Reflective & Evidence-Based Practice in Nursing & Healthcare

About this Library Guide...

Welcome to the RGO Library & Learning Commons (LLC) guide for reflective practice and evidence-based practice in nursing and healthcare.

This guide is designed to help students find resources to complete assignments on these important topics by:

  1. Finding background and introductory information in reference sources (such as dictionaries and encyclopedias)
  2. Searching the online library catalogue and databases for books, e-books, and articles published in scholarly journals
  3. Verifying sources are scholarly and peer-reviewed

Reflective Practice

According to Boyd and Fales (1983), reflective practice is "'the process of creating and clarifying the meaning of experience in terms of self in relation to both self and the world. The outcome of this process is changed conceptual perspectives’" (as cited in "Reflective practice," 2006).

There are a variety of models and theories informing how to engage in reflective practice, such as Johns' Model of Reflection (1994), Gibbs' Model of Reflection (1988), and Atkins and Murphy's Model of Reflection (1994). 

In the professional context, such as nursing practice, reflection generally refers to the process of:

  • Looking back at one's experiences in the workplace, such as clinical settings;
  • Critically examining and analyzing these experiences by considering one's personal actions and the outcomes for all participants involved;
  • Drawing instructive conclusions about these experiences, such as areas for personal improvement or skills that need to be further developed in order to create more successful outcomes in the future.

In this way, reflective practice builds self-awareness and contributes to experiential learning and professional development in the workplace (Lillyman, 2010). 

Evidence-Based Practice

Evidence-based practice (EBP) was defined by Sackett et al. (1996) as "the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients" (as cited in Louw, 2009).

In general, EBP in nursing and healthcare refers to:

  • The "selection and application of ‘best evidence,'" which entails the professional using both "critical appraisal skills" and their "own clinical experience" (Edwards, 2008)
  • The use of research evidence to inform and enhance the medical and clinical decision-making abilities of professionals (Louw, 2009)

​Evidence-based practice typically requires a process in which the health practitioner:

(1) Formulates a focused research question 

  • This often involves applying a structured format such as the PICOT method (Population/Patient Problem; Intervention; Comparison; Outcome; Time)

(2) Locates the best evidence from published research sources

(3) Critically evaluates the evidence for "validity, importance, and usefulness" using "specific criteria to determine the methodological rigor, significance, and generalizability of research findings."

  • One tool for source evaluation and appraisal is a "Pyramid of Evidence," which ranks overall reliability and depth of key research methodologies

(4) Combines the evidence with local professional expertise and the values of the patient(s) involved ("Evidence-based practice," 2010). 

"Pyramid of evidence - quantitative studies" (Louw, 2009)

References

Edwards, M. (2008). Evidence-based practice. In A. Bryan, E. Mason-Whitehead, & A. McIntosh (Eds.), Key concepts in nursing. London, United Kingdom: Sage UK. Retrieved from http://search.credoreference.com

Evidence-based practice (EBP). (2010). In A. Powers, Dictionary of nursing theory and research. New York, NY: Springer Publishing Company. Retrieved from http://search.credoreference.com

Lillyman, S. (2010). Reflection. In A. McIntosh-Scott (Ed.), SAGE key concepts series: Key concepts in Healthcare Education. London, United Kingdom: Sage UK. Retrieved from http://search.credoreference.com

Louw, G. (2009). Evidence-based practice. In F. Wilson and M. Mabhala (Eds.), Key concepts in public health. London, United Kingdom: Sage UK. Retrieved from http://search.credoreference.com

Mannix, J. (2008). Reflection. In A. Bryan, E. Mason-Whitehead, & A. McIntosh (Eds.), Key concepts in nursing. London, United Kingdom: Sage UK. Retrieved from http://search.credoreference.com

Reflective practice. (2006). In C. Brooker (Ed.), Churchill Livingstone's dictionary of nursing. Philadelphia, PA: Elsevier Health Sciences. Retrieved from http://search.credoreference.com

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