Please use this identifier to cite or link to this item: http://hdl.handle.net/1893/1795
Appears in Collections:Faculty of Health Sciences and Sport Journal Articles
Peer Review Status: Refereed
Title: Evidence and expertise
Authors: Paley, John
Contact Email: jhp1@stir.ac.uk
Keywords: decision-making
evidence-based practice
expertise
judgement
research
Issue Date: Jun-2006
Publisher: Blackwell Publishing
Citation: Paley J (2006) Evidence and expertise, Nursing Inquiry, 13 (2), pp. 82-93.
Abstract: This paper evaluates attempts to defend established concepts of expertise and clinical judgement against the incursions of evidence-based practice. Two related arguments are considered. The first suggests that standard accounts of evidence-based practice imply an overly narrow view of 'evidence', and that a more inclusive concept, incorporating 'patterns of knowing' not recognised by the familiar evidence hierarchies, should be adopted. The second suggests that statistical generalisations cannot be applied non-problematically to individual patients in specific contexts, and points out that this is why we need clinical judgement. In evaluating the first argument, I propose a criterion for what counts as evidence. It is a minimalist criterion but the 'patterns of knowing', referred to in the literature, still fail to meet it. In evaluating the second argument, I will outline the powerful empirical reasons we have for thinking that decisions based on research evidence are usually better than decisions based on clinical judgement; and show that current efforts to rehabilitate clinical judgement seriously underestimate the strength of these reasons. By way of conclusion, I will sketch the ways in which the concept of expertise will have to be modified if we accept evidence-based practice as a template for health-care.
Type: Journal Article
URI: http://hdl.handle.net/1893/1795
DOI Link: http://dx.doi.org/10.1111/j.1440-1800.2006.00307.x
Rights: The publisher does not allow this work to be made publicly available in this Repository. Please use the Request a Copy feature at the foot of the Repository record to request a copy directly from the author; you can only request a copy if you wish to use this work for your own research or private study.
Affiliation: HS Health - Stirling

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