Conceptualizing clinical expertise in evidence-based practice: a narrative literature review with implications for clinical decision-making.

Abstract

Objective: This review aimed to explore clinical expertise within evidence-based practice (EBP) by examining contemporary definitions of clinical expertise, how it can be acquired and developed over time, and its role within EBP.

Methods: PubMed, Web of Science, and Scopus databases were searched for literature on clinical expertise published between January 2016 and August 2024. Titles and abstracts were screened for relevance. Full-text review was conducted for papers deemed potentially relevant.

Results: 23 articles were included in this review. Clinical expertise receives different treatments across literature. However, a commonality is that clinical expertise requires proficiency, skill, and clinical judgement that can be acquired only through clinical experience, collaboration, and hands-on clinical practice. Operating within Haynes' model of EBP, clinical expertise is central to integrating patient preferences and bridging the gap between standardized objective evidence and personalized care.

Conclusions: Clinical expertise represents the core of integrating EBP to inform clinical decision-making and is developed through experience and keeping current with research.

Author’s note: This paper is one of seven in a series exploring contemporary perspectives on the application of the evidence-based framework in chiropractic care. The Evidence Based Chiropractic Care (EBCC) initiative aims to support chiropractors in their delivery of optimal patient-centred care. We encourage readers to review all papers in the series.