‘A local habitation and a name’: how narrative evidence‐based medicine transforms the translational research paradigm

Goyal, R. K.; Charon, Rita; Lekas, Helen‐Maria; Fullilove, Mindy T.; Devlin, Michael J.; Falzon, Louise; Wyer, Peter C.

doi:10.1111/j.1365-2753.2008.01077.x

Cited by 31 publications

(24 citation statements)

References 61 publications

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“…2 Narrative methods have also been used to nurture scientific manuscript penetration into medical practice as an evolving paradigm of translational medicine. 3 Educators are using personal illness storytelling to help medical students incorporate empathy into routine practice early in their careers. 4 Training health care professionals using humanistic storytelling to convey the individual impact of key medical decisions cultivates relationship-centered care delivery.…”

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confidence: 99%

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“…15 In addition, deimplementation of ineffective practice once dogma is established can take even longer than implementation of evidence-based behavior. 16,17 Evolving approaches to conduct pragmatic implementation research have led to proposals for a narrative approach to evidence-based medicine, 18,19 whereas others envision a more structured process that encompasses the setting, personnel, practice adaptation strategy, process, measures, resources, and outcomes. Implementation science affords one approach to simultaneously accelerate the integration of SDM into clinical practice and empirically study the process, effectiveness, unintended consequences, adaptability, and sustainability of SDM in the EM setting.…”

Section: Section 1: the Science And Strategies Upon Which To Build Dandimentioning

confidence: 99%

Dissemination and Implementation of Shared Decision Making Into Clinical Practice: A Research Agenda

Kanzaria

Booker‐Vaughns

Itakura

et al. 2016

Academic Emergency Medicine

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Shared decision making (SDM) is essential to advancing patient-centered care in emergency medicine. Despite many documented benefits of SDM, prior research has demonstrated persistently low levels of patient engagement by clinicians across many disciplines, including emergency medicine. An effective dissemination and implementation (D&I) framework could be used to alter the process of delivering care and to facilitate SDM in routine clinical emergency medicine practice. Here we outline a research and policy agenda to support the D&I strategy needed to integrate SDM into emergency care.

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“…It has been claimed that, in most journals in the clinical sciences literature, less than 1% of published journal papers are clinically relevant [6,7]. Doubts are being raised about a too singular reliance on traditional high-powered big- N randomised clinical research approaches, as well as systematic reviews based on such evidence, for the multi-factorial decision-making contexts of clinical practice [6-11]. …”

Section: Introductionmentioning

confidence: 99%

“…The developing science of ‘translational research’ for clinical practice and associated journals such as Implementation Science and Translational Research are part of a growing body of 21 st Century research literature on the evidence-practice divide [11]. ‘Translational science’ has taken a strong ‘laboratory bench to clinical bedside’ (‘T1’) focus, as well as ‘clinical research to clinical practice’ (‘T2’) focus [1,12,13].…”

Section: Introductionmentioning

confidence: 99%

The evidence-policy divide: a ‘critical computational linguistics’ approach to the language of 18 health agency CEOs from 9 countries

Bell

Seidel

2012

BMC Public Health

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BackgroundThere is an emerging body of literature suggesting that the evidence-practice divide in health policy is complex and multi-factorial but less is known about the processes by which health policy-makers use evidence and their views about the specific features of useful evidence. This study aimed to contribute to understandings of how the most influential health policy-makers view useful evidence, in ways that help explore and question how the evidence-policy divide is understood and what research might be supported to help overcome this divide.MethodsA purposeful sample of 18 national and state health agency CEOs from 9 countries was obtained. Participants were interviewed using open-ended questions that asked them to define specific features of useful evidence. The analysis involved two main approaches 1)quantitative mapping of interview transcripts using Bayesian-based computational linguistics software 2)qualitative critical discourse analysis to explore the nuances of language extracts so identified.ResultsThe decision-making, conclusions-oriented world of policy-making is constructed separately, but not exclusively, by policy-makers from the world of research. Research is not so much devalued by them as described as too technical— yet at the same time not methodologically complex enough to engage with localised policy-making contexts. It is not that policy-makers are negative about academics or universities, it is that they struggle to find complexity-oriented methodologies for understanding their stakeholder communities and improving systems. They did not describe themselves as having a more positive role in solving this challenge than academics.ConclusionsThese interviews do not support simplistic definitions of policy-makers and researchers as coming from two irreconcilable worlds. They suggest that qualitative and quantitative research is valued by policy-makers but that to be policy-relevant health research may need to focus on building complexity-oriented research methods for local community health and service development. Researchers may also need to better explain and develop the policy-relevance of large statistical generalisable research designs. Policy-makers and public health researchers wanting to serve local community needs may need to be more proactive about questioning whether the dominant definitions of research quality and the research funding levers that drive university research production are appropriately inclusive of excellence in such policy-relevant research.

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‘A local habitation and a name’: how narrative evidence‐based medicine transforms the translational research paradigm

Abstract: We offer innovative approaches to study, teach and improve the therapeutic intimacy and integrative effectiveness of the practitioner-patient relationship.

Cited by 31 publications

References 61 publications

Carpenter et al. Respond

Carpenter et al. Respond

Dissemination and Implementation of Shared Decision Making Into Clinical Practice: A Research Agenda

The evidence-policy divide: a ‘critical computational linguistics’ approach to the language of 18 health agency CEOs from 9 countries

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