Kuhn held that a scientific revolution occurs when a new paradigm-a theory or perspective that dominates the science and is generally accepted by all members of the scientific community-replaces an old paradigm, and two theories cannot coexist. The arguments of these critics of EBM are supported mainly by the theories of Thomas Kuhn and Michel Foucault. 4– 6 Every health discipline should reflect on its practices and goals to construct a pertinent definition of evidence-based practice. Several authors have criticized EBM methods, which they see as an attempt to monopolize science for standardizing methods and research tools around a unique scientific truth. It is important to highlight EBP as a field of study and research in which physiotherapists can collect relevant information, use a variety of research methods to produce scientific evidence on topics related to patient evaluation and interventions in physiotherapy, and assess the quality of the scientific evidence already available. In this way, physiotherapy professionals can be agents of transformation and participate in the production of science rather than merely be followers of new paradigms. The reason for including both study and research as elements in our definition of EBP is to motivate critical thinking among physiotherapists, who should feel comfortable questioning the quality of the scientific evidence. There is an intrinsic connection between research and study, in that study is always part of research, but research, or the action of doing research, is not necessarily included in study. On the other hand, research (or knowledge creation) goes beyond the study of existing knowledge and requires a complex set of skills to develop new knowledge in a specific topic or field. On one hand, to study is to learn a topic or some knowledge that has already been discovered and revealed it can stimulate the eager to investigate, go deeper in their studies, and perhaps originate an innovation on existing knowledge in this case, research skills would be needed to systematize the new knowledge and make it coherent and acceptable for the academic field. Although the terms study and research are often used as synonyms, for our purposes study (or knowledge acquisition) is defined as the act of devoting time to learning about any topic or area of knowledge.
Thought field therapy scientific evidence professional#
Therefore, we propose defining EBP as follows: an area of study, research, and practice in which clinical decisions are based on the best available evidence, integrating professional practice and expertise with ethical principles. For instance, it did not include ethical principles of autonomy, beneficence, non-maleficence, and justice, which are of utmost importance in evidence-based clinical decisions and go beyond patient values. However, it did not yet include all the elements that characterize EBM or EBP. In 2000, Sackett and colleagues published a revised definition of EBM as “the integration of best research evidence with clinical expertise and patient values.” 3(p.1) This definition showed some progress because it now included research, clinical practice, and the values of the patient. The World Confederation for Physical Therapy (European region) has defined EBP as “a commitment to use the best available evidence to inform decision-making about the care of individuals that involves integrating physiotherapist practitioners and individual professional judgement with evidence gained through systematic research.” 1(p.1) This definition is based on Sackett and colleagues' definition of evidence-based medicine (EBM), published in 1996 by BMJ (formerly British Medical Journal). Although it is increasingly used worldwide, a precise and appropriate definition has not been agreed on among clinicians and researchers. Evidence-based physiotherapy (EBP) is an emerging and increasing theme in rehabilitation and physiotherapy.
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