a community of practitioners

Evidence based practice

Line 931 of the fist draft states “The scientific process and its importance to evidence based medicine.” Implying the EBP must be based totally in science or it is not objective. This is controversial. I think that while we agree that EBP is based of objectively measure results I believe that the best EBP combines science and Wholistic observations to achieve the best approach. If you reduce something to just what you can measure and fits into a tight scientific theory you are limiting yourself to the very simplistic.
I also believe that are we work on people who are very complex we develop intuitive sense that can be a very valuable part of deciding how to help people if we apply EBP to both left-brained and right brained thinking. In think business when confronted with the unexplainable we either reject it, develop some pseudo-scientific or fantastical explanation for it. Instead we could simply acknowledge that we cannot explain it but we can see what results it produces and objectively test the results of what we do. If we reject it altogether we are reducing the person to a simple set of measurements which give us an incomplete picture. If we dream up an explanation that does not fit we end of following the false theory not the observation. We have intuitive right brained thinking to deal with complex issues and to reject what we cannot reduce to left-brained reason is to use half of what we can.
We need to be trained how to use the right-brain in an objective way. In many ways this is much harder than science.

Replies to This Discussion

Permalink Reply by Christopher A. Moyer on October 25, 2009 at 6:43pm

Hi Carl. I just saw this today, probably because that other thread we were participating in was so busy! I can hardly keep up around here.

Christopher, true scientific practices are objective but EBP is geared on evidentially proven results. The best science does not always produce the best results.

That statement doesn't make any sense. The results of sound science are simply what they are. What do you mean by "best results"?

The problem with science is that to fit into a set of theories you have to limit your input.

No, this isn't true at all. One can proceed scientifically outside of any established theory. This is how theories get overthrown.

Psychatry is good example sure you can stick someone in a Skinner box but while scientific it is a limited tool. Better to use the soft skills of reading people which while not an exact science can provide better results.

The Skinner box, or operant conditioning chamber, is more of a psychological than psychiatric tool. And it's not a therapy device, whereas reading people would be (it could be other things, as well, but I think you have treatment in mind). And reading people can be studied scientifically.

We work in a world in intangibles like the act of touch. While what we do is not all science it does not stop us from evaluating what works and does not work objectively.

For example, I can usually feel pain in a client. This is certainly not science and I have no idea how it works. But I can check to see if it is working and find things wrong with people that medical tools cannot. I know that when I feel the pain disappear that patients feel the pain go also. However, some times I feel something that does not exist or fail to feel what they do. By objectively monitoring what I do I can use this tool effectively.

But that's not objective, nor is it evidence-based. That's not to say it is invalid, but to meet standards of objectivity and of being evidence-based, there is more that must be done in your example. If we were able to show that you and another therapist were able to get correlated results working independently (which, using your example, I expect we could do), that would be a step toward objective, evidence-based results.

-CM

‹ Previous
1
2
3
Next ›