Chapter 2: Evidence-based Practice

Quizzes give you the chance to test your knowledge through multiple choice questions, short answers, matching activities and other revision tools.

1. Discuss the importance of focussing a problem into a sharply defined clinical question.


A focussed question provides a greater opportunity to search, locate and retrieve information that is relevant. The clearer the question the more useful the answer.

An example of a focussed question might be:

Primary Care patients for specific long term condition

I  Information leaflets

C No information leaflets

O  Patient empowerment

2. All new research should be based on evidence drawn from previous research. Explain what is involved in efficient literature searching and how the hierarchy of evidence can be used to classify different types of research.


Efficient literature searching involves focussing a question, using a PICO.  Using key words & synonyms as search terms.  Could also identify type of study – systematic review, RCT etc.  Searching relevant databases ensures that the right type of information is located e.g.  Medline for diagnosis etc.  Qualitative for nursing.



Systematic reviews provide the best answers to sharply define clinical questions and are most useful to inform potential research as they are rigorously developed and include up to date information about the nature of the topic and how best it might be researched.  If a review is not available then it is advisable to follow the hierarchy downwards in the search.

The hierarchy is so called because the types of evidence each layer yields systematic review being the most robust and opinion being the least.

3. Explain the features of a randomised controlled trial (RCT).


See the consort guidelines on Randomised controlled trials: Use the online version to check what features of an RCT have been included: explanations and examples of each feature are on the e version.

4. Explain the ways in which researchers can minimise bias in an RCT.


There are many types of bias. See Chapter 7 Box 7.3 for a full list.

5. Identify three types of qualitative methods and provide brief explanations of each.


See Chapter 9 for the three most commonly used qualitative methods.

6. What is the particular value of qualitative research to patient care?


Qualitative studies are useful for underpinning further, quantitative research as well as in their own right. Using a qualitative approach could address questions such as ‘what are the influences/barriers to patient empowerment in primary care consultations?’  They could also look at the patients’ experiences which should give practitioners a valuable insight from the participants’ perspective as to what the issues are, as opposed to being surveyed using predetermined questions.