Journal of evaluation in clinical practice
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Evidence-based medicine is being applied to decisions in a range of contexts beyond one-to-one patient care. Yet considerable disagreement persists regarding the defining components of evidence-based decision-making, particularly in institutional and public health contexts. ⋯ Asking critical questions about the purposes and context of a specific decision, basic principles of evidence-based reasoning can be appropriately applied beyond the bedside.
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To establish the effectiveness of clinical guideline implementation strategies. Data sources/study setting Systematic reviews in full text, English language, 1987-2007, reporting any measure of clinical process change or cost-benefit analysis. ⋯ Successful guideline implementation strategies should be multifaceted, and actively engage clinicians throughout the process.
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To evaluate the impact of protocol-based care on nursing roles, practice and service delivery. ⋯ The potential of standardization was mediated by the patchy use of protocol-based care approaches and negative perceptions about standardization. Use of protocol-based care has the potential to impact on nurses' roles, increasing their autonomy and subsequently impacting on service delivery.
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Knowledge in evidence-based medicine (EBM) is increasingly becoming a core competence in medical education. We evaluated the trainee doctors' attitudes and knowledge of EBM to obtain the basis required for developing appropriate teaching and learning opportunities. ⋯ The present study demonstrates that the majority of trainee physicians at a Tehran University hospital lack adequate knowledge about basic concepts of EBM. Furthermore, most of them continue to use traditional sources of knowledge rather than evidence-based sources. On the positive side, there was an overall positive attitude towards EBM and the majority had a positive tendency to take part in EBM training courses.