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[Video title animates reading, “The History of Evidence-Based Practice in Healthcare Part 2”]
[On-screen text: Catherine Quatman-Yates, PT, DPT, PhD, Associate Professor, Division of Physical Therapy]
Narrator: As the healthcare community began to acknowledge the importance of EBP, we started to see the development of a variety of tools designed to bridge the gap between research and practice. 
By the end of this video, we aim for you to be aware of the tools and solutions developed to support evidence-based practice. 
Evidence Identification tools such as PubMed and Cochrane Library became widely used, offering a repository of research articles from around the globe. 
Similarly, evidence critique tools such as those developed through the CASP (Critical Appraisal Skills Programme) and JBI, the Joanna Briggs Institute, helped healthcare professionals evaluate the reliability and relevance of research findings. 
Further, tools like evidence synthesis deliverables gave rise to systematic reviews, clinical practice guidelines, and Cochrane reviews. 
All these became significant in evidence-based practice. 
For instance, systematic reviews gather all empirical evidence that fits pre-specified eligibility criteria to answer a specific clinical question. It uses systematic methods to minimize bias, providing reliable findings to aid decision-making. 
Clinical practice guidelines, on the other hand, provide explicit recommendations for clinicians about potential care paths for clinical circumstances. 
They are typically derived through expert consideration of a synthesis of systematically reviewed literature and provide grading of the strength of the evidence to support a given clinical care recommendation. 
Let's consider a real-world example: the management of diabetes. 
Without EBP, a physician might rely solely on their experience, which can vary widely among physicians and may not be up to date with the latest research. 
However, with EBP, a physician can consult clinical practice guidelines that synthesize the latest research on diabetes management, ensuring the patient receives the most effective care. 
To support the development of these tools, funding mechanisms emerged. 
For example, the Agency for Healthcare Research and Quality, or AHRQ, was a notable early funder in this space. AHRQ funded the National Guideline Clearinghouse, a public resource for summaries of evidence-based clinical practice guidelines. 
Unfortunately, this clearinghouse has since closed down due to funding limitations. 
This has shown the importance of foresight in ensuring sustainable financial resources for maintaining such valuable resources. 
Other guideline resources have since emerged, but the need to secure funding and infrastructure to provide ongoing support for guideline updates will likely continue to be a challenge. 
As the number of clinical practice guidelines increase, the need for a standard to ensure their rigor and reliability became evident. 
In response, the Institute of Medicine, now the National Academy of Medicine, released a report in 2011: Clinical Practice Guidelines We Can Trust. 
This report outlines standards that demanded transparency, patient-centeredness, accuracy, and systematic methodology for developing best practices. 
From 1990 to 2011, we witnessed a concerted effort to support clinicians’ ability to integrate evidence into practice. 
Along with these tools, a push for rigor in defining best practices emerged, shaping the EBP landscape. 
However, the development of tools and guidelines did not instantly solve all challenges associated with the implementation of EBP. 
Despite having these resources, many clinicians and health systems found it difficult to adopt them due to various factors such as time constraints, lack of awareness or training and resistance to change. 
In our current healthcare landscape, EBP continues to be a critical component driving health care providers to deliver the most efficient, safest and most cost-effective care to patients. 
However, there's still room for improvement in the way EBP is integrated into daily practice and decision-making. 
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Narrator: Stay tuned for our next video where we will discuss the efforts to bridge the gap between knowledge and practice, known as knowledge translation, and explore the fields that have arisen to support the adoption of EBP.
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