Evidence-based Practice - EBP and The History of Medicine and Education

EBP and The History of Medicine and Education

In recent years, EBP has been stressed by professional organizations such as the American Psychological Association, the American Occupational Therapy Association, the American Nurses Association, and the American Physical Therapy Association, which have also strongly recommended their members to carry out investigations to provide evidence supporting or rejecting the use of specific interventions. Equivalent recommendations apply to the Canadian equivalent of these associations. Pressure toward EBP has also come from public and private health insurance providers, which have sometimes refused coverage of practices lacking in systematic evidence of usefulness.

Areas of professional practice, such as medicine, psychology, psychiatry, rehabilitation and so forth, have had periods in their pasts where practice was based on loose bodies of knowledge. Some of the knowledge was lore that drew upon the experiences of generations of practitioners, and much of it had no valid scientific evidence on which to justify various practices.

In the past, this has often left the door open to quackery perpetrated by individuals who had no training at all in the domain, but who wished to convey the impression that they did, for profit or other motives. As the scientific method became increasingly recognized as the means to provide sound validation for such methods, the need for a way to exclude quack practitioners became clear, not only as a way of preserving the integrity of the field (particularly medicine), but also of protecting the public from the dangers of their "cures." Furthermore, even where overt quackery was not present, it was recognized that there was a value in identifying what actually does work so it could be improved and promoted.

The notion of evidence based practice has also had an influence in the field of education. Here, some commentators have suggested that the putative lack of any conspicuous progress is attributable to practice resting in the unconnected and noncumulative experience of thousands of individual teachers, each re-inventing the wheel and failing to learn from hard scientific evidence about 'what works'. Opponents of this view argue that hard scientific evidence is a misnomer in education; knowing that a drug works (in medicine) is entirely different from knowing that a teaching method works, for the latter will depend on a host of factors, not least those to do with the style, personality and beliefs of the teacher and the needs of the particular children. Thus, opponents of EBP in education suggest that all teachers do indeed need to develop their own personal practice, dependent on personal knowledge garnered through their own experience.