Skip to Main Content
It looks like you're using Internet Explorer 11 or older. This website works best with modern browsers such as the latest versions of Chrome, Firefox, Safari, and Edge. If you continue with this browser, you may see unexpected results.

SOM Nursing Evidence Based Medicine: EBM Overview

What is EBM?

Evidence based medicine (EBM) is the process of utilizing clinical expertise, research evidence and considering patient values, to come to a final clinical decision. This process of EBM de-emphasizes intuition and unsystematic clinical experience as sufficient grounds for clinical decision-making and stresses the examination of evidence from clinical research.

Steps of EBM

The practice of EBM consists of 5 steps:

  • Ask: Constructing a relevant, answerable question derived from the case.
  • Acquire: Selecting the appropriate databases or platforms in which to conduct a search, and then finding the most relevant evidence resources, such as journal articles, books, guidelines, or other information sources.
  • Appraise: Appraising the evidence you’ve acquired for its validity and applicability.
  • Apply: Applying the evidence to your practice.
  • Assess: Reviewing the effect of the evidence-based decision you made upon your patient’s care, and continuing to apply the previous four steps to improve your overall EBM practice.

Constructing a Question

There are two types of questions:

  • Background: Refers to questions that ask for general knowledge about a disorder, test, treatment, etc.
  • Clinical Foreground: Refers to questions that are specific to a patient or problem. This type of question is what you will most commonly use to find evidence to apply in your practice. A well-constructed foreground question is formatted using the PICO structure.

Types of Clinical Foreground Questions

1. Guyatt G, Rennie D, Meade MO, Cook DJ, editors. User’s guide to the medical literature: a manual for evidence-based clinical practice [Internet]. 3rd ed. New York: McGraw-Hill; 2015 [cited 2017 Dec 12].

PICO Structure

PICO stands for:

  • Patient/Problem: Looking at things such as gender, age range, and medical condition
  • Intervention: For example, form of therapy being proposed, type of diagnostic test, etc.
  • Comparison: Is there a comparable test, therapy, or gold standard that can be compared to the proposed intervention? Keep in mind that in some cases a comparison element may not exist.
  • Outcome: What is the overall outcome you wish to accomplish, measure, effect, etc.?

Additional Resources

Hofstra University

This site is compliant with the W3C-WAI Web Content Accessibility Guidelines
HOFSTRA UNIVERSITY Hempstead, NY 11549-1000 (516) 463-6600 © 2000-2009 Hofstra University