Abstract
Practitioners face three challenges in delivering evidence-based practice: limitations in the evidence available to guide routine clinical decisions; limitations in clinical judgment that are hard to remedy with typical work routines; and the practical difficulties of training and sustaining the breadth of skills relevant to meet diverse patient needs in a generalist practice. We recommend designing practice environments that support development of excellent clinical judgment with use of standardized work routines that help detect relationships between clinical decisions, interventions, and patient outcomes. We describe examples illustrating how technology can support training and supervision within this framework.
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