Clinical Reasoning: Combining Research and Knowledge to Enhance Client Care

Making sound and client-centered clinical decisions in an area that demands accountability and evidence-based practice requires not only scientific knowledge, but also a deep knowledge of the practice of one’s profession and of what it means to be human in the world of combined strength and vulnerability that is health care. Every clinician must understand the importance of applying best research evidence to client care, the essence of evidence–based practice, to improve the overall quality of healthcare. Research continues to find that using evidence-based guidelines in practice, informed through research evidence, improves patients’ outcomes (Dykes et al, 2005). The literature is replete with definitions of evidence-based practice. Simply stated, evidence-based practice is the process of applying research to practice. Originating from the medical field in 1991, the term evidence-based medicine was established to ensure that medical research was systematically evaluated in a manner that could "inform medicine and save lives and that is superior to simply looking at the results of individual clinical trials" (Wampold & Bhati, 2004). An evidence-based practice is considered any practice that has been established as effective through scientific research according to a set of explicit criteria (Drake, et al, 2001). The term evidence-based practice is also used to describe a way of practicing, or an approach to practice. For example, evidence-based medicine has been described as “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients” (Sackett, Rosenberg, Gray, et al, 1996). Evidence-based medicine is further described as the "integration of best research evidence with clinical expertise and patient values" (Sackett, Straus, Richardson, Rosenberg, & Haynes, 2000). Rather than a relationship based on asymmetrical information and authority, in evidence-based practice the relationship is

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