This book is about current policies and political agendas that shape health care research. The authors critically examine evidence with reference to a range of issues such as efficiency and effectiveness, inequality and emotions. Shaping the Facts will assist the reader to: think critically about the ways in which evidence is constructed; assess a range of methodologies and tools for gathering evidence; review the influences of organisations and culture on evidence-based health care; and encourage reflection on the role of evidence in health care commissioning, managing, teaching and practice. The authors explore the relationship between research, knowledge and evidence and encourage the reader to seek different ways of 'seeing, thinking and knowing'. The book will interest a wide range of health care practitioners and students, including nurses, midwives and health visitors. It is highly recommended for final year diploma and degree students and those engaged in continuing professional development and post-graduate programmes. The book will include illustrative testimonies and exemplars of particular relevance to nurses, midwives and health visitors. These testimonies and exemplars will be compiled from literature and the authors' research. Different perspectives will be considered including the origins of effectiveness and efficiency in the NHS drawing on Archie Cochrane's classic text on the topic, randomized controlled trials, statistics, normalization and eugenics, qualitative approaches, eg narrative studies, autobiographical evidence, testimonies, participatory and action research, professional and lay perspectives. There will also be specific debate on methodologies and tools for generating evidence and the philosophies that drive them. The authors will also consider evidence-based teaching, the development of critical evaluation skills and strategies for practitioners to negotiate change in the current complex health care environment. Finally the authors will consider the broader issues of systems and organizational cultures that enhance or hinder the integration of evidence-based health care. Revan's classic studies on standards for morale and action learning will be drawn. Policies supporting the delivery of care will also be critically examined.