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Evidence Based Practice: Evidence-Based Practice (EBP) Home

Evidence-Based Practice (EBP)

EBP has developed from Evidence-Based Medicine (EBM), expanded to include other health professions.

Sackett, et al. defined Evidence-Based Medicine (EBM) as "integrating individual clinical expertise with the best available external clinical evidence from systematic research...[and the] use of individual patients' predicaments, rights, and preferences in making clinical decisions about their care."

-- Sackett DL, Rosenberg WM, Gray JA, Haynes RB, Richardson WS. Evidence based medicine: what it is and what it isn't. BMJ. 1996;312(7023):71-72. doi:10.1136/bmj.312.7023.71

Venn diagram of clinical expertise, best research evidence, and patient values combining into Evidence based practice.

Evidence Cycle

Clinical practice is an ongoing process, which is why evidence-based practice is often represented as a cycle. When you've reached the end of the cycle you may find yourself adjusting your question and starting over.

Ask, access, appraise, apply, assess in a circle with arrows pointing to indicate it's a cycle.

There are 5 Steps to EBP that can be repeated as necessary. 


Assess the patient/problem. 

Assess the results.

You start with a patient and/or clinical problem. 

A new question can come from working on a previous one. 

ASK Ask an answerable question. Based on the case, build a relevant and answerable question. 
ACCESS Access the evidence.  Conduct a search in appropriate resources. 
APPRAISE Appraise the evidence.  Evaluate evidence for validity, risk of bias, and applicability. 
APPLY Apply the evidence to patient care. Combine the evidence with clinical expertise and patient preferences. Apply it to your practice and assess the results. 

-- Table adapted from Cantrell, S., von Isenburg, M. Evidence-based practice for the medical librarian [Course content]. Medical Library Association & University of North Carolina at Chapel Hill School of Information and Library Science, Sakai.

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EBP Tutorial

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