Evidence-Based Practice: Implications for Social Work Education Fall Faculty Development Workshop University of Utah College of Social Work November 13. 2006

What is “Evidence-Based Practice” (EBP)? Originated with “Evidence-Based Medicine” (Sackett, Richardson, Rosenberg, & Haynes, 1997; Sackett, Straus,Richardson, Rosenberg, & Haynes, 2000) Now “the buzz” in social work education (e.g., Conference sponsored by University of Texas at Austin School of Social Work last month on “Improving the Teaching of Evidence-Based Practice”) Model is commonly misunderstood and misinterpreted within Social Work. There is still much disagreement even among proponents as to what the term means.

What is EBP not? Based only on randomized controlled trials, which are rare in social work. Based only on scientific evidence. The same as “Empirically-oriented Practice.” The same as the “Scientist/Practitioner Model.” The same as “Best Practices.” The same as “Eminence-based Practice.”

Eminence-Based Practice

What is the Model as commonly conceptualized? Converting information needs into a well-formulated answerable question. Tracking down with maximum efficiency the best evidence with which to answer the question. Critically appraising the evidence for its validity and usefulness. Applying the results of this evidence appraisal to policy/practice. Evaluating performance. From: Gibbs, L. E. (2003). Evidence-based practice for the helping professions: A practical guide with integrated multimedia. Pacific Grove, CA: Thomson/Brooks/Cole. Pp. 8-9.

“Evidence-based Practice” is really “Evidence-informed Practice.” Social work ethics and the EBP model calls for shared decision-making with client, taking into account their wishes, preferences, and values. Intervention is constrained by agency and social policy. Social workers must practice within their competencies.

Evidence-Informed Practice Model

How is it being integrated into Social Work Education here at the CSW? Research Sequence: First course focuses on the EBP process, and teaches students how to consume social work-relevant research. We hope to change the second year research curriculum to have them apply the process to domain-relevant questions in the first semester and then learn to evaluate the effectiveness of their efforts in the second semester. We’re still considering our options!

How is it being integrated into Social Work Education here in Utah? Practice Sequence: First year curriculum integrates evidence related to practice interventions at every opportunity. Second year sequence, within domains, is starting to integrate evidence content more consistently Policy Sequence: Students are taught to examine evidence relevant to social policies. Other Sequences are still being developed!

Why did I ask to come here today? The campus faculty depend on the practicum faculty to help reinforce the importance of critical thinking and sound evidence-informed practice procedures. The practicum faculty are usually more knowledgeable than the campus faculty about which questions are important to address. We want to work collaboratively with field instructors to improve social work education. We need your help!

Deconstructing EBP: Asking well-formed questions “converting information needs related to practice decisions into well-structured answerable questions; Students bring questions from the field into class and learn to develop well-formed questions from which they can derive keywords for their evidence searches (COPES)

Deconstructing EBP: Finding the evidence tracking down with maximum efficiency, the best evidence with which to answer them, Students are taught to select keywords based on their questions, make use of MOLES (methodological locators) to find the best evidence available, and to use the University of Utah indexes and databases to quickly locate evidence relevant to their questions. Gibb’s website provides helpful suggestions: (http://www.evidence.brookscole.com/)

Deconstructing EBP: Selecting the best evidence available critically appraising that evidence for its validity, impact (size of effect) and applicability (usefulness in practice) Students are taught to utilize basic criteria of sound science to appraise the articles that they find. Some tools are publicly available from Bandolier (http://www.jr2.ox.ac.uk/Bandolier/learnzone.html)

Deconstructing EBP: Applying the evidence to practice and policy decisions applying the results of this appraisal to practice-policy decisions. This involves deciding whether evidence found (if any) applies to the decision at hand (e. g., is a client similar to those studied? Is there access to services described?) and considering client values and preferences in making decisions as well as other application concerns Students learn about evidence-based practices in their practice classes and in the practicum.

Deconstructing EBP: Evaluating the effectiveness of evidence-informed interventions evaluating our effectiveness and efficiency in carrying out steps 1-4 and seeking ways to improve them in the future (Sackett, et al., 2000, pp. 3-4, cited in Gambrill, 2006). Students can apply the tools learned in the research sequence about clinical and program evaluation within their practicum settings.

Why are our partners in practicum settings so critical to teaching EBP? Students prefer learning a “hands on approach” that is not possible in classrooms. Students look to their field instructors and then their supervisors as models of good practice. We need to assure that the curriculum content on EBP is relevant to today’s practice, agencies, and clients. Only the world of practice can inform us.

What are next steps? Ongoing development of BSW and MSW curricula to reflect the College of Social Work’s commitment to infusing evidence-based content. Working with our practicum agency partners to adapt evidence-informed practice models to their settings. Developing practicum experiences which will allow students to practice what they learn about evidence-informed practice in the classroom within their field placements.

What are some EBP resources? Gibbs Text (Gibbs, L. (2003). Evidence-based practice for the helping professions: A practical guide with integrated multimedia. Pacific Grove, CA: Brooks/Cole-Thomson Learning.) Len Gibbs’ website (http://www.evidence.brookscole.com/) The University of Utah Library databases (http://db1-sql.staff.library.utah.edu/databaseOfDatabase/) The Cochrane Collaboration (http://www.cochrane.org) The Campbell Collaboration (http://www.campbellcollaboration.org)

Want to help? Want to learn more? Please contact me! Jo Yaffe, PhD, ACSW Joanne.yaffe@socwk.utah.edu (801) 581-4829

Thank you!! Comments? Questions?