Evidence Based Practice

Reality is vast.  Yet, action requires knowledge.  So over time, we have created systems of practice and knowledge by which we can understanding reality and effectively do something.  Clearly, then, the way in which minds are training within systems, and the relationship between knowledge and practice, is crucial.


Medicine is one such system of practice and knowledge that has an associated educational process.  There have been many criticisms leveled against medical education, to varying degrees of validity.  However, arguably the most damaging outcome of the current medical education system is a certain biased way of thinking: that practices are determined by theoretical pathophysiological reasoning more so than adopted from evidence garnered from the field.


There is a certain receptor found in heart cells, a beta-receptor, that increases the speed and strength of the heart’s pump.  “Beta-blockers”, they are called, a class of medicine that blocks the workings of this receptor, was frequently used, logically so, for patients with high blood pressure.  And when a patient has heart failure – ie, the speed and strength of the heart’s pump is no longer adequate enough – it seemed, from knowledge gained through pathophysiological reasoning, the worst possible practice to administer a beta-blocker.  Yet, over the last few decades, the system of medicine has learned, through evidence, that the opposite is true: beta-blockers are first-line medicines for heart failure and generally fourth-line at best for high blood pressure.  And I’m not quite sure why (probably because I didn’t pay enough attention in medical school).  But, ironically, that might be a good thing – reasoning through the basic science of the cardiac system leads to an ineffective practice.  Knowledge of experiential evidence leads to an effective practice.


Now, this doesn’t mean that theoretical knowledge isn’t important; in fact, conceptual understanding contributes to an agility of mind that can use creativity to solve difficult problems and explore reality to contribute to systems of knowledge.  Yet the theoretical must be moderated by the practical.  If too much emphasis is given on theoretical reasoning (as in the case with the training of physicians in medical education), it results in arrogance, extreme individualism, lack of standardization, and stagnation.  When there is too much emphasis on training in technique without conceptual understanding (as in the case with the vast majority of educational programs), the result is passivity, blind obedience to protocol, lack of creativity, and, again, stagnation.  It seems the only way to progress forward is to understand how to move between conceptual and practical in a healthy way.


Analogous to scientific systems of knowledge and practice (like medicine), there is religion, a system that seeks to gain knowledge about the Word of God and spiritual dynamics in order to put it into practice into individual and social progress.  Again, the same insights can apply.  It’s true that the Revelation has transformative effects on both individual hearts and society as a whole.  Yet the practice – ie, the interaction with the Word of God – is something that cannot be reasoned through by simply reading the Writings and coming to conclusions; for 10 people will have 10 interpretations, just like 10 medical students will have 10 preferences of which blood pressure med to start with.  And the question is not “does blood pressure medicine work?”, just like the question is never “does interaction with the Word of God lead to transformation?”; obviously the answer to both is “yes”.  Rather, a good scientist will put the question of “what kind of interaction with the Word of God” to the field of experience, in the same way that a good physician will survey two decades of actual patient experiences to try to learn “what kind of blood pressure medicine?”.


Enter the Ruhi Institute.  Of the many, many, curricula that were developed over the years, each fostering a certain kind of interaction with the Word of God, it proved through experience to be the most effective.  And probably because it wasn’t the brainchild of a group of people who worked very hard and very sincerely to come up with a set of courses based on their theoretical understanding; rather it emerged from decades of practical experience trying to learn about effective methods.  Its system of knowledge and practice is based on evidence.  So maybe we don’t exactly know why it works, but we know it does.  And that a practice works is great foundation place to start to gain knowledge, to learn more about reality, answering the “why” questions.


At the end of the day, reality is vast.  It is presumptuous to think we can reason through it and then determine best actions.  Rather, let proven practice guide our quest for knowledge.  We know beta-blockers are effective treatments for heart failure – given this, what, now, can we learn about the relationship between myocardial contractility and neurocardiac receptor feedback?  We know that the Ruhi Institute’s sequence of courses effectively fosters individual and collective transformation – given this, what, now, can we learn about the elements of interaction with the Word of God and the spiritual dynamics of the environment within which it takes place?


As we build a conceptual understanding from effective and rich practices and experiences at the grassroots, we learn to exercise moderation and avoid extremes.  We avoid arrogance and passivity and instead become active protagonists with a humble posture of learning; we avoid blind obedience and extreme individualism and instead become empowered through cooperative action towards collective betterment; we purposely exert creativity within fruitful areas of inquiry; and, as is the pattern since humanity’s birth, learning propels progress.