“…Thus, despite an increasingly vocal EBM movement, there is still the need for more direct evidence of both its benefits, the kind of evidence that is used in practice and the role of educational engagement and attainment in this. A number of writers also propose that EBM results in an 'evidential hierarchy' that not only favours certain kinds of 'research evidence' (randomised control trials and positivist, quantitative research paradigms), but which also results in less importance being given to other aspects of managerial decision-making, such as instinct, intuition and experience (Harrison, 1998;Marks, 2002;Learmonth and Harding, 2006;Rousseau, 2006;Arndt and Bigelow, 2007;Morrell, 2008;Reay et al, 2009;Hovmand and Gillespie, 2010). However, a more recent conceptualisation of EBM broadens the 'evidence base' from the originally narrower views of the more academic type of evidence sources to those including expertise and judgment, local context data, stakeholder opinion and ethical considerations:…”