Letter

Process Versus Outcomes in Evidence-Based Practices

To the Editor: The article "Transformational and Transactional Leadership: Association With Attitudes Toward Evidence-Based Practice" ( 1 ) in the August issue correctly focuses on the supervisory relationship in supporting change in clinical practice. However, the clinician's interest will ultimately be in utility of method, not a scripted "evidence-based practice." To the extent that leadership is viewed by practitioners as supporting outcomes over process, their input will be valued. Evidence-based practices have a role and can be important tools in achieving effective outcomes, but they may also become an impediment to ongoing improvement in care if they are seen as ends in themselves.

The process should not become more important than the product. There may indeed be a better mousetrap out there. Too much emphasis on "fidelity to the model" tends to obscure the fact that in the final analysis it is outcomes that should be measured, not the means to reaching them.