Some commentators have the EBP practice of consisting of only four steps - Ask, Acquire, Appraise, Apply - see for example Part 2 of Del Mar, Glasziou, & Salisbury's Evidence-Based Practice Workbook (2007) - but most commentators add a fifth step of assess and/or audit.

This involves assessing/auditing the effectiveness and efficiency of the process and practice of evidence-based practice, identifying strengths and weaknesses and ways that it might be improved the next time.

Self-reflective questions that might be asked include:

• Did I ask a well-formulated clinical question?
• Did I consider the best sources of evidence for the type of clinical question?
• Have I searched the databases efficiently? 
• Did I use the hierarchy of evidence as my guide for the type of evidence that I should be searching for?
• Where possible, did I search for and use information that is higher up in the pyramid of levels of organisation of evidence (for example, syntheses, synopses, summaries and pre-appraised original studies)? 
• Am I integrating the critical appraisal into my clinical practice? 
• Can I clearly explain what the evidence means to my patients and involve them in shared decision making where appropriate?
• Am I proactively monitoring for newly emerging evidence in my field of practice? (Hoffman, Bennett, & Del Mar, 2013, p. 11)

Hoffmann, T., Bennett, S., & Del Mar, C. (2013). Evidence-based practice across the health professions (2nd ed.). Retrieved from ProQuest Ebook Central.

Salisbury, J., Del Mar, C., & Glasziou, P. (2007). Evidence-based practice workbook: Bridging the gap between health care research and practice (2nd ed.). Retrieved from ProQuest Ebook Central.

Library Guide

• Evidence-Based Practice: Step 5: Evaluation
  from Northern Territory Health - Library Services.

Website

• EBP Step 5
  from the International Centre for Allied Health Evidence, University of South Australia's EBP e-Learning Resource.