Monday

On using "evidence-based practice" as the lens for the new iteration of my course

Evidence-based practice is a jargony term that is bandied about by students, professors and social work practitioners alike - and we often mean something different by the term.  Some people think this means "research proves that this intervention works" and some people think it means "collecting data about your intervention to show whether it works" and some people, like me, embrace the idea that “evidence-based practice is a process of consideration.”

During the course of planning for and running this fall's SONAR FLC, I have also been working with our School of Social Work's field education department (each student has at least one internship as part of their graduate work) to think about how to bring our field work instructors under the same umbrella re: what EBP is...especially now that we will introduce this framework to our students.  We need to bridge the gap between academic experience/thinking and community-based social work practice...

We use this definition in our conversations "with the field":
 
Definition:  Evidence-based practice (EBP) is a process that can aid decision making based on the best scientific evidence. This is as opposed to operating from gut feelings, tradition, prior education, or even a 3 particular helping professional’s experience. Helping professionals (physicians, nurses, counselors, social workers, dentists, etc.) can use EBP to pose specific questions of vital significance to their clients/patients, then search electronically quickly and efficiently for the current best evidence to answer the specific question.  Evidence-based practice is possible now because of increased speed, accessibility, and utility of electronic access to evidence (assuming access to evidence, ability to interpret – and time to do this work).

Much of my understanding of EBP comes from Gibbs, who states that:  Evidence-based practice represents both an ideology and a method. The ideology springs from the ethical principle that clients deserve to be provided with the most effective interventions possible. The method of EBP is the way we go about finding and then implementing those interventions (see, e.g., manuals on EBP methods by Gibbs, 2003; Cournoyer, 2003; and Rubin, 2007).
 
Evidence-based practice represents the practitioner’s commitment to use all means possible to locate the best (most effective)evidence for any given problem at all points of planning and contacts with clients. This pursuit of the best knowledge includes extensive computer searches, as described in the following (Gibbs & Gambrill, 2002). Evidence-based practice is an enormous challenge to practitioners because the methods of locating the most effective interventions go beyond, or are more rigorous than, even those of empirically-based practice.

Points to go over with group:

-History of EBP and evidence-supported instruments/interventions in medical research vs. EBP is discussed in broader SW circles
-Gibbs’ steps method of considering evidence for use in practice as “evidence-based practice” as a process

Step 1. Develop A Question.

Step 2. Find the Evidence.

Step 3. Analyze the Evidence.

Step 4. Combine the Evidence with Your Understanding of the Client and Situation.

Step 5. Application to Practice. I

Step 6. Monitor and Evaluate Results.

-Here, there is a big discussion about the debate about qualitative vs. quantitative evidence

Discussion on challenges in the field re: implementation of an EBP process:

-The problem of accessing evidence and interpreting evidence (note: I think we should work towards getting access to library databases for field instructors and doing a refresher course on how to interpret evidence)
-The problem of time to do this work in the current agency environment
 
So, much of this overlaps with the new approach to the old course...and this is the basis for the lens/framework I will be using in the new course.





1 comment:

  1. I was just wondering if I could use your ven diagram in my presentation on EBP? Thanks

    ReplyDelete