Conference report: qualitative evidence-based practice.

An innovative and exciting conference took place recently at Coventry University in May 2000. This first Qualitative EvidenceBased Practice Conference brought together qualitative researchers and evidenced-based practitioners from throughout the United Kingdom and around the world. The conference emerged from two main motivations. The first was our realization that few places existed where those interested in qualitative evidencebased practice could share their ideas and their research. We were excited to learn from colleagues that many were doing qualitative research but disappointed about their struggles with gaining acceptance within the quantitative domain of evidence-based medicine. The second was a desire to begin to grapple with the possibilities for such research at a time when there is an increasing demand for occupational therapists to undertake such activities as quality assurance and outcome-based practice. The 3-day conference offered delegates the opportunity to explore the spectrum of qualitative research and to discuss the role of qualitative approaches in evidence-based practice. The conference was both multidisciplinary and multiprofessional in nature, with delegates from the fields of health and social care, higher education, management, and business studies. For us, the conference not only reflected an increasing interest in qualitative evidence-based practice, but also showed us that this kind of research has not yet received global acceptance. This lack of acceptance was evident from the many queries from conference participants before the conference about whether it was possible to have “qualitative evidence-based practice,” a debate many of us had at the conference. Yet one final reflection from an American delegate will always stand out: “Thank you for taking a risk and doing this conference; I feel I have just spent 3 days in a sweet shop!” What was fascinating about bringing together such an interdisciplinary mix were the ways in which complex issues about doing and managing qualitative research raised common issues and concerns across all fields. For example, many delegates raised concerns about the lack of acceptance and support for qualitative research, the struggles of data management and the insufficient funding for qualitative evidence-based practice. These concerns became apparent not only through a series of hands-on workshops, where delegates could explore and discuss the process of interpreting qualitative data and practice the skills of critically appraising qualitative research papers, but also through interesting discussions that emerged from the keynote speeches. Delegates heard keynote lectures from a number of eminent speakers. Professor Mike Bury, a sociologist from the University of London, argued that the current research emphasis on client or personal narratives can be seen to stem from changes in morbidity patterns, the expansion of information about disease and illness, and public debates about the effectiveness of medicine. He then presented three types of narrative form used in research: 1. contingent narratives that address beliefs about the origins of a disease, the causes of an illness episode, and the immediate effects of illness on everyday life; 2. moral narratives that provide accounts of changes relating to the interplay of the person (in terms of his or her identity), illness, and social identity; and 3. core narratives that reveal connections between a layperson’s experiences and deeper cultural levels of meaning attached to suffering and illness. Although we agreed with Bury’s concerns about using narrative analysis with caution (he had argued that narrative forms can be used simplistically and without rigor), to some extent we believed that occupational therapists were already effectively and sensibly using this approach in the context of clinical evaluation and intervention and as a research method. However, it seems that in occupational therapy this form of Maggi Savin-Baden, Clare Taylor