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Evidence%20Based%20Practice

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Evidence Based Practice Lecturer Foluke Blackburn * * Parton (2000) says it is perhaps the relationship between theory and practice that lies at the heart of social ... – PowerPoint PPT presentation

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Title: Evidence%20Based%20Practice


1
Evidence Based Practice
  • Lecturer Foluke Blackburn

2
The overall aim of this session is to Emphasise
the essential role of Evidence Based Practice in
making decisions about the welfare of people in
need of services
  • By the end of the session you should be able to
  • Define Evidence Based Practice
  • Examine the components which contribute to EBP
  • Explore the use / lack of use of EBP by
    practitioners

3
  • What is evidence based practice

EBP
4
Evidence based practice
  • (EBP) is an approach which tries to specify the
    way in which professionals or other
    decision-makers should make decisions by
    identifying such evidence that there may be for a
    practice, and rating it according to how
    scientifically sound it may be. Its goal is to
    eliminate unsound or excessively risky practices
    in favour of those that have better outcomes.

5
Evidence Based Practice
  • EBP uses various methods (e.g. carefully
    summarizing research, putting out accessible
    research summaries, educating professionals in
    how to understand and apply research findings) to
    encourage, and in some instances to force,
    professionals and other decision-makers to pay
    more attention to evidence that can inform their
    decision-making.

http//en.wikipedia.org/wiki/Evidence_based_practi
ce
6
Evidence Based Practice
  • Evidence Based Practice is the conscientious,
    explicit and judicious use of current best
    evidence in making decisions regarding the
    welfare of those in need of services
  • (Sackett et al 1996).

7
Evidence Based Practice
When Sackett writes of evidence-use as being
conscientious, judicious and explicit this
appears to entail three kinds of claim A moral
claim - conscientious suggests done according
to conscience as a moral duty. A wisdom claim.
Judicious suggests sound judgement, and is a
mark of practical wisdom and discretion. A claim
to transparency and openness. Explicit appears
to have the sense of leaving nothing merely
implied.
Ian Shaw University of York 2004
8
Evidence Based Practice
  • Macdonald says that evidence based practice
    represents an approach to decision-making which
    is transparent, accountable, and based on a
    consideration of current best evidence about the
    effects of particular interventions on the
    welfare of individuals, groups and communities
    (Macdonald, 2000b 123).

9
Current Best Evidence
  • Theories / Methods /Models
  • Research
  • Studies on the effectiveness of particular
    interventions
  • Legislation / policies
  • Experience

10
  • Mullen 2004 for the most part social work
    practitioners are not engaged in evidence based
    practice
  • Kirk and Reid 2002 EBP remains on the cultural
    margins, struggling for a voice and
  • following
  • Go back over the last few slides and revisit
    your definition.
  • Why is it that not all social workers use current
    best evidence in their practice?

11
Why dont all practitioners use EBP
  • General lack of awareness of available evidence
    based practices and the difficulty in processing
    or understanding identified research
  • How to best access, evaluate, and translate
    evidence (Anderson, Cosby, Swan, Moore,
    Broekhoven, 1999 Mullen Bacon, In press).
  • Misunderstanding of what constitutes an evidence
    based practice such as (Gibbs Gambrill, 2002)
  • Were already using evidence
  • Its a matter of opinion
  • There is no evidence

12
Why dont all practitioners use EBP
  • Basic distrust for evidence, based on objections
    related to political, ethical, or control issues
  • Politically motivated, guided by efficiency,
    researcher preferences, or simply a cost-cutting
    tool (something other than clients best
    interest)
  • Devalues the practitioners professional judgment
    or clients preferences
  • Trendy, more about research reputations, and
    malleable evidence
  • (Gibbs Gambrill, 2002 Mullen Bacon, 2003)

13
Why dont all practitioners use EBP
  • Evidence or research that is available or
    accessible is not often particularly helpful
  • Cookbook/stilted approaches
  • Overly broad
  • Ignores contextual or cultural issues
  • Not realistic in practice
  • Mismatch with current policy and technology
  • The culture of knowledge transmission within
    social work has been historically unsupportive of
    the use of research evidence in practice
  • (Barratt, 2003 Anderson, Cosby, Swan, Moore,
    Broekhoven, 1999 Gibbs Gambrill, 2002 ).

14
Practice under the spot light
  • Go through the reasons previously stated and
    discuss with someone which of these might apply
    to you.
  • What are the benefits of using EBP?

15
What are the strengths and benefits of Evidence
based Practice?
  • Accountability to service users, employers and
    funding agencies
  • - Service users preferred. SW who appeared
    clear about what they were doing and why they
    were doing it , and be able to explain the
    assumptions underpinning their work (Howe 1987,
    Munro 1998)
  • - New managerial reforms focus on efficiency
    and effectiveness ( Taylor and White 2000)
  • - Provides a safety net
  • Framework for action
  • -By understanding a broad range of
    theoretical frameworks, we are in a good position
    to develop practice strategies (Healy 2005)
  • Builds on experience and expertise
  • Improving quality services

16
What are the strengths and benefits of Evidence
based Practice?
  • Argument for resources
  • Can Change legislation
  • Raises public awareness
  • Allows one to anticipate and plan
  • With out it social workers would be forced to
    invent social work from scratch every time they
    started work with a new client (Healy 2005)
  • Ethical
  • ethical duty to offer the most effective help
    (Trinder 2000)
  • Improves the profile (and Status)of the
    profession
  • A profession has
  • a) Series of indispensible features
  • b) Being founded on a mission of service
  • c) The use of specialist and definable body of
    knowledge and set of skills
  • d) Regulation of entry to the professional group
    by a professional body (Fooke 2006)

17
Evidence Based practitioners
  • Make a conscious effort to keep a breast of
    research and the implications for social work
    practice.
  • Study the effectiveness of particular
    interventions.
  • Openly reviews options with service users based
    upon a thorough assessment and understanding of
    what is known to be effective in similar
    situations.
  • Are aware of the evidence base that underpins
    their practice
  • Seeks to identify and understand assumptions
    which influence the evidence and their practice
  • Critically reflect on their own practice to
    identify what is effective

18
Integration Skills What Needs Integrating?
Haynes, Devereaux, and Guyatt, 2002
19
Evidence Based Practice
  • What do we understand by these terms as
    associated with social work
  • Theory
  • Research
  • Model
  • Method
  • Values
  • Identify an example for each of these terms

20
Theory
A theory is a group of related concepts
hypothesis, and constructs based on facts and
observations, it attempts to explain a particular
phenomenon. Theories provide workable
definitions of the world about us. According to
Howe (1997), a clear theoretical perspective
guides and influences practice in five key areas
21
  • Read Paragraph
  • What are the issues here?
  • Theories do not stand in isolation many are
    underpinned or influenced by various assumptions.
  • Psychologically based social work theories locate
    the cause of the distress and its solution in the
    client
  • Sociological theories suggest that society causes
    problems for people and that society should be
    targeted for change
  • P Green from the University of Glasgow provides a
    useful framework for analysis of Theory. (seminar
    groups will look at this further)

22
Theory
  • Observation it tells us what to see, what to
    look out for
  • Description it provides a conceptual vocabulary
    and framework within which observations can be
    arranged and organised.
  • Explanation it suggests how different
    observations might be linked and connected it
    offers possible causal relationships between one
    event and another
  • Prediction it indicates what might happen next
  • Intervention it suggests things to do to bring
    about change
  • (Howe 1997)

23
Research
  • Research is seeking through methodological
    processes to add to ones own body of knowledge
    and hopefully to that of others, by the discovery
    of non trivial facts and insights (Howard,K.and
    Sharpe,J 1983)
  • Research is a systematic way of asking questions,
    a systematic method of enquiry. It is a process
    of discovery, a way of enhancing your existing
    knowledge. It involves

24
Methods of research
  • Quantitative
  • Qualitative
  • Action
  • Case Studies
  • Ethnographic
  • Narrative analysis

25
Research
  • Consider Table 1 or 2
  • What does this tell us?
  • What should we be careful of?
  • How should we/not use this information?
  • Always question research (see handouts).

26
Models
  • A model defines, describes and imposes an order
    on what might otherwise be a jumble of
    information. It provides structure, offering
    principles and patterns which help our
    understanding and retention of a vast amount of
    information (Payne 1997)

27
(www.changecycle.com/changecycle.htm
28
Models
  • How would you critique this model?

29
http//www.stevenmsmith.com/my-articles/article/th
e-satir-change-model.html
30
Methods
  • Forms of practice, the way in which activities
    are undertaken, the approach.
  • These are often based on theory and or research
    (it may embrace 2 or 3 of these).
  • The method may follow a particular model or may
    be influenced by different perspectives, values,
    legislation policy and guidance.
  • When asked to discuss social work methods, we
    refer to formal methods as identified in the
    literature

31
(No Transcript)
32
Integration

Values and Beliefs
Values and Beliefs
Haynes, Devereaux, and Guyatt, 2002
33
Values and beliefs
  • Social Worker values and beliefs that will
    influence choice of theories methods
  • attitudes towards
  • Age
  • Loss
  • retirement
  • bereavement
  • abuse
  • Gender
  • Health and wellbeing
  • holistic (social issues)
  • influence of medical model
  • Risk assessment
  • Importance of protecting client from risk
  • Importance of respecting clients wishes and
    seeking to minimise risk
  • Clients right to self determination
  • the right to decide what constitutes acceptable
    quality of life
  • the right to a view on whats best for him that
    clashes with his family
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