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INTRODUCTION
Evidence-based practice, a movement toward an increased assimilation of newly generated research evidence into direct patient care delivery, has been underway in the health care sector for over two decades. Beginning with the medical profession (physicians), it has now taken hold in the discourse of other health professions and has become a prominent mode of thought in many nursing circles. The implementation of evidence-based practice in nursing is not, however, without its resisters and critics. By considering the historical context of nursing practice, including evidence-based nursing practice, and examining the content of key publications on this topic, it is possible to uncover the assumptions that form the basis for the push toward an increased use of research in practice. When taken-for-granted, these assumptions support the continuing dominance of the evidence-based practice discourse. Feminist/post-structuralist theory offers a perspective from which to challenge these assumptions and question the appropriateness of evidence-based practice in the goals of nursing.
THE RISE OF EVIDENCE-BASED NURSING PRACTICE
For those who follow the historical development of nursing as a profession, it will not come as a surprise to know that the evidence-based nursing practice movement has arisen out of an increasing focus on research utilization in the medical profession. Foucault (1980) suggests that, in understanding how power, knowledge, and subjects are viewed, it is useful to develop a genealogy, which is a tracing of a historical context, a return to the past to understand the present. In its early history, nursing enjoyed a distinctive role and autonomy and independence from medicine. Although the professional distinction between nursing and medicine allowed nurses to contribute to health care in a unique way, this distinction was criticized because it perpetuated traditional perspectives on the role of women. In an effort to distance nursing from 'women's work', nursing leaders in the early part of the 20th century sought to formalize nursing education (Boutilier, 1994). Ironically, however, with the advent of hospital-based training programmes for nursing, nursing education came under the control of physicians. Nurses were taught 'complete subordination... absolute loyalty and unquestioning obedience to physicians' (Coburn, 1988, pp. 443-444). Today, nurses have been able to regain limited recognition for their professional distinctiveness. Strategies to accomplish this have taken two paths: legitimation by affiliation with medical...