Teaching with Pre-Appraised Evidence Sources: A New Model to Assist with Clinical Decision Making and Evidence Based Practice (EBP)

Achieving the goal of establishing evidence-based care is not always easy. In fact, determining how to find and maintain access to the most comprehensive, current evidence base at any given time can be the initial difficult challenge faced by the Advanced Practice Registered Nurse (APRN) or APRN student. With the development of sophisticated pre-appraisal tools a paradigm shift has occurred for researchers and practitioners when seeking and evaluating new evidence. A graduate nursing faculty member and health sciences librarian have teamed up to develop new methods of engaging APRN students in locating and appraising the best evidence for clinical practice to assist with clinical decision making. Prior to the explosion of pre-appraised evidence, a “bottom up” approach to EBP was used; that is, a major focus on understanding research methods, locating guidelines and studies through broad literature searches, and appraising individual studies. Due to this paradigm shift, we propose a new four step model for EBP and clinical decision making using a “top-down approach.” Within this new model, pre-appraised evidence is the first step and the final step ends with synthesis and clinical decision making.

This presentation will define and describe the four steps in the new model. Information on the major issues surrounding the access and evaluation of available evidence, including attention to the benefits and limitations of clinical practice guidelines as a major component of the evidence base, will be threaded throughout the discussion of the description of the major components in the model.   Results obtained from qualitative studies using the model will be presented. Participants will learn benefits, strategies and caveats related to teaching with EBP tools via the new model.