Practice-based Evidence for Healthcare: Clinical Mindlines

This book challenges the evidence-based practice movement to re-think its assumptions. Introducing the reader to a range of theoretical frameworks to analyse observations of practitioners, it examines afresh how clinicians use knowledge.Evidence-based practice and policy making has recently become firmly established as a part of the training of all health professionals, both clinical and managerial. Yet despite its 'gold-standard' status, the evidence-based practice movement is faltering because too much effort has gone into trying to achieve an idealised model of the way clinicians ought to find and use best evidence, while not enough has been done to understand why they so often don't.Practice-based Evidence for Healthcare sets out to examine how clinicians do actually develop and use clinical knowledge day-to-day. It puts forward the concept of 'mindlines'- internalised, collectively reinforced, tacit guidelines. Mindlines are built up during training and continually updated by reading, by personal experience and that of others. But above all it is clinicians' interactions with their communities of practice and networks of trusted colleagues that facilitate the exchange of knowledge that becomes embedded in collective and individual mindlines.This groundbreaking book draws on ethnographic data from the UK and the US. It will help students to understand more about implementing new knowledge in practice and will be of practical use to clinicians, health service managers, policymakers, researchers and educators working on the promotion of evidence-based practice.