The evidence-based practice ‘movement’ is now at least 20 years old, and there is extensive debate about what are the next challenges. We have made significant progress in promoting and understanding the use of scientific research to understand many of the tests and treatments commonly in use in healthcare today. But there is still a large gap between knowing the evidence and putting this into everyday practice. I suggest that there are 3 big challenges to EBP as it currently stands…
1. Current and existing research that is limited by study design and research conduct eg limited publication of trial data. The research that is reported is likely to be biased and therefore it will not be clear as to how the results can be generalised or transferred.
2. In areas where the research evidence is limited, there is confusion about how to integrate the knowledge and experience of expert clinicians and patients. Often, there is no transparency in the way experts make recommendations for clinical guidelines – and sometimes these flawed guidelines are used to indicate basic or minimum standards for practice. At other times, the lack of high quality evidence is covered up by misleading media and academic papers eg sports drinks
3. There is a big time delay between the publication and implementation of research evidence. We know that this time lag can be anything from 5-50 years between when new evidence is published and adopted into practice. However, we have not organised the evidence for effective implementation in a way that it can be easily accessed and used. We need clear strategies to evaluate the local context, assess barriers, select and tailor the appropriate implementation strategy and plan and monitor change!!