Postgraduate Course One or two things about Evidence-Based Management Pitstop Evidence-Based HR, VOV lerend netwerk, Gent, 27 september 2012

Postgraduate Course Evidence-Based Management? VOV leden, n= 86

Postgraduate Course Evidence-Based Practice 1991Medicine 1998Education 1999Social care, public policy 2000Nursing 2000Criminal justice ????Management?

Postgraduate Course Definition Evidence-based management means making decisions about the management of employees, teams or organizations through the conscientious, explicit and judicious use of four sources of information: 1. The best available scientific evidence 2. Organizational facts, metrics and characteristics 3. Stakeholders’ values and concerns 4. Practitioner expertise and judgment

Postgraduate Course Four sources

Postgraduate Course Four sources

Postgraduate Course Trust me: 20 years of management experience!

Postgraduate Course Bounded rationality

Postgraduate Course Bounded rationality

Postgraduate Course  Seeing order in randomness  Mental corner cutting  Misinterpretation of incomplete data  Halo effect  False consensus effect  Group think  Self serving bias  Sunk cost fallacy  Cognitive dissonance reduction  Confirmation bias  Authority bias  Small numbers fallacy  In-group bias  Recall bias  Anchoring bias  Inaccurate covariation detection  Distortions due to plausibility Het feilbare brein

Postgraduate Course if you’re hyperventilating breathe into a bag

Postgraduate Course elderly people who have an irregular heartbeat are much more likely to die of coronary disease give them a drug that reduces the number of irregular beats

Postgraduate Course How 40,000 cardiologists can be wrong In the early 1980s newly introduced anti- arrhythmic drugs were found to be highly successful at suppressing arrhythmias. Not until a RCT was performed was it realized that, although these drugs suppressed arrhythmias, they actually increased mortality. The CAST trial revealed Excess mortality of 56/1000. By the time the results of this trial were published, at least 100,000 such patients had been taking these drugs.

Postgraduate Course Errors and Biases of Human Judgment Doctors and managers hold many erroneous beliefs, not because they are ignorant or stupid, but because they seem to be the most sensible conclusion consistent with their own professional experience! available evidence.

Postgraduate Course  Half of what you learn will be shown to be either dead wrong or out-of-date within 7 years of your graduation; the trouble is that nobody can tell you which half  Sackett: remember that your teachers are full of crap, just like your parents. Problem II: false information

Postgraduate Course 1. Incompetent people benefit more from feedback than highly competent people. 2. Task conflict improves work group performance while relational conflict harms it. 3. Being intelligent is a disadvantage for performing low skilled jobs. Evidence-based?

Postgraduate Course Evidence-based?  Competentie management  Excellente zorg  Kwaliteits management  Het nieuwe werken  Kennis management  Magnet, Investors in People  Plain Tree, Healing Environment  Balanced Score Card / INK  Lean / Six Sigma / TOC

Postgraduate Course Think critically about experience, question your assumptions, and challenge what you think you know. Don’t be a parrot! (Show me the evidence!)

Postgraduate Course

1.Formulate a focused question 2.Searching for the best available evidence 3.Critical appraisal 4.Turning evidence into practice 5.Monitor the outcome 5-step approach

Postgraduate Course Step 3: Critical appraisal of studies

Postgraduate Course Best available evidence?

Postgraduate Course Research designs What is the BEST car?

Postgraduate Course Which design for which question? Research designs

Postgraduate Course Twee type vragen Effect vs Non-effect

Postgraduate Course Type vraag: effect Werkt het? Werkt het beter dan....? Heeft het een effect op....? Wat zijn de succesfactoren voor....? Wat is nodig om het te laten werken? Effect

Postgraduate Course Type: non-effect Needs:Wat hebben mensen nodig, waar hebben ze behoefte aan? Attitude:Wat denken of vinden mensen van...? Experience: Wat zijn de ervaringen van mensen met...? Prevalence:Hoeveel mensen / organisaties....? Procedure: Hoe kunnen we.... implementeren? Explanation:Waarom werkt het? Economics:Hoeveel kost het (tijd en geld)?

Postgraduate Course Explanation Which design for which question?

Postgraduate Course Best research design?

Postgraduate Course Best available?

Postgraduate Course Evidence is not the same as ‘proof’ or ‘hard facts’  Evidence is not the same as ‘proof’ or ‘hard facts’  Evidence can be - so strong that no one doubts its correctness, or - so weak that it is hardly convincing at all What is evidence?

Postgraduate Course The best available evidence = Studies with the highest internal validity Studies with the highest external validity

Postgraduate Course internal validity = indicates to what extent the results of the research may be biased and is thus a comment on the degree to which alternative explanations for the outcome found are possible ( confounding ). Internal validity

Postgraduate Course Confounding is the idea that a 3rd variable can distort or confuse (or confound..) a relationship between two other variables. For instance, when factor X causes disease Y, that relationship could be confounded by factor C that is associated with both factor X and disease Y. C would be an alternative explanation for the relationship observed between X and Y. Confounding

Postgraduate Course What are the confounders? 1.Shoe size & quality of handwriting 2.Body length & body weight 3.Number of storks & birth rate 4.Smoking youngsters & better lung function

Postgraduate Course ? Successful companies Charismatic leaders Reverse causation

Postgraduate Course Levels of internal validity 1.Were there enough subjects in the study? 2.Was a control group used? 3.Were the subjects randomly assigned? 4.Was a pretest used? 5.Was the study started prior to the intervention or event? 6.Was the outcome measured in an objective and reliable way? 6x yes = very high (A) 5x yes = high (A) 4-3x yes = limited (B) 2x yes = low (C) 1-0x yes = very low (D)

Postgraduate Course Levels of internal validity Levels of internal validity

Postgraduate Course Levels of internal validity Levels of internal validity It is shown that … It is likely that … Experts are of the opinion that … There are signs that …

Postgraduate Course Best available evidence: external validity

Postgraduate Course Ecological validity: Is your organization so different from those in the study that its results may be difficult to apply? Population validity: Is your population so different from those in the study that its results may be difficult to apply? External validity: generalizability Always ask yourself to what extent the evidence is generalizable to your situation:

Postgraduate Course Generalizability Generalizability Keep in mind: What works in one narrowly defined setting might not work in another, but some psychological principles are generalizable to all human beings. but some psychological principles are generalizable to all human beings.

Postgraduate Course Step 4: Turning evidence into practice

Postgraduate Course

Feasible?  organizational facts and characteristics  cultural aspects  stakeholders’ values and concerns  political aspects  financial aspects /cost-effectiveness / ROI  priorities  change readiness / resistance to change  implementation capacity  timing

Postgraduate Course Tot slot: Focus on the decision making process! (not the outcome)