Integrating clinical reasoning and evidence-based practice

Area of Science:

• Nursing Science
• Clinical Practice Research

Background:

• Evidence-based practice (EBP) is central to clinical decision-making.
• Nurses face challenges in integrating clinical reasoning with EBP.
• Current definitions of evidence for EBP may be too narrow.

Purpose of the Study:

• To advocate for a broader definition of evidence in clinical practice.
• To explore the role of clinical reasoning alongside empirical evidence in nursing.
• To identify the types of knowledge essential for accountable clinical decisions.

Main Methods:

• The study presents a conceptual argument against narrow definitions of evidence.
• It emphasizes the integration of various research methodologies (experimental, interpretive, action research).
• It highlights the importance of expert clinical knowledge and clinical reasoning in nursing.

Main Results:

• A broad definition of evidence is superior for guiding clinical decisions for individual patients.
• Credible clinical decisions require multiple forms of knowledge, not just randomized controlled trials.
• Expert clinicians use clinical reasoning to contextualize evidence for specific patient situations.

Conclusions:

• Best practice should be defined by the best available information for a specific patient and setting.
• Nursing practice benefits from integrating diverse research findings with the tacit knowledge of expert clinicians.
• Clinical reasoning is crucial for nurses to effectively apply evidence in uncertain practice environments.