Kathleen M. Williamson

Evidence-Based Practice: Critical Appraisal of Qualitative Evidence

One of the key steps of evidence-based practice is to critically appraise evidence to best answer a clinical question. Mental health clinicians need to understand the importance of qualitative evidence to their practice, including levels of qualitative evidence, qualitative inquiry methods, and criteria used to appraise qualitative evidence to determine how implementing the best qualitative evidence into their practice will influence mental health outcomes. The goal of qualitative research is to develop a complete understanding of reality as it is perceived by the individual and to uncover the truths that exist. These important aspects of mental health require clinicians to engage this evidence.

Strategies for translating knowledge into practice

Despite the vast amounts of research evidence that is readily available to many nurses worldwide, the gap between research and practice still exists. For example, in a recent survey, nurses in Turkey expressed a belief that nursing practices should be based on research evidence, but this belief was not reflected in their behaviour (Ozsoy & Ardahan 2008). So what about practice elsewhere? The literature suggests that in many parts of the world, health professionals still base much of their decision-making and practice on less scientific sources of evidence than research, including, as Estabrooks (1998) identified, experiences, intuitions, discussions with associates, and clinical observations. Relatively few research findings are translated into practice and used consistently to inform clinical decisionmaking, especially at the bedside (Lang et al. 2007). Reasons for this include lack of time, limited access to resources, and lack of knowledge and skills with computers and interpreting statistical information (Thompson et al. 2005). In a previous column, we highlighted one such example: the problematic uptake of preoperative fasting guidelines into practice (Kent et al. 2009). Clearly, one of the many challenges facing educators is to facilitate the translation of evidence that is derived from research and ensure it is embedded into everyday nursing practice. This is challenging because of the complexity of health care today, the multiplicity of evidence (of varying quality), and the varying effectiveness of different strategies for knowledge translation (Lang et al. 2007). We discussed knowledge translation in a previous column (Kent et al. 2009); the term “knowledge translation” is widely used to refer to the process of moving evidence into practice (i.e., evidence-based practice). Further, the term “knowledge translation” is often used as a keyword in articles published in leading journals in the evidence-based practice field (Kent et al. 2009). A useful resource that has open access is the The RM Knowledge Translation Toolkit: A Resource for Researchers (Campbell 2008).