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In Reply: We appreciate Dr Davis' suggestions for alternative classification schemes for the EBP evaluation instruments in our systematic review. We were not familiar with the Bloom taxonomy of objectives or the Kirkpatrick levels of evaluation. We disagree, however, with his assessment that our approach was overly simplistic. Our classification system, which deferred to 3 previously published conceptual frameworks for EBP evaluation,^1-3 discriminated among much more than just knowledge, skill, attitude, and behavior domains. For example, we divided the knowledge and skill domain into the 4 EBP steps of "ask," "acquire," "appraise," and "apply" and acknowledged 3 different levels of EBP behavior. Our detailed assessment of psychometric properties relied on a system endorsed by 3 major organizations involved in assessment.⁴

Our framework does mirror the Kirkpatrick hierarchy in its progression from "reaction" (the excluded satisfaction ratings) to "learning" (EBP knowledge and skills) to "behavior" (performance of EBP steps in practice) . . . [Full Text of this Article]

Terrence M. Shaneyfelt, MD, MPH
terry.shaneyfelt@med.va.gov
University of Alabama School of Medicine
Birmingham

Michael Green, MD
Yale University School of Medicine
New Haven, Conn

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RELATED LETTER

Evaluating Education in Evidence-Based Practice
James Davis
JAMA. 2007;297(1):39.
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