Definitions of EBP Popular in SW.
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Definitions of EBP Popular in SW • Evidence-based practice is the integration of best research evidence with clinical expertise and patient values. Best research evidence refers to clinically relevant research, often from the basic health and medical sciences, but especially from patient-centered clinical research into the accuracy and precision of diagnostic tests (including the clinical examination); the power of prognostic markers; and the efficacy and safety of therapeutic, rehabilitative, and preventive regimens. Clinical expertise means the ability to use clinical skills and past experience to rapidly identify each patient’s unique health state and diagnosis, individual risks and benefits of potential interventions, and personal values and expectations. Patient values refers to the unique preferences, concerns, and expectations that each patient brings to a clinical encounter and that must be integrated into clinical decisions if they are to serve the patient. (Institute of Medicine 2000) • Evidence-based medicine has been defined as “--- the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients” (Sackett, et al., 1996, p. 71); and the "integration of best research evidence with clinical expertise and patient values" (Sackett, Straus, Richardson, Rosenberg, & Haynes, 2000, p. 1).
Social Work Specific EBP Definitions • Placing the client’s benefits first, evidence-based practitioners adopt a process of lifelong learning that involves continually posing specific questions of direct practical importance to clients, searching objectively and efficiently for the current best evidence relative to each question, and taking appropriate action guided by evidence. (Leonard Gibbs)
Columbia University Working EBP Definition • Model of life-long learning, collaboration & accountability using question-guided decision-making, critically appraising & integrating client values, social work expertise, & current research evidence. • Client Values (individual, family, group, organization, community) • Preferences, concerns, expectations • Goals & preferred course of action • Cultural, spiritual, community norms & values • Collective ideas about change & values • Perceived barriers • Expertise • Practice wisdom • Experience • Agency culture, values, practices & procedures • Professional code of ethics • Professional use of self • Relationship skills & boundary setting • Assessment & intervention skills • Research Evidence - Qualitative & Quantitative • Descriptions of client strengths & risks • Engagement • Assessment • Prevention • Treatment • Identifying barriers to EBP
Current Activities • Campbell /Cochrane Collaboration • Society for Social Work & Research • Institute for the Advancement of Social Work Research • EBP Project • 2006 National Symposium: Improving the Teaching of Evidence-Based Practice - University of Texas at Austin School of Social Work • NIMH Partnerships to Integrate Evidence Based Mental Health Practices into Social Work Education & Research April 2007 • Small Business Innovative Research (SBIR) contract announcement to support development of multi-media tools & strategies to train social workers in evidence-based practices &/or psychotherapies – July 2007 • Rapid Inclusion in Curricula & Conferences • Brown School of Social Work, Washington University • Now many schools moving toward EBP • EBP tracks in major national conferences • Publications • Journal • Texts • CD-ROM & web-based EBP resources • DANYA International, Inc SBIR - NIMH
Challenges Facing EBSW • Evidence-of-effectiveness • Authority • Conflicting hierarchy • Definition of evidence • Shortage of evidence • Variation by field of practice • Inflation of evidence • Small & transient effects • Assessment validity • Nomothetic versus ideographic knowledge • Efficacy versus effectiveness • Diffusion, adoption and implementation • Policy & system level issues • Training & sustaining
Implementation Challenge: Many Practitioners & Schools • Over 70% of mental health personnel social workers • 457 Baccalaureate Programs • 179 Masters Programs • 74 Doctoral Programs • Accreditation Educational Policy • Qualitative & quantitative research content provides understanding of scientific, analytic, & ethical approach to building knowledge for practice. Content prepares students to develop, use, & effectively communicate empirically based knowledge, including evidence-based interventions. Research knowledge is used by students to provide high-quality services; to initiate change; to improve practice, policy, & social service delivery; & to evaluate their own practice.