Te Puawai
The over-arching theme in definitions of the systematic review is the notion that the review is a
form of research itself. Webb and Roe refer to the systematic review as “Pieces of research, which
aim to identify, appraise and summarise studies of relevance to a particular topic”.[16] Straus and
colleagues describe it as “A summary of the medical literature that uses explicit methods to
systematically, search, critically appraise, and synthesize the world literature on a specific
issue”.[17]
In any case, the prominence of the systematic review is buttressed by the similar prominence of
evidence-based practice in clinical practice and decision-making. Yet, Goodman[7] has pointed out
that there is an important tension between between efforts to make medicine more scientific and
remain true to “clinical judgement,” a tension which is present in nursing discussions of EBP. Many
have railed against the prominence that the tenets of evidence based practice have assumed in
nursing. Gary Rolfe, for one, has maintained that EBP is open to many of the criticisms that it
directs at other forms of knowledge generation. It lacks the “hard” evidence to support claims of its
validity that it requires of other forms of practice. Evidence based practice fails to meet its own
standards, “it is no more based on evidence than the forms of practice it seeks to replace” he
writes .[18 p85]
Others have pointed out that evidence-based practice is the fascist imposition of a empirical
project−a dominant ideology excluding alternative forms of knowledge.[19] The dominant hierarchy
privileges certain kinds of research, and particular positions. Morse[20] positions EBP as a politics
of ignorance—myopic and exclusionary—which uses Cochrane standards for evaluating funding
for all forms of research. It is a fine sieve which ends up funding drug trials by the powerful, and
relegating qualitative researchers unable to access funds, credibility, and importantly, power.
Many authors, including myself, have argued that EBP is a significant means for advancing nursing
knowledge, but not one which should be used to the exclusion of all others. I have used the
exampl R