Putting It Into Practice
The HCPC (2014) requires its registrants to ‘be able to engage in evidence-based practice’, defined by Sackett et al. (1996) as ‘the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients’. In order to deliver evidence-based medicine in practice, the day-to-day care provided must be firmly grounded in research (Boswell & Cannon, 2014, p. 3).
However, as ambulance clinicians, we must be clear that the mere existence of a piece of research is not sufficient justification to change our practice. Clinicians must ‘be able to evaluate research and other evidence to inform their own practice’ (HCPC, 2014).
Therefore, we must consider the study findings in the context of our clinical environment, question the conclusions drawn by authors and seek the validity of a study conduct and its design. Ask questions such as are the authors’ findings in line with wider texts evaluating the topic? Do you believe the study findings – are they valid and reliable? Are the authors credible and without conflict?
Whilst considering the research evidence base, we must also understand the position of Trust policy, legislation and national guidance such as JRCALC and NICE guidelines which themselves are largely based upon current evidence.
Another Language?
The prospect of reading medical research can initially seem like a daunting task. The language used and the different types of research can seem very unfamiliar but there are various resources online to guide our learning.
- The BMJ EBM Toolkit is a free resource the explores the fundamentals to learn, practice and discuss EBM and is highly recommended to both EBM beginners and those who are familiar with the concept.
- The University of Southampton has a guide on how to read a paper which is available here and a useful starting point – don’t miss the ‘Useful Downloads’ at the bottom of their page.
- The YouTube channel ‘Sketchy EBM‘ has a 4 minute video which suggests a way of reading medical research papers. You can watch the video here.
- In addition to its new EBM Toolkit, the BMJ also has a series of more in-depth guides which, while dated, are still relevant today. You can view these using your OpenAthens login here.
- A free e-book is available to read online by Trisha Greenhalgh, the author of the BMJ series called ‘How to Read a Paper’. This can be viewed using your OpenAthens login here.
Staying Up-To-Date
Keeping up with the latest literature can be time consuming and was partly the driving force behind this project in the first place. The New England Journal of Medicine has produced an editorial with some useful advice on how to go about this here.
References
BOSWELL, C. and CANNON, S., 2014. Introduction to nursing research: incorporating evidence-based practice. 3rd edn. Burlington, Massachusetts: Jones and Bartlett Learning.
HEALTH AND CARE PROFESSIONS COUNCIL [HCPC], 2014. Standards of Proficiency – Paramedics. London: HCPC.
SACKETT, D.L., ROSENBERG, W.M.C., GRAY, J.A.M., HAYNES, R.B. and RICHARDSON, W.S., 1996. Evidence based medicine: what it is and what it isn’t. BMJ, 312(7023), pp. 71-72.