cultures and experiences that affect a person. For quantitative studies there is a hierarchical level of scientific evidence, with the systematic review and meta-analysis at the top followed by the randomised controlled trial, cohort study, case-control study, cross-sectional study, case series and case study. For the qualitative studies there are various methods for obtaining the data; these include the phenomenology, ethnography, grounded theory, and case study. There are also studies that use a combination of quantitative and qualitative methods, referred to as mixed methods. The data collection process varies for different studies, from a data collection form to direct observation, one-on-one interviews and focus groups. There are issues within the study that may affect the study outcomes, including bias, confounding and blinding. This chapter provides an overview of evidence-based practice, where the paradigm emanated from, and some of the different study types for both quantitative and qualitative methods. We also discuss how evidence-based practice provides the basis for evidence-based education for the health-related professions.