Explain the difference between internal and external evidence. Then: How can each of these types of evidence be utilized for quality improvement in the clinical setting?

Explain the difference between internal and external evidence. Then: How can each of these types of evidence be utilized for quality improvement in the clinical setting?

The definition of evidence-based practice (EBP) has evolved over the years. I admit I was using the previous definition of “conscientious use of current best evidence in making decisions about patient care” (Melnyk & Fineout-Overhold, 2015). In the older model, internal evidence was clinician experience and external evidences is the best available research. Patient values were not included as evidence, which has since been proven to be an invaluable source of evidence that shapes clinical decision. McKeon & Medina McKeon (2020) modified the model: Internal evidence – clinician expertise External evidence – best available research + patient values + many other sources. The source I just referenced has helpful tips and examples for asking questions relating to internal and external evidence in epidemiology, etiology, diagnosis, prognosis, and therapy. These questions directly relate to how we use these evidences in patient encounters. To make a clinical decision, clinicians use their experience, research-based evidence, and individual patient factors into account. EBP requires us all to be capable and life-long learners (McKeon & Medina McKeon, 2020; Rohwer et al., 2017)