Description/Overview: This symposium discusses and assesses the role of evidence-based practice (EBP) in nursing. It examines two critical approaches to EBP, and two approaches by EBP organizations to respond to identified weaknesses. The first critical approach to be addressed relates to the postmodernist assertion that EBP restricts the directions that knowledge development can take, resulting in ‘a system of exclusion of evidence that does not align with the dominant discourse’ (Holmes et al. 2006, p. 98). We argue that, while this argument is overstated, EBP does entail a restrictive hierarchy. The second critical approach is that of Fawcett et al. (2001), who argue that EBP entails a reduction of nursing knowledge to empirics, thus devaluing knowledge that is constituted by ethics, personal knowing and aesthetics. We argue that, while there is much merit to this criticism, one of the reasons for the dominance of empirics lies in the fact that this form of knowledge is discursively formulated and publicly verifiable. In order to compete with it, it is essential that other forms of nursing knowledge become similarly amenable to scrutiny. We examine two responses by EBP institutions to the accusation that they marginalize qualitative knowledge. First, we address the British Medical Research Council’s framework for research into complex healthcare interventions which advocates the inclusion of qualitative data as well as trials. Second, we examine the Cochrane Collaboration’s recent inclusion of qualitative research as appropriate subject matter for reviews. While commending these developments, we point to their partial and problematic nature. Fawcett, J., Watson, J., Neiman, B., Walker, P., Fitzpatrick, J., 2001. On nursing theories and evidence. Journal of Nursing Scholarship 33 (2), 115-119. Holmes, D., Perron, A., O’Byrne, P., 2006b Evidence, virulence, and the disappearance of nursing knowledge. Worldviews on Evidence-Based Nursing, Third Quarter, 95-102.

Learner Objective #1: The learner will be able to appreciate and assess critiques of evidence-based practice that have been posited by postmodernist critics and nursing theorists

Learner Objective #2: The learner will be able to appreciate and assess the responses that evidence-based practice institutions have made to criticisms of their approaches.