TY - JOUR T1 - Mindlines: making sense of evidence in practice JF - British Journal of General Practice JO - Br J Gen Pract SP - 402 LP - 403 DO - 10.3399/bjgp16X686221 VL - 66 IS - 649 AU - John Gabbay AU - Andrée le May Y1 - 2016/08/01 UR - http://bjgp.org/content/66/649/402.abstract N2 - Coffee-room chat may impact on evidence-based practice at least as much as all those guidelines that deluge GPs. If so, we need to understand better how and why that is, so that our informal conversations help rather than impede the spread of best practice.The pressure to comply with guidelines and evidence-based patient pathways has been rising inexorably, but so too has the feeling that the evidence-based medicine movement often misses the point.1 Its champions, who include many policymakers and managers as well as researchers, lament clinicians’ apparent slowness in implementing research evidence, while clinicians grumble that their hard-learned clinical judgement is undervalued by an overemphasis on conforming to guidelines. The struggle is not just about practice, but also professional autonomy and identity. Yet both sides of the argument recognise that best practice must be grounded in best evidence and that guidelines have their place. So what exactly is that place and how do we get from the linear rationalism of guidelines to the complex wisdom of good practice?Fifteen years ago we decided to examine such questions afresh by observing what actually happens when practitioners develop and use their clinical knowledge. We used the ethnographic methods of anthropologists, who while retaining some analytical distance immerse themselves among their chosen subjects to try to get an inside understanding of their beliefs and actions. Our subjects were deliberately selected as highly respected primary care teams, and our aim was to comprehend the complexities of their everyday practice, observing and analysing exactly how they put their knowledge into practice. We published our preliminary findings in 2004,2 but continued to gather data from our principal study site over the next 5 years3 while supplementing and exploring our … ER -