Evidence based practice from the ashes of clinical freedom

Clinical freedomPrior to the 1980s, clinical judgement played a large part in decision-making (Hampton, 2011; Hampton, 1983), by in large leaving research the role of informing education, rather than practice. The perception at the time was that evidence based practice would simply result in a plethora of protocol driven instructions which would remove clinicians' ability to develop a treatment based on individual patient needs (Schwalm and Yusuf, 2011).This fear may not have been entirely borne out in medicine; however, in paramedic practice it could be argued that being subject to strict protocols such as those found in the national clinical guidelines give some credibility to the argument of 30 years ago. Clinical freedom may often be elusive for paramedics, but true evidence based practice does allow for freedom based on evidence.Evidence based practice is a means to improve clinical practice, where scientific literature (evidence) forms the basis for clinical decisions. It is not the intention that research results will be able to overtake professional skills or negate patient/client choice; quite the reverse, only by using clinical knowledge and listening to patients or clients can Paramedics use research results appropriately.

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