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"EBM is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research ... thoughtful identification and compassionate use of individual patients' predicaments, rights, and preferences in making clinical decisions about their care”.1

Evidence-Based Medicine (EBM) or Evidence-Based Practice (EBP) involves a cycle of enquiry:

Evidence-based Practice cycle diagram

  Source: Duke University Medical Center Library

Steps of EBM

It begins with a patient dilemma, or problem - then a question is asked - the literature is searched to acquire information- the results are appraised - then applied to the specific question and patient.

  1. Health care knowledge grows so rapidly that you will be out of date by the time you ‘memorise the textbook’.
  2. Health care knowledge is now too vast to keep up to date with all the key publications, even in your field.
  3. Today’s information environment allows you to get information ‘just in time’ rather than ‘just in case’.
  4. EBP allows you to individualise the information for your patient’s situation.
  5. EBP teaches you to integrate the best available information with clinical expertise, patient values, and your health care environment.
  6. EBP helps you to challenge dogma and avoids uncritical acceptance of ‘usual practice’.
  7. EBP can be simple, quick, and will give you skills for lifelong learning and up to date practice.
Barriers Solutions
Uncritical acceptance of 'usual practice' Learn to question dogma
Failure to recognise and ask clinical questions Practice recognising and asking clinical questions
Perceived lack of time Understanding the resources available to find answers quickly and effectively
Lack of EBP skills Learn EBP skills
Lack of access to information resources The Internet removes this barrier, as some good quality resources are freely available
Applying the right answer to the wrong patient Remember the final step in EBP is to consider the individual patient, their values, and your practice setting
Lack of knowledge and support from colleagues for an EBP approach Explain, teach, and model EBP in your practice

Source: Faculty of Health and Medical Sciences, University of Western Australia. Barriers to using Evidence Based Practice (EBP) to answer clinical questions [Internet]. 2015 [updated 2015 May 11; cited 2017 Jun 21]. Available from:


EBM Video

EBM and Study Design

A brief introduction to study design for the EBM.
Duke University Medical Center Library & Archives

Published on Dec 31, 2010