Julie is a physiotherapist working in an inpatient rehabilitation centre specializing in musculoskeletal conditions. She is asked whether Mrs. Jones, her 79-year-old recently widowed patient with a...

Julie is a physiotherapist working in an inpatient rehabilitation centre specializing in musculoskeletal conditions. She is asked whether Mrs. Jones, her 79-year-old recently widowed patient with a new onset of falls, is a suitable candidate for an outpatient fallsprevention program offered in the community. Knowing that Mrs. Jones lives alone, that she has limited social support and is at risk for recurrent falls, Julie discusses the benefits of the program with Mrs. Jones and suggests that they look into transportation services. In this example, Julie is not formally searching for scientific research and not engaging in the ‘stepwise’ approach to EBP, nor is she appraising papers for their quality or relevance to Mrs. Jones'  situation. She is, however, drawing from her practice knowledge of the effectiveness of fall-prevention programs to help her in suggesting and promoting the program to her patient. Most importantly, her ‘clinical decision’ is very much influenced by her in-depth knowledge of the lived experience and situation that her patient finds herself in. She ‘knows’ that a recently widowed older adult with limited social support may isolate herself by fear of being a burden on her family or putting herself at greater risk for falling by venturing out of her home more often. Yet Mrs. Jones refuses to participate. Her decision to forego the fall-prevention program is further justified given her limited access to transportation services to the community centre where the program is being offered.