Question Five: Evidence-Based Practice

Hello all,

Here is question five, and a video of the question can be found here:

There has been a lot of discussion over the last few years over the value of evidence-based medicine (EBM) or practice (EBP)in health care.

There have been some severely critical papers on the subject posted, and mainly taking the stance that the scientific EBP approach is wrong as it has a limited view of what constitutes evidence. These arguments usually make some reference to post-modern approaches always seem to mention “ways of knowing” somewhere along the way, arguing that scientific research is not value free, evidence is really based upon individual perceptions, ways of being, intuitive knowing and that different perspectives are equally valid. A key example is the paper by ¬†Holmes et al. here, which also suggested Archie Cochrane (one of the fathers of EBM) was an intellectual fascist.

Indeed, a growing trend is exemplified by attempts to change the terminology to evidence-informed practice McSherry (2002) argues that evidence-based practice is focused on a hierarchy of evidence whilst evidence-informed practice is focused on the practitioner knowledge.

So my question is what do you think of the concept of EBP, and is there a difference between evidence-based practice and evidence informed practice or is this merely semantics/bunk? Ok, I know that’s cheating and really two questions, but please do post your thoughts on this one. As always we look forward to your responses.

Regards Bernie


McSherry R., Simmons M., Abbott P.(2002) in McSherry R., Simmons M., Abbott P. Evidence-Informed Nursing: A Guide for Clinical Nurses. London: Routledge; 2002. An introduction to evidence-informed nursing; p. 1-13

Holmes D., Murray S.J., Perron A., Rail G. (2006) Deconstructing the evidence-based discourse in health sciences: truth, power and facism. International Journal of Evidence Based Healthcare, 4, 180-186.