What is Praxis Med (Practical Medical Application)?

What is Praxis Med?

Praxis Med refers to the practical application of medical knowledge in clinical settings, focusing on improving physician performance and patient outcomes through evidence-based practice.

Understanding Praxis in Medicine

Praxis in medicine encompasses several key elements:

• Praxis involves the application of knowledge in practice to advance goals in healthcare and eliminate injustice and discrimination in care 1
• It represents the integration of theoretical knowledge with practical clinical skills, requiring coherent application of various patterns of knowing in nursing and medical practice 1
• The term "practice" in healthcare has dual meanings: both the clinical scope of work performed daily and the process of training through repeated exercises to improve skills 2

Evidence-Based Components of Praxis Med

Praxis Med is grounded in evidence-based medicine, which is defined as:

• The application of a rigorous scientific framework to patient care 3
• A systematic approach that combines clinical expertise with the best available research evidence 3
• The foundation for clinical practice guidelines, which are "systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific circumstances" 3

Continuing Medical Education (CME) as a Key Element

Praxis Med heavily relies on continuing medical education to maintain and improve clinical performance:

• CME is effective in improving physician application of knowledge, with multiple exposures and longer durations recommended to optimize educational outcomes 3
• The preponderance of evidence demonstrates improvement in physician application of knowledge with CME 3
• CME interventions are recommended to improve physician practice performance (Grade IC recommendation) 3
• More active forms of CME and those using multiple media formats, multiple instruction techniques, and multiple exposures show greater efficacy in changing practice behavior 3

Practical Application in Clinical Settings

Praxis Med emphasizes practical wisdom and application in real-world settings:

• Practical wisdom in medicine is considered a multidimensional virtue that is deliberative, goal-directed, context-sensitive, and integrated with ethics 4
• It requires the ability to apply knowledge in specific clinical contexts, adapting to the unique needs of each situation 4
• Praxis-based research networks combine knowledge generation with multistakeholder learning, experimentation, and application of practical knowledge 5
• The catalytic processes in praxis-based approaches involve cycles of action and reflection based on experience, observation, conceptualization, and experimentation 5

Implementation Strategies for Best Practices

Effective implementation of medical knowledge is central to Praxis Med:

• Various strategies are employed to encourage providers to bridge the science-practice gap, including educational approaches, practice audit and feedback, decision support approaches, incentives, and multifaceted interventions 3
• Clinical practice guidelines serve as important tools for standardizing selected aspects of medical care to ensure both high quality and cost-effectiveness 3
• Guidelines should be practical, address important clinical issues, and their strength should be graded to reflect the underlying uncertainty about the evidence 3
• Implementation strategies for practice guidelines require consideration of local factors and contexts that cannot be fully anticipated by guideline developers 3

Barriers and Facilitators to Praxis

Understanding what helps or hinders the practical application of medical knowledge is important:

• Desirable and humanistic attributes and effective provider-patient communication are facilitators of praxis 1
• Prejudice, occupational barriers, negative thoughts, and discriminatory beliefs are barriers to praxis in practice 1
• Clinical inertia (failure to initiate or intensify therapy when indicated) may reflect a lack of provider motivation to change practice behavior 3
• Effective primary care systems protect time for practice and learning, demonstrating "adaptive reserve" through action and reflection cycles, facilitative leadership, and a learning culture 2

Praxis Med ultimately represents the bridge between medical knowledge and its practical application in clinical settings, with the goal of improving patient care through evidence-based practice and continuous professional development.