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SUMMARY:Clinical Mindlines: How and why evidence is used in clinical practi
 ce
DESCRIPTION:Based on our recently published ethnography of primary care we 
 will show how (a) knowledge from many sources is collectively transformed 
 by practitioners into what we have called “knowledge-in-practice-in-cont
 ext”\; (b) this involves complex social processes\, often within communi
 ties of practice\; (c) “contextually adroit” practitioners use knowled
 ge-in-practice-in-context to meet practical needs that go far beyond just 
 the technical (e.g. clinical). They must encompass the many other competin
 g demands and constraints that stem from their multiple roles\, (e.g. mana
 gerial\, financial\, political) and therefore their knowledge-in-practice-
 in-context must be flexible and multifaceted\, relying not simply on clear
 -cut\, research-based guidance but instead on what we have termed “mindl
 ines”\, internalised\, malleable\, tacit guidelines\, which over a lifet
 ime are continually developing and collectively reinforced.  We argue tha
 t a clear understanding of these processes is essential for the implementa
 tion of effective care.\nAndrée le May qualified in nursing at Chelsea Co
 llege\, University of London in 1982. After working in the community she w
 as appointed as a Specialist Nurse for Research and Development at West Mi
 ddlesex University Hospital and became interested in how nurses used knowl
 edge in practice.  This led to early research on the use of evidence.  S
 ince then she has continued to work in this area\, publishing books on evi
 dence-based practice\, the dissemination and implementation of research an
 d the use of communities of practice for improving learning (Communities o
 f Practice in Health and Social Care: Wiley 2009).  Before retiring from 
 full-time work she was Professor of Nursing at Southampton University wher
 e she ran a large\, pioneering doctoral programme in clinical practice. \
 nJohn Gabbay is Emeritus Professor at the University of Southampton. After
  qualifying in medicine in 1974 he worked at the University of Cambridge o
 n the historical and social origins of medical knowledge.  As a public he
 alth physician in the 1980s in Oxford and London he developed an interest 
 in the organisation and management of acute health services\, especially t
 he interface between medicine and management\, and was involved in the dev
 elopment and evaluation of clinical audit.  From 1992 to 2004 he directed
  the Wessex Institute for Health R&D including from 1996 directing the Nat
 ional Coordinating Centre for Health Technology Assessment.  His main rec
 ent research has been on the social and organisational aspects of the way 
 knowledge enters clinical practice and policy.\nTheir recent book\, Practi
 ce-based evidence for health care: clinical mindlines (Routledge 2011) is 
 based chiefly on an ethnography of primary care and challenges existing as
 sumptions about the way the clinicians use knowledge in practice. They are
  also co-authors (with Cathy Pope and Glenn Robert) of Organisational Inno
 vation in Health Services Lessons from the NHS Treatment Centres (Policy P
 ress 2011)\, which uses case studies to critically examine how national po
 licy was translated into new local services.
URL:https://www.imperial.ac.uk/events/109510/clinical-mindlines-how-and-why
 -evidence-is-used-in-clinical-practice/
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LOCATION:United Kingdom
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