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38 Teaching evidence based practice – it’s time to tackle the ‘apply’ domain
  1. Eve O’Toole1,
  2. Niamh O’Rourke2
  1. 1National Cancer Control Programme, Health Service Executive, Dublin, Ireland
  2. 2Clinical Effectiveness Unit, Department of Health, Dublin, Ireland


Objectives In 2017 Evidence Based Practice Ireland (EBPI) was established to promote the use of evidence-based practice in the healthcare system in Ireland with the ultimate goal of improving patient outcomes. One of the challenges to the widespread adoption of the EBP paradigm is the lack of teaching of EBP to healthcare professionals. The teaching taking place rarely addresses the domain of how to apply evidence in practice. To address this deficit a three-day workshop in EBP was held in Ireland in March 2019 for practicing healthcare professionals with an emphasis on putting evidence into practice. The aims of the workshop were to develop and deliver a teaching module on ‘evidence into practice’. To empower healthcare professionals to become evidence-based practitioners. To build capacity in teaching EBP and to create international links by inviting speakers form the Centre for Evidence Based Medicine (CEBM) in Oxford.

Method The workshop was delivered through a blend of plenary and small group sessions modelled on the CEBM approach to teaching EBP. In all plenary’s speakers used real life examples from their own experience with consistent emphasis on the impact to patients and the importance of patient values.

The programme for day one covered the Ask and Search domains. Day two explored appraisal of different study designs. Day three focused on putting evidence into practice with plenaries on

  • From Evidence to recommendations

  • Shared decision making

  • Implementation planning

These topics were chosen to reflect the real-word challenges health care professionals face. Each small group was required to demonstrate the skills attained including, asking an answerable question in PICO format, finding the evidence, critical appraisal of the best evidence and how they would put the evidence into practice in the real-world setting

Results The small group presentations covered a wide range of topics which were based on a real clinical query of a participant. Each group discussed the quality of the evidence to answer their question, the potential benefit and harm, patient preferences and values and resources required before presenting their recommendations. They also described barriers and facilitators to the implementation of their recommendations.

In the evaluation form all participants rated their ability to practice EBP a 4-5 on a five-point scale compared with a range of 2-5 in a previous workshop. When asked what aspects of the course were most useful, comments included;

‘Practical aspects of bringing EBP to patients’

‘Guidelines to aid implementation’

‘Connection of theory to real world practice’

‘Shared decision making’

‘Apply information in practice’

Conclusions Our goal in EBPI is to promote the practice of EBP throughout the healthcare system in Ireland to improve patient outcomes. To be successful we need health care professionals to understand the principles of EBP. Much work internationally has gone into addressing the skills needed to ask focused questions, search the literature and appraise the literature for its quality and applicability. However, there is less agreement on how to teach integrating the best evidence with clinical expertise and patient values and applying it in practice. By developing this ‘evidence into practice’ module we are addressing the curriculum gap in how to teach the ‘apply in practice’ domain of EBP while building capacity and leadership in EBP in Ireland.

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