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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 transforme
 d by practitioners into what we have called  “knowledge-in-practice-in-c
 ontext”\; (b) this involves complex  social processes\, often within com
 munities of practice\; (c)  “contextually adroit” practitioners use kn
 owledge-in-practice-in-context  to meet practical needs that go far beyond
  just the technical (e.g.  clinical). They must encompass the many other c
 ompeting  demands and constraints that stem from their multiple roles\, (e
 .g.  managerial\, financial\, political) and therefore their  knowledge-in
 -practice-in-context must be flexible and multifaceted\,  relying not simp
 ly on clear-cut\, research-based guidance but instead  on what we have ter
 med “mindlines”\, internalised\, malleable\, tacit  guidelines\, which
  over a lifetime are continually developing and  collectively reinforced.
   We argue that a clear understanding of these  processes is essential fo
 r the implementation of effective  care.\nAndrée le May qualified in nurs
 ing at Chelsea  College\, University of London in 1982. After working in t
 he community  she was appointed as a Specialist Nurse for Research and Dev
 elopment at  West Middlesex University Hospital and became interested  in 
 how nurses used knowledge in practice.  This led to early research  on th
 e use of evidence.  Since then she has continued to work in this  area\, 
 publishing books on evidence-based practice\, the dissemination and  imple
 mentation of research and the use of communities  of practice for improvin
 g learning (Communities of Practice in Health  and Social Care: Wiley 2009
 ).  Before retiring from full-time work she  was Professor of Nursing at 
 Southampton University where she ran a  large\, pioneering doctoral progra
 mme in clinical  practice. \nJohn Gabbay is Emeritus Professor at the Uni
 versity  of Southampton. After qualifying in medicine in 1974 he worked at
  the  University of Cambridge on the historical and social origins of medi
 cal  knowledge.  As a public health physician in  the 1980s in Oxford and
  London he developed an interest in the  organisation and management of ac
 ute health services\, especially the  interface between medicine and manag
 ement\, and was involved in the  development and evaluation of clinical au
 dit.  From 1992  to 2004 he directed the Wessex Institute for Health R&D 
 including  from 1996 directing the National Coordinating Centre for Health
   Technology Assessment.  His main recent research has been on the social
   and organisational aspects of the way knowledge enters  clinical practic
 e and policy.\nTheir recent book\, Practice-based evidence for  health car
 e: clinical mindlines (Routledge 2011) is based chiefly on an  ethnography
  of primary care and challenges existing assumptions about  the way the cl
 inicians use knowledge in practice.  They are also co-authors (with Cathy 
 Pope and Glenn Robert) of  Organisational Innovation in Health Services Le
 ssons from the NHS  Treatment Centres (Policy Press 2011)\, which uses cas
 e studies to  critically examine how national policy was translated into n
 ew  local services.
URL:https://www.imperial.ac.uk/events/109673/clinical-mindlines-how-and-why
 -evidence-is-used-in-clinical-practice-2/
DTSTART;TZID=Europe/London:20121122T170000
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LOCATION:United Kingdom
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