Foundations of Evidence-Based Practice: From Sicily Statement to the CREATE Framework

This article examines the conceptual evolution of Evidence-Based Practice (EBP) as a foundational framework for decision-making across healthcare and leadership contexts. Drawing on seminal literature, the paper traces the development of EBP from the Sicily Statements (2005, 2011), which articulated a structured five-step evidence-based process, to the Classification Rubric for Evidence-Based Practice Assessment Tools in Education (CREATE) framework, designed to standardise the assessment of EBP competencies. The analysis situates Evidence-Based Health Care and Evidence-Based Medicine within a broader EBP paradigm, highlighting how EBP bridges macro-level policy and system design with micro-level clinical decision-making. In addition, the article synthesises key competency frameworks that emphasise leadership, interdisciplinary collaboration, shared decision-making, and continuous improvement as central to effective EBP implementation. Importantly, the discussion extends beyond clinical practice to consider the role of non-clinical executives in shaping evidence-informed policy, resource allocation, and organisational strategy. By integrating research evidence, professional expertise, and contextual considerations, the article positions Evidence-Based Practice as a unifying framework for informed, effective, and accountable leadership across healthcare systems.