Evidence, virulence, and the disappearance of nursing knowledge: A critique of the evidence-based dogma.
BACKGROUND
Within the domain of health care, the new discourse of evidence-based practice has appeared and gained momentum, giving rise to a plethora of correlates such as specialized scientific journals and best practice guidelines. Following the crowd, nursing has jumped onto this trend's bandwagon. Although some scholars and clinicians have tried to expand these notions, few have considered a deconstructive approach to do so.


METHODS
Drawing on the works of continental postmodern thinkers such as Baudrillard, Deleuze & Guattari, and Foucault, this paper critically examines the rise of the evidence-based nursing (EBN) movement in order to deconstruct the "taken-for-granted" assumption that EBN is in and of itself the favored path to the sound development of nursing knowledge.


CONCLUSIONS
We argue against the hierarchical differentiation of varied research approaches so as to allow diverse methodologies to guide research and ultimately practice. The status quo is challenged, where research agendas are currently dominated by one paradigm of knowledge development; that of post-positivism in which randomized control trials are portrayed as superior evidence. There is a hazard in excluding many other venues to build nursing knowledge and in oversimplifying the complexity of clinical nursing practice. Furthermore, we argue that this preferred path of knowledge development contradicts nursing academics' efforts to distance itself from the medical model of health care provision and research.
Holmes
Dave
D
School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada. dholmes@uottawa.ca
Perron
Amélie
A
O'Byrne
Patrick
P
D001291:Attitude of Health Personnel; D019985:Benchmarking / Q000458:organization & administration; D003220:Conflict, Psychological; D019317:Evidence-Based Medicine / Q000458:organization & administration*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D019359:Knowledge; D016294:Models, Nursing; D024802:Nurse's Role; D009736:Nursing Process; D015399:Nursing Research / Q000458:organization & administration*; D010687:Philosophy, Nursing; D011057:Politics; D033302:Postmodernism; D017410:Practice Guidelines as Topic; D016032:Randomized Controlled Trials as Topic; D012107:Research Design; D013850:Thinking