Evolving the EBP Process Model: Advancing a Brown School Approach
An Alternative Re-Affirmation Project Proposal Submitted to the
Commission on Accreditation, Council on Social Work Education
December 1, 2008
Submitted by George Warren Brown School of Social Work, Washington University in St. Louis
authors
Brett Drake, PhD
Associate Professor
Re-Affirmation Project Director
Tonya Edmond, PhD
Associate Professor
Associate Dean for Academic Affairs
Re-Affirmation Project Director
Ellen Rostand, MBA
Assistant Dean for Communications
our vision
To create positive social change through our path-breaking research
and educational excellence.
our mission
•To educate and prepare future social work and public health leaders in areas of policy,
practice, and research.
•To pioneer research and apply results to impact policy and practice locally, nationally,
and internationally.
•To collaborate with organizations to use evidence to improve access to and quality of
social services and to address social and economic justice.
Contents
A History of the Brown School...............................................................................1
The Evolution of the EBP Process Model...........................................................3
A Review of the Literature................................................................................3
The Brown School Approach.............................................................................6
Reaffirmation Project: Goal, Objectives, Strategies, and Evaluation..............9
Implementation Tools and Trainings....................................................................16
Product Development and Dissemination.............................................................20
Timeline.........................................................................................................................23
Why Now? Why the Brown School?.....................................................................25
Reaffirmation Project Leadership.................................................................... 25
Resource Commitment....................................................................................... 26
Appendices....................................................................................................................29
Appendix A: Faculty EBP publications over past 5 years or longer....... 29
Appendix B: Members of Brown School EBP Task Force....................... 39
Appendix C: References..................................................................................... 40
Appendix D: Members of Brown School Macro Work Group................ 41
Appendix E: Parish/Rubin Instrument.......................................................... 42
Appendix F: Members of Brown School Curriculum Committee.......... 50
Appendix G: Members of Brown School Foundations Work Group..... 51
Appendix H: Sample syllabus from a foundation course............................ 52
Appendix I: Members of Brown School EBP Steering Committee........ 61
Appendix J: Members of Brown School National Council....................... 62
Appendix K: Members of Dean’s Professional Advisory Council.......... 64
the brown school
A History of the Brown School
Is social work a profession? This is the question that Abraham
Flexner, a champion of medical school education reform, posed
at the 1915 National Conference of Charities and Corrections.
His stinging criticism of the lack of scientific rigor of early
social work education helped spark a pedagogical evolution that
continues today. Ironically, at this same time while social work
programs began to flourish, Washington University in St. Louis,
established in 1853, was getting out of social work education
altogether, having offered social work training courses since 1909.
Financial constraints and strained relations between the program
director and the University Chancellor resulted in the demise
of the fledgling program. But the University eventually heard
the community’s call for trained social workers, and established
a formalized social work program in 1925, and later our School
in 1945. Today the Brown School is ranked as the top graduate
school of social work in the country according to U.S. News &
World Report, and regularly ranked among the top schools in
terms of faculty productivity.
We have been continually
accredited, first by the
American Association of
Schools of Social Work and
then by the Council on Social
Work Education.
Our last three
reaccreditation reviews
(2002, 1994, 1986) resulted
in approval of our submitted
documents without revision.
Most recent affirmation of
accreditation was formally
granted on February 27,
2003, extending until
February 28, 2011.
Although the language we have used over the past century has changed, we have never wavered
from our commitment to advancing our curriculum and identifying and applying the best
available evidence to tackle challenging social problems. Evidence-based practice, however, did
not become an official Brown School watchword until a little more than a decade ago. Since that
time, we have been at the forefront of the movement to advance the utilization of evidencebased practice in the social work profession, both inside and outside the classroom.
In 2000, we became one of the first U.S. schools of social work to embrace an EBP approach
for its MSW curriculum. This same year, we convened and hosted a national conference on
advancing EBP in social work. Our Office of Field Education has provided field instructor
workshops and revised our practicum evaluation forms to include questions about students’
ability to apply EBP in their agency work. We also have sponsored several highly subscribed
sessions on EBP for local agencies, and our orientation for incoming MSW students now
includes a session on the role of research in social work.
In our most recent reaccreditation application (2002), we adopted evidence-based practice and
capacity building as core teaching themes and over the past 10 years our faculty has published
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numerous articles on critical issues pertaining to evidence-based practice (See Appendix A).
And in fall 2005, our new dean, Edward F. Lawlor, convened an EBP Task Force (See Appendix
B) to assess our status with regard to evidence-based practice and consider how EBP cross cuts
several areas of school activity and institutional next steps.
The Task Force was critical of our efforts to date, finding that despite the strides we have
made in gaining visibility around EBP, we needed a much more comprehensive systematic
restructuring of our curriculum, including field education, to effectively train our students as
true evidence-based practitioners.
We want to continue to endorse and advance EBP with energy,
innovation, and vision. The goal of our re-affirmation submission
is to address this curricular challenge by designing, disseminating,
and evaluating a model MSW curriculum that will further
advance the capacity of evidence-based social work practitioners.
By advancing a “Brown School Approach” to the EBP Process
Model, we aim to prepare social work students here and elsewhere
to employ the best available evidence when making practice
decisions. Specifically we plan to:
The goal of our re-affirmation
submission is to address
this curricular challenge by
designing, disseminating,
and evaluating a model MSW
curriculum that will further
advance the capacity of
evidence-based social work
practitioners.
1. Build capacity of all Brown School educators (current full-time faculty, new faculty, adjunct
faculty, doctoral teaching fellows) to cogently and consistently teach our MSW students the
Brown EBP Process Model (the Brown School Approach).
2. Restructure our MSW curriculum, including both foundation and concentration courses,
to systematically and progressively teach the Brown School Approach, ensuring effective
horizontal and vertical integration.
3. Build capacity of field education/practicum sites to model, supervise and support the
implementation of the Brown School Approach.
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The Evolution of the EBP Process Model
Although we begin our description of evidence-based practice with recent usage of the term,
we are cognizant of the longstanding commitment of social work to the use of evidence.
Many of our profession’s best and most defining moments have centered on the thoughtful
generation and/or use of evidence. Nonetheless, there has been a long standing interest in and
many efforts toward strengthening the links between research and practice. We are mindful
of previous efforts in our profession to advance the use of scientific evidence in social work
practice that have been met with limited success (single-subject designs, the practitionerresearcher model). Consequently, some have argued that the current excitement about EBP is
not entirely new, and concerns exist that this is yet another fad that will eventually fade away as
others have.
We believe that EBP is essential to the field of social work, that we have an ethical imperative
to employ evidence, and that to fail to do so puts our profession at risk of irrelevancy. Medicine,
nursing, public health, and psychology, important allied disciplines, are all making rapid strides
in advancing the use of evidence-based practice and social work is perhaps in its strongest
position ever to join in these efforts to ensure that clients, consumers, and other constituencies
receive the highest quality of service. Through our reaffirmation project, we aim to extend the
next chapter of EBP into the mid-century.
A Review of the Literature
EBP has gained considerable momentum in social work over the past two decades. What
follows is a brief overview of the literature and a description of some of the guiding principles
informing our reaffirmation project (See Appendix C for References).
1992- 1996: Origins of the Contemporary Term “Evidence-based practice.”
The term EBP has its roots in medicine; coming to the national forefront in the early 1990’s
when the first article on evidence based medicine was published in the November 4, 1992 issue
of JAMA by the Evidence Based Medicine Working Group (EBMWG, 1992). EBM was further
codified with the publication of the medical text Evidence Based Medicine: How to Practice and
Teach EBM (Sackett, Richardson, Rosenberg & Haynes, 1996).
During this time, EBP represented a radical departure from prior forms of medical and social
service delivery because it placed a “much lower value on authority” (EBMWG 1992, p. 2421).
Historically (EBMWG, 1992; p. 2420), practitioners had no choice but to rely mainly on
tradition and opinions of those in authority when making decisions. Driven by a growing body
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of high quality scientific evidence and technological advancements, such as the Internet and
search engines, practitioners had the ability to access good evidence in real time to make their
own practice decisions.
According to Sackett and his colleagues (Sackett et. al. 1996), EBP was a formalized five-step
process:
1.
2.
3.
4.
Converting the need for information into a question
Tracking down the best evidence to answer the question
Appraising that evidence for validity, impact, and applicability
Integrating this appraisal with our expertise and client’s unique biology, values, and
circumstances
5. Evaluating effectiveness and efficiency in completing steps 1-4
The circles in Sackett’s model (see below) visually emphasize how critically important
professional judgment and client factors are to the EBP Process. Too often the discussions
of EBP become myopically focused on the best available evidence circle, but the reliance on
evidence without the application of good professional judgment or consideration of client
values, preferences, and context is problematic, and not equivalent to true evidence-based
practice. EBP’s focus on the primacy of the individual practitioner is very desirable in graduate
social work education because the MSW is the terminal practice degree, a prerequisite for
licensure, and is geared toward creating social workers who can practice autonomously.
Best Available
Evidence
EBP
Professional
Judgment
Client Factors
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Mid 1990’s – Mid 2000’s: A Different EBP Model Emerges
Although the process model developed by Sackett and his associates is clearly delineated,
during the 1990’s, a different and much more limited definition emerged. During this time,
EBP was sometimes employed to refer to the use of empirically supported treatments (ESTs),
which were often confusingly described as “evidence-based practices.” This was particularly
true in the field of mental health where there was much discussion occurring regarding the
role of practice guidelines in clinical decision making. While guidelines provided very useful
information about recommended evidence-based intervention options, there were concerns that
they would potentially reinforce the over reliance of expert opinion and authority. Certainly
ESTs are an essential resource in evidence-based practice and are highly valuable, but this
restricted definition led to some confusion and debate about what constituted evidence-based
practice. A common question was: Is EBP a process or a product? (Rubin, 2007).
Virtually all of the criticisms of EBP in social work have been criticisms of the “practices”
model (Gibbs & Gambrill, 2002) and involve concerns that clinical judgment, client diversity
and preferences, context, and other critical factors would be downplayed in favor of “cookbook”
application of validated treatments. The irony is that the focus on clinical judgment and client
factors are strengths of the original process definition of EBP, which when described rarely
fosters resistance among practitioners.
2006–Present: A Return to the Process Model
Today the tide has turned. Thanks to two key milestones – the “Austin Conference” and a
groundbreaking issue of the Journal of Social Work Education – the social work profession is
moving toward consensus of EBP’s definition and a return to EBP’s process-oriented roots.
First, the “National Symposium on Improving the Teaching of Evidence-based Practice”
(aka “The Austin Conference”) hosted by Allen Rubin at UT Austin in October 2006 brought
together many of the key social work leaders in EBP, including one of our own faculty
members, Dr. Enola Proctor. The papers presented remain one of the most concentrated
sources of “must read” EBP material in our field. This conference is not only useful for its indepth analysis of social work educational issues stemming from EBP, but it is invaluable as a
frozen “moment in time” capturing disparate views of the “practices” and “process” versions of
EBP.
The second milestone was the fall 2007 special issue (43[3]) of the Journal of Social Work
Education. In the lead editorial article, we begin to see that social work is reaching a consensus,
embracing the “process” model of EBP. This article (“Implementing and Sustaining
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Evidence-based Practice in Social Work,” Walker, Briggs, Koroloff & Friesen (2007)) remains
the most clear and concise source on the current status and future direction of EBP in social
work. Essentially, this article, and the journal issue as a whole, suggests the necessity of
embracing the “process” model of EBP, and includes substantial general guidance on how EBP
can be used in social work. It includes important content concerning current challenges related
to EBP (Rubin & Parrish, 2007) and curricular issues with implementation of EBP at the MSW
level (Drake, Hovmand, Jonson-Reid & Zayas, 2007).
The Brown School Approach: Our EBP Process Model
As a result of our involvement in the scholarly and intellectual examination of evidencebased practice, we have come to a number of conclusions that inform our approach to teaching
evidence-based practice and subsequently this proposal.
1. EBP is a process. Our work is aligned with the emerging consensus that EBP is a process.
We view empirically supported treatments as an important element of social work practice
that is easily and naturally subsumed under the EBP process model.
2. EBP can bridge the research-practice gap. We view EBP as an approach that has
the potential to effectively bridge the gap between research and practice. True EBP
practitioners need a strong grasp of research methods, an ability to assess and integrate
existing research in practice decision-making, and the ability to generate needed evidence
from one’s own practice when possible. Similarly, under an EBP framework, researchers
can best claim utility for their work by showing how their work can answer questions that
practitioners generate in the field. One of the critical features of the EBP Process Model
that has been missing from previous models that promised to bridge the research-practice
divide is an integrated understanding of and explicit expectation for the importance of the
practitioner’s judgment and experience.
3. The EBP Process Model is a framework for social work practice. We view the EBP
Process Model as a coherent framework for social work practice, not a competitor with or
replacement for traditional professional touchstones. Core social work touchstones, such
as social and economic justice, diversity, and the “person-in-environment” perspective are
in fact strengthened under the EBP framework, which requires attention to these elements
as part of all practice decisions. In fact, it provides a means for showcasing and supporting
social work’s unique strengths. The EBP Process Model also supports social work’s long
standing commitment to critical thinking (Gambrill, 1997, 2000). Futhermore, the model is
consistent with the value social work has always placed on lifelong learning, as the process
requires social workers to engage in lifelong learning as a standard part of everyday
practice.
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4. The EBP Process Model applies directly to macro practice. Although the EBP Process
Model works well for all forms of social work practice, too often the language used in the
literature is heavily skewed towards direct practice, which can be a barrier to receptivity
to and adoption of evidence-based practice. To address this shortcoming, in fall 2007,
we formed a macro practice work group to ensure that our approach and model of EBP
practice was truly applicable to all fields of social work practice. The group concluded that
the model needed a modification to more explicitly depict the importance of social context
and the formal and informal structures influencing all involved persons. (See Appendix D
for list of members of Macro Practice Work Group)
In addition we created an acronym, “FLAIR,” to help students and practitioners remember the
five steps on the process. The Brown School Model of EBP is graphically depicted below.
Brown School EBP Process and “Circles”
Best Available
Evidence
Practitioner
Judgment and
Experience
Involved Persons
(clients and
others)
Social Context
(formal and
informal)
1. Formulate Question
2. Locate Best Available Evidence
3. Assess Quality of Evidence
4. Integrate Evidence with
judgment, involved persons and
social context
5. Review process
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Although social workers engage in a wide array of practice activities with varying emphasis
on macro, mezzo and micro levels (e.g. lobbying vs. direct mental health practice), through the
Brown School Approach to EBP, they will share a common practice framework that includes
our five-step “FLAIR” process; and consideration of best available evidence, practitioner
judgment, involved persons and social context.
Our model of EBP also assures the explicit use of the ecological model, one of the hallmarks
of social work practice. The model stresses explicit consideration of the social context, both
formal and informal, requiring the student to consider and address formal structural factors
(e.g. organizational context and dynamics, availability of employment opportunities, policies
that influence access to and availability of resources, etc.) and informal factors (e.g. community
or societal values and norms that might bear on the situation) affecting all involved persons. To
better include the macro level of social work practice and to acknowledge that social workers
often operate in the context of multi-disciplinary teams, we have moved away from using
the word “client” to “involved persons.” For example, in a community development project,
involved persons might include community members, members of organizations serving
the community, experts in other disciplines like public health, and policy makers. In a policy
context, involved persons might range from those impacted by a policy, to advocates, persons in
relevant organizations, policy makers and even business leaders. Our EBP approach will provide
a structured framework to help new students learn to consistently apply an ecological approach
to their work, making both models a reflexive part of their social work practice.
Our EBP model also assures the centrality of social justice and diversity in social work
practice. Framing a question (Step 1) will often be done differently in different contexts and
depending on the population/community being served. Steps two and three (finding and
critiquing best available evidence) will also change radically based on diversity issues:
• Is there evidence on treatment effectiveness in which the study samples included the
population you will apply the intervention to?
• Are populations broken out in the literature with regard to differential effectiveness?
• Are there studies available exploring how different groups may perceive or react to the
intervention?
As diversity and the environmental perspective are highlighted in Step 4, so too is social and
economic justice. All social work students are trained to be sensitive to, recognize, and combat
unjust formal and informal structures. To embrace this social justice perspective requires a
broad view of the word “evidence” as well. So, Steps 2 and 3 must also change to address the
nature of the problem. Using our EBP Process Model, we will teach our students exactly how
these necessary and defining social work acts fit into every practice decision.
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Reaffirmation Project: Goal, Objectives,
Strategies and Evaluation
Our reaffirmation proposal
The literature on EBP continues to flourish, both within and
is geared to infuse the EPB
beyond social work. We believe that social work education in
Process Model in all aspects
the next twenty years will feature a substantial shift toward the
of our curriculum with the
process model of EBP as described by Walker et. al. (2007) and
goal of graduating true EBP
Drake et. al. (2007). Our reaffirmation proposal is geared to infuse
practitioners.
the EPB Process Model in all aspects of our curriculum with
the goal of graduating true EBP practitioners. By advancing a
“Brown School Approach” to the EBP Process Model, we aim to prepare our own students,
and hopefully other social work students to employ the best available evidence when making
practice decisions.
In fact, work is already underway to ensure that if our reaffirmation proposal is approved, our
first MSW cohort under this model will have graduated just prior to our CSWE site visit in
2010. Consequently, we felt it critical to start now to ensure that we design our program to
complement the 2009 version of EPAS.
Below we have outlined our three main objectives and a set of implementation strategies
and evaluation measures for each. Where appropriate, we have included an update of the
groundwork completed to date.
Objective 1: Build capacity of all Brown School educators (current full-time
faculty, new faculty, and adjunct faculty, as well as doctoral teaching fellows) to cogently and
consistently teach our MSW students the Brown School EPB Process Model.
Implementation Strategies:
1. Develop specific training modules on the EBP Process Model for each target group.
Dr. Danielle Parrish and Dr. Allen Rubin from the University of Texas at Austin have
developed a day-long training module to teach the EBP Process Model to social work
practitioners. In spring 2008 we piloted this model with a small group of full time faculty,
adjunct faculty and teaching fellows to assess how it would work for these target groups. The
model worked very well and we received excellent feedback on the value and quality of the
training from our pilot group. However, we plan to strengthen the applicability of the training
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for macro social work practice. We will modify the training to match the specific training
needs of each target group. For example, full time faculty and doctoral students in most cases
will not need training to understand how to conduct a search of the literature or to critically
appraise the methodological quality of the literature obtained, but adjunct faculty most likely
would.
We will require this training for all new full-time faculty, current and future adjunct faculty, and
doctoral students that serve as TAs or Teaching Fellows (independent instructors). Current
full-time faculty has already had extensive exposure to our EBP Process Model through faculty
retreats, the EBP Taskforce, and various EBP-related work groups.
Evaluation:
1. We will conduct a pre-training/post-training assessment utilizing an instrument
developed by Dr. Danielle Parrish and Dr. Allen Rubin at the University of Texas at Austin
to evaluate the effectiveness of the EBP Process training they developed for social work
practitioners (See Appendix E). We will modify as needed to reflect the changes that are
made to construct the specific training modules.
Objective 2: Restructure our MSW curriculum, including both foundation and
concentration courses, to systematically and progressively teach the EBP Process Model
ensuring effective horizontal and vertical integration.
Implementation Strategies:
1. Restructure foundation courses. Beginning in fall 2007, we formed a work group
of all the lead teachers for the Foundations Curriculum and tasked the group with the
responsibility of developing a strategy for infusing the Brown EBP Process Model and
the new EPAS competencies across the foundation courses. The group met weekly for
nine months and diligently crafted a systematic approach for introducing our model and
establishing specific responsibilities for each foundation course related to key knowledge
and skills needed to develop competencies with the EBP Process Model. In the process we:
• restructured the content and format of all foundation courses syllabi to make explicit the
core EPAS and EBP competencies expected for each course;
• developed common pedagogical elements for courses with multiple sections to ensure
consistency in learning opportunities; and
• developed recommendations for a required sequencing of courses to facilitate the
progressive acquisition of requisite knowledge and skills, as well as good horizontal and
vertical integration of course content.
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Our Foundations Committee regularly presented reports of their work to the Curriculum
Committee, which ultimately gave full approval to their recommendation of these curricular
changes. In May 2008, the full faculty unanimously approved the recommended changes to the
foundation curriculum. We are currently pilot testing the restructured foundation curriculum to
identify potential modifications that might be warranted for our reaffirmation project.
2. Increase exposure to Brown EBP Process Model for incoming advanced standing
students. The newly restructured foundation curriculum is well positioned to ensure
that all incoming MSWs who do not have a BSW receive rigorous training in the EBP
Process Model. However, BSWs can receive up to 19 hours of credit for foundation level
courses leaving them without the necessary exposure to the EBP Process Model and the
opportunity to develop the knowledge and skills needed to implement it in practice. To
address this concern we have developed a new course exclusively for BSWs - “Evidence
Based Social Work for BSWs.” We are currently piloting this course to identify potential
modifications we may need to make for our reaffirmation project.
3. Restructure concentration courses. Beginning fall 2008 our Curriculum Committee
began discussing how to build on the work of the Foundations Work Group to ensure
vertical integration of both the new EPAS competencies and opportunities to develop the
knowledge and skills needed to implement the EBP Process Model within the context
of a specific concentration. Each of the Concentration Chairs, who are members of the
Curriculum Committee, will be working with faculty within their respective concentrations
to review current EBP relevant content covered in the current syllabi and to identify
potential modifications that may be needed. This preliminary work is expected to continue
through the 2008-2009 academic year and to produce substantive recommendations
for curriculum changes to advance the goal of producing high quality EBP social work
practitioners within each of our concentrations. We plan to pilot recommended changes
in the 2009-2010 academic year to identify any modifications that we may need to make.
Faculty will formally approve these changes later in the academic year. (See Appendices F
and G for members of Curriculum Committee and Foundations Work Group)
4. Develop Empirically Supported Treatments Skills Labs. According to Weissman,
Verdeli, Gameroff, Bledsoe, Betts, Mufson, Fitterling, & Wickramaratne (2006), very
few graduate students in social work or psychology graduate with any real exposure to
empirically supported treatments. They conducted a national survey on psychotherapy
training that included psychiatry, psychology and social work. Although social work and
PsyD programs train the largest number of clinical students, they have the lowest rates
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(10%) of meeting the gold standard for learning a new treatment approach—combining
didactic programs with clinical supervision. Weissman and her colleagues state that “until
the training programs in the major disciplines providing psychotherapy increase training in
EBP [evidence based treatments], that gap between research evidence and clinical practice
will remain (p. 925).”
We are committed to ensuring that all of our students will graduate with a thorough
understanding and ability to implement the EBP process, and they will be knowledgeable about
specific empirically supported treatments or practice approaches that are viewed as critically
important within their field of practice. Our students will gain much of this knowledge in
their practice methods courses within their concentrations. To supplement this knowledge and
to create more focused opportunities for practice skill development, we will develop a series
of skills labs on empirically supported treatments. The Curriculum Committee approved this
idea in spring 2008, and we are currently piloting the idea this academic year by offering 1.5
credit hour skills lab courses. This fall we offered Motivational Interviewing and Assertive
Community Treatment, and in the spring we will offer Dialectical Behavior Therapy and
Interpersonal Therapy. To support the interests of our macro students we are offering a
skills lab in GIS (Geographical Information Systems). All of the Concentration Chairs have
been encouraged to identify specific skills labs that they would like to make available to their
students.
5. More fully integrate field education efforts. We cannot educate competent EBP
practitioners without the inclusion and integration of field education. Our field education
staff has been actively engaged on every internal work group related to EBP that has
existed for the past eight years. They have been at the forefront of our efforts to advance
evidence-based practice inside the classroom and within the community. As a part of the
Foundations Work Group, the field education staff integrated the EBP Process into the
Integrative Seminar and they are currently piloting those changes. In preparation for our
reaffirmation project, we are revising virtually all of our practicum related documents to
support students’ learning of the Brown EBP Process Model and capacity building within
the practice community. We are planning to modify our Educational Learning Agreements
that students complete as a contract with their practicum site to ensure that EBP Process
activities are explicitly described. The midterm and final evaluations that practicum
instructors complete, and student evaluations of the site and their field instructor will also
be modified.
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Evaluation:
1. Each lead teacher and concentration chair will conduct a content analysis of all syllabi
under their responsibility to assess degree of compliance with course competencies and
expectations for common pedagogical elements, and explicit EBP relevant content and
assignments.
2. We will modify course evaluations to gather student feedback on their self reports of
learning the EPAS competencies and the EBP Process Model.
3. We will collect data from field instructor evaluations of student implementation
of EBP Process Model by modifying our current field instructor mid-term and final
evaluations.
4. We will assess current students’ knowledge of the Brown EBP process. Because
we are testing a number of changes in an incremental process prior to the start of our
reaffirmation project, we plan to collect data from several cohorts at different points in
time. In May 2009 we will have a cohort of students graduating who have been exposed to
the general principle of the importance of using evidence to guide practice that has been
in place since our last reaccreditation in 2002. These students have heard repeatedly about
the value of the best available evidence but they have not been trained in the EBP Process
Model in a systematic and progressive manner. We will assess their knowledge of the EBP
Process with a post-test using the instrument previously discussed that was developed by
Dr. Parrish and Dr. Rubin. We will also use this instrument as a post-test for the students
graduating in May 2010 who will have only been exposed to an incomplete version of
the piloted revised curriculum. This will allow us to make preliminary comparisons in the
effectiveness of teaching students to be EBP practitioners between our old model and our
revised model.
5. We will pre-test knowledge of incoming students. In August 2009 we will be able to
pre-test our incoming students who will be the first cohort to receive our fully revised
curriculum. Using the same instrument, we will compare these data to the 2010 exit
cohort scores (pre/post using different cohorts). Later we will also compare the 2009 entry
cohort data to the May 2011 exit data (pre/post using same cohort). This will allow for a
comprehensive evaluation of the effectiveness of our curriculum. We will supplement this
data with self assessment information gathered from a modified version of an exit survey
we currently give to our graduating students.
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Objective 3: Build capacity of field education/practicum sites to model, supervise
and support the implementation of the EBP Process Model.
Implementation Strategies:
1. Develop a training module on the EBP Process Model for field instructors (Practicum
site supervisors). We will build on the training module developed by Dr. Parrish and Dr.
Rubin previously described. In spring 2008 when we piloted this model, we included several
practicum instructors from a range of agencies and they all provided very positive feedback
about their training experience.
2. Hold mandatory day long training for all local affiliated field instructors. Specifically,
we will hold a series of workshops limited to 20 practitioners at a time. Given that we
have approximately 200 field instructors we anticipate that it will take two years to train
everyone. Consequently, our field instructors will be given two years to complete the
mandatory training.
3. Allow field instructors to attend the Empirically Supported Treatment Skills Labs.
As Weissman and her colleagues (2006) point out, the gold standard for learning a new
treatment requires clinical supervision in the method. To strengthen the capacity of our
field instructors to provide clinical supervision in empirically supported treatments we
will invite them to attend these skills labs, create incentives for them to attend and reduce
barriers that might inhibit their participation. These 1.5 credit courses will only be offered
to field instructors at no cost and will only be held during weekends to reduce potential
scheduling barriers that might inhibit field instructor participation. They will also be given
parking passes free of charge as an expression of appreciation for their service to our
students and the profession. They will participate jointly in the lab with MSW students, an
effective approach used by the University of Michigan.
4. Offer Empirically Supported Treatments Skills lab through our ongoing Professional
Development Series that is well attended by alumni, field instructors, and other
community practitioners.
Evaluation:
1. We will conduct a pre-training/post-training assessment utilizing the modified
instrument originally developed by Dr. Parrish and Dr. Rubin following completion of the
mandated day long training on the Brown EBP Process Model.
2. We will modify the current instrument that our students use to evaluate their field
instructor and practicum site. We will make modifications to incorporate the student’s
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evaluation of the field instructor’s knowledge of and receptivity to the use of the EBP
Process Model.
3. We will track the number of field instructors who elect to take one of our skills labs or
EBP-related professional development workshops and evaluate increase in participation
over time.
4. We will develop and implement a survey that assesses the implementation of any
empirically supported treatments that field instructors obtain through one of the skills
labs.
A note about human subjects and Institutional Review Board.
We will implement our reaffirmation proposal with the highest ethical regard and in compliance
with all applicable guidelines. All measures except the EBP knowledge instrument (Parrish/
Rubin) are standard in-house measures (e.g. course evaluations, exit survey, field evaluation)
which would be given in any case. However, the reaffirmation proposal is distinct from normal
administrative surveys directed towards improving and/or developing Brown School services
and programs. Given the potential for publication and dissemination, we fully expect that
our project will be generalizable and therefore meets the federal definition to be considered
research with human subjects. Accordingly, we will seek human subjects approval from the
Washington University Human Research Protections Office (HRPO). We will seek approval
under exempt category 1 for research in educational settings. Faculty and staff undertaking
this project have significant experience conducting research in educational settings and
understand the confidentiality and coercion risks attendent to this type of work. All materials
will be submitted to HRPO for review and approval. The protocol will thoroughly describe the
purpose of the project, data to be obtained, standards for protecting data and publication goals.
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Implementation Tools and Training
To help support the implementation of the Brown School Approach in the classroom and the
field, we will develop the following trainings and tools.
• EBP Process Model Introduction Workshop: We will develop and make this eight hour
workshop available to classroom teachers and field instructors.
• New Faculty “Up-to-Speed” EBP Workshop: We will develop and make this three-hour
training available to all new faculty.
• New course syllabus structure: We have restructured our course syllabi in order to make
transparent (Gambrill, 1997, 1999) the EBP and CSWE required competencies that will
be expected for each specific course along with common pedagogical elements designed
to ensure consistency in teaching across multiple sections of one course. We have already
revised syllabi for our foundation courses. Syllabi for all concentration courses will be
restructured by August 2009. These syllabi include three sections:
o Course Domain that outlines the purpose and content of the course.
o Course Competencies that outline those specific competencies taught in the course.
Viewed across classes, this section provides a structured way of presenting or evaluating
the curriculum as a whole, and are directly linkable to 2008 EPAS competencies.
o Common Pedagogical Elements that offer specific guidance to teachers regarding
assignments, activities and instruction within the course. In short, this section allows us
to provide some concrete guidance about activities that need to occur in the classroom
within each section of the course. (See Appendix H for sample syllabus from foundation
course)
• New course evaluations. We will revise our course evaluations to enhance teachers’ ability
to gain feedback on how students perceive their teaching relative to EBP.
• New field education documents. We will revise all field education documents, specifically
Educational Learning Agreements, mid-term and final evaluations of student performance,
student evaluation of practicum instructor and practicum site to highlight EBP content.
To provide additional 24/7 student and faculty support to this effort, we have expanded our
intranet, Inside Brown, to include an EBP online support system that links together all aspects
of the curriculum, including field. This fall we created two online elements in this system:
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• An EBP Literature Retrieval Guide developed by the director of the Brown School
Library, in consultation with faculty. This guide serves as a reference that our MSW
students can use throughout their studies and instills an understanding of the Brown
School Approach that they can use in future practice. The guide:
o Illustrates how to formulate questions
o Provides definition and core materials to be consulted for finding current evidence
o Assists in formulation of search strategies for seeking literature in various databases
o Emphasizes the questions related to evaluating current literature
o Assists in analyzing articles for applicable tools
o Provides suggestions for what to do with evaluations of the applications
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• Course-specific EBP resources such as links to key guidelines, data sources and related
databases, tests and measures, and other relevant web sites.
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Since we launched the first components of our online resource this fall, our online support
system has been viewed more than 829 times by students, faculty, and staff; all or portions of
the Literature Retrieval Guide have been downloaded 287 times. (Data as of November 15).
Over time, this resource will grow to support all courses and to provide support for areas of
EBP efforts, including space for on-demand training (video, audio, etc) around EBP.
Because of the investment of time and talent in developing this online system, we plan to
evaluate its effectiveness as well. Specifically we will:
• Incorporate questions about the system in course evaluations to understand how the
system is supporting the goals of the classroom.
• Hold discussion groups each semester with students, faculty, and relevant staff to
understand their perceptions, attitudes, and use of the system, as well as ways in which the
resource can be enhanced. Brown School’s Office of Communications, in consultation with
Reaffirmation Project Directors, the Brown School’s Library, and Office of Information
Technology will structure and oversee the groups.
• Complete an analysis of usage statistics each semester to understand the number and
type of resources accessed and the number of returning visitors to the site.
• Showcase this internal resource to field instructors and other agency partners to begin
to understand if and how we might be able to provide this type of online support tool to
the field overall.
In addition, we will create the Brown FLAIR Blog, to help enhance regular dialog among
students, field educators, and Brown School Academic Affairs staff. Managed by Academic
Affairs, lead faculty and staff will post regular (at least weekly) postings discussing specific
EBP topics, issues, and opportunities. We will promote the blog through regular Brown School
communications channels (see next section) as well as online outreach to our audiences. We will
also use the blog to reinforce content included in our other communications channels.
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Product Development and Dissemination
We want to teach EBP effectively in the classroom and field, but also assist in promulgating
EBP, specifically the process model, in the community, nation, and world. As a result, we
are committed to sharing our learnings, and the tools and resources from our reaffirmation
initiative, with other social work educators.
Specific products we plan to develop and disseminate include:
The Brown School EBP Process Tool Kit. We will create and make available a tool kit for
social work schools interested in learning more about and possibly adopting the Brown School
Approach to the EBP Process Model. Contents of the tool kit include, but are not limited to:
•
•
•
•
Digestible overview of our philosophy and approach to EBP
Key learnings and success factors
Relevant articles including monographs and peer-reviewed journal articles
Examples of all tools developed – including course syllabi, classroom activities and
assignments, course and field evaluation forms, field education documents, exit survey of
graduating students, and pre/post-tests for EBP knowledge
• Training resources including power points and audio/video for both the EBP General
Introduction Workshop and our New Faculty “Up-to-Speed” EBP Workshop
To conserve resources and minimize printing costs, the tool kit will be available both online and
via CDROM or jump drive. We will develop and execute a promotional plan to ensure visibility
of and access to the tool kit by social work educators.
Publish peer-review articles. We will use the data obtained through our knowledge surveys,
course and field evaluations, exit surveys and other tools to share the successes and lessons
learned from this initiative via journal articles. Specifically, we will submit 2-5 articles for
publication by fall 2010. Probable topics:
•
•
•
•
•
“The role of theory in EBP”
“Advancing the EBP process in practice methods courses”
“The application of the EBP process model in macro social work courses”
“Building capacity for EBP in practicum sites”
“Supporting EBP through technological adoption of online tools”
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Speaking engagements and workshops. Brown School faculty
will take the learnings from the development and implementation
of its EBP Process Model on the road, showcasing lessons
learned at industry conferences such as CSWE’s Annual Program
Meeting and SSWR. We will also promote Brown School faculty
as being available to present at other schools of social work
interested in developing similar approaches to teaching EBP.
In addition, we will take advantage of a number of existing
Brown School communications tools that target a wide range
of social work practitioners, educators, researchers and policy
makers, including the following:
• Social Impact. Social Impact is our award-winning magazine
dedicated to sparking dialogue and debate about issues
impacting social work, social policy, and public health. We
distribute the publication two times a year to approximately
24,000 individuals, including graduates, field instructors,
community partners, policy makers, and funders. The
magazine is distributed by mail, but we make key articles
available on our web site.
• Knowledge Monograph Series. Periodically, we distribute
a 6-8 page monograph dedicated to a single issue or specific
piece of research. We will leverage this series to showcase the
progress, process, and outcomes of our reaffirmation project.
The monograph targets educators and is distributed by mail
and is available online.
• Nexus. Each semester, the Office of Field Education publishes
its newsletter, Nexus. We will use this newsletter as a key
vehicle for communicating information about our new
curriculum, as well as training opportunities and additional
resources for field educators. The newsletter is distributed
by mail and it is always available online. Field education
will supplement this publication with periodic electronic
communications to field instructors, to keep news and resource
information top-of-mind.
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• Impact Bulletin. In January, we will launch an e-newsletter titled Impact Bulletin, which
is a bi-monthly supplement to Social Impact. We will showcase news and developments
related to our reaffirmation project through this channel.
• Media outreach. Where appropriate, Washington University’s media relations team will
conduct outreach to target publications geared to social work (e.g. Social Work Today) and/
or higher education (e.g. Chronicle of Higher Education). Also, as appropriate, we will explore
ways to pitch this story to more mass media outlets.
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Timeline
The timeline below outlines at a high level the timeframe for implementing each of the
strategies, as well as tactical tools and trainings. We’ve included evaluation activities as
well. The colors indicate various stages of activities, specifically planning, piloting, and
implementing.
2007-08
2008-09
2009-10
2010-2011
FL
SPR
SU
FL
SPR
SU
FL
SPR
SU
FL
SPR
SU
07
08
08
08
09
09
09
10
10
10
11
11
Develop EBP Process Introductory workshop
X
X
X
X
X
X
X
X
X
X
Develop new faculty “Up-to-Speed” workshop
X
X
Objective 1: Build capacity of all Brown School educators
Expand and enhance online support tools
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
Create, launch, and promote blog
Conduct pre-training and post-training assessments
XX
X
X
X
X
X
X
X
X
X
X
X
X
X
X
Objective 2: Restructure MSW curriculum
Revise foundation courses
Increase exposure to model for advanced standing
students
Develop macro practice work group
X
XX
XX
X
XX
XX
XX
X
X
X
X
X
X
XX
XX
X
XX
XX
XX
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
Revise concentration courses
Develop EST skills labs
X
X
Conduct content analysis for syllabi
Fully integrate field ed
X
X
X
Modify course evaluations to get student feedback
X
X
Evaluate and enhance online support tool
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
Collect data from field instructor evaluations
X
X
X
X
X
Assess current students’ knowledge
X
X
X
X
X
X
X
X
Pre-test knowledge of incoming and graduating students
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X
X
X
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2007-08
2008-09
2009-10
2010-2011
FL
SPR
SU
FL
SPR
SU
FL
SPR
SU
FL
SPR
SU
07
08
08
08
09
09
09
10
10
10
11
11
X
X
Objective 3: Build capacity of practicum sites
Develop training module for field instructors
Hold day-long training for field instructors
X
X
X
Allow field instructors to attend EST skills labs
X
X
X
X
X
X
X
Offer EST skill labs through Professional Dev. Series
X
X
X
X
X
X
X
Conduct pre-post training assessments
X
Modify instrument that students use to evaluate
X
practicums
X
X
Track number of field instructors who take trainings, labs, etc.
X
X
X
X
X
Develop survey that assesses the implementation of ESTs
X
X
X
X
X
X
X
X
X
X
X
X
XX
X
X
X
X
X
X
Product Development & Dissemination
Develop promotional plan
X
X
Create and package tool kit
Promote tool kit availability
Submit and publish peer review articles
X
Create, launch, and promote EBP implementation blog
Promote in Social Impact, Knowledge Monographs, and/
or Nexus
X
X
X
web, #tool kits distributed, # inquiries, etc)
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
Promote in Impact Bulletin
Track general dissemination process measures (activity on
X
XX
X
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Why now? Why the Brown School?
Economic insecurity. Greater cultural diversity. Aging population.
Changing demographics. Global climate change. Our society
needs well-trained social work graduates with critical problemsolving and analytical skills now more than ever. The School,
as part of a larger University-wide planning process, has just
completed an ambitious ten-year strategic plan which reaffirms
our commitment to not only evolve, but where needed, transform
our curriculum to meet the changing demands of this dynamic
profession. As a result, this initiative has the full support of the
entire Brown School community.
Reaffirmation Project Leadership:
Advancing the “Brown School Approach” has been and will
remain a major aim of our Academic Affairs arm. Tonya
Edmond, associate dean for academic affairs and Brett Drake,
associate professor, will direct the work of this reaffirmation
project, working closely with the curriculum and concentration
committees, adjunct faculty, field education and career services
that will support and inform this work.
Impact 2020
A BLUEPRINT FOR BROWN
“(the) systematic approach
and use of evidence will be
the defining characteristic
of our work and specifically
of future graduates of both
our master’s and doctoral
programs.” – Impact 2020,
pg. 12, December, 2007
Our faculty is the bedrock of the project and they will continue to be fully engaged in the
process. Dr. Brett Drake and Dr. Tonya Edmond, our Reaffirmation Project Co-Directors, have
been instrumental in the design of this proposal and will continue to provide leadership in
the implementation of this project. A review of the appendices illustrates the depth of faculty
engagement across our EBP related committees: EBP Taskforce, EBP Steering Committee,
Foundations Work Group, Macro Work Group, and the Curriculum Committee. Collectively
the work of these committees has involved the full participation of six full professors, eight
associate professors, seven assistant professors, and three associate deans. Virtually twothirds of our faculty has been actively working on advancing our EBP initiatives. Taking full
advantage of committee assignments, this project will continue to leverage the administrative
responsibilities of participating faculty. These assignments are important and are valued in the
annual performance review process and in promotion/tenure applications. It is important to
note that our governance structure ensures faculty ownership of this process. Each committee
referenced reports either directly to the Curriculum Committee and/or the full faculty for
approval of their curricular recommendations.
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Our senior leadership will be closely involved in the progress of the project. Faculty meetings
will regularly focus on elements of the plan, as well as on the overall progression of activities.
Dean Edward F. Lawlor and the School’s associate and assistant deans meet on a biweekly basis.
These meetings will serve as forums to discuss the project, to brainstorm challenges, consult
on decision points and, most importantly, help ensure resources are consistently available and
managed to provide the continued support necessary to advance the work. (See Appendix I for
members of EBP Steering Committee)
Our National Council and Dean’s Professional Advisory Council will provide meaningful
opportunities to obtain input from external constituents to provide insight in developments in
the field and objective evaluations from outside stakeholders. (See Appendices J and K)
Resource Commitment:
EPB is a central theme of our educational focus and the future direction of the School. As
a result, our administrative resources are tactically and strategically aligned to provide the
necessary capacity to support the program outlined in this proposal. Administrative units,
especially the library, information technology, and communications, will provide critical support
in advancing EBP and attaining the stated goals of the project
Libraries
The Washington University Libraries provide a wide range of computerized services and
availability of all relevant periodicals to the project. Washington University libraries have been
partial government documents depositories since 1912. The government document holdings
of Olin Library also include access to a select part of the Government Accounting Office
series and statistical information on current populations in the United States. Investigators can
also access the Missouri Institute for Mental Health (MIMH) Center for Policy, Research and
Training library within the University of Missouri, which is one of the most extensive mental
health services research facilities in the mid-west.
The Brown School library houses one of the finest collections in the nation for the fields of
child welfare, community development, family therapy, mental health, children and youth,
gerontology, public welfare, management of human services, and social policy. It maintains a
collection of approximately 51,000 books, journals, audio visual materials, and U.S. government
documents. The library has more than 450 current periodical subscriptions; over 1,000 bound
volumes are added to the collection each year. The library has a comprehensive print and
electronic reference collection. It also provides access to a broad collection of online journal
indices (including Social Sciences Citation Index, MEDLINE, PsycInfo, and Academic Search
Premier), as well as hard copy indices and abstracts.
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We have two professional librarians available to assist investigators and students with online
database searching, accessing electronic resources, reference queries, searching the Washington
University Libraries’ catalog, bibliographies, and any other library need. Bibliographies on
the following topics are available at the circulation desk: African Americans; alcoholism; Asian
Americans; children/families and youth; family therapy; gay/lesbian issues; gerontology;
health; Hispanic Americans; international, social, and economic development; managed care;
mental health; minorities; Native Americans; reference; social and economic development; and
women.
The Bernard Becker Medical Library integrates a modern health sciences library, a media/
learning resources center, a computer teaching and information management laboratory, and
a health information network that links regional, national, and international information
resources. The 8-level, 114,000 square foot facility houses more than 269,000 volumes and an
extensive media collection, and is also one of the most technologically advanced health sciences
libraries in the world.
Office of Information Technology
We maintain a state-of-the-art technological support system for faculty and staff. Our local
area network (LAN) consists of a Windows 2003 file server, a Microsoft Exchange 2003
mail server, and a Windows 2003 web server, as well as a connection to the University’s T3
backbone, providing access to the Internet. Available network applications include Telnet,
FTP, and Outlook 2007 for electronic communications. Available software includes Windows
2000, Windows XP, Lisrel 8.0, Stata 10, NVivo, SPSS 15, SAS 9.1, Microsoft Office 2007,
SNAP 9, and ARCVIEW/GIS 8.0. The Office of Information Technology assists with software
licensing, obtaining hardware resources, and technological consulting. Our network firewall
enhances data and communication security for the perimeter of our network, and allows
administrators to control-- on a very detailed level-- the information and resources accessible to
external sources.
Washington University, the Brown School, and select research centers and initiatives have
websites to assist in raising the visibility of our work. Web site use and development is
a shared responsibility between the Office of Information Technology and the Office of
Communications. We use Microsoft Office SharePoint Server (MOSS) 2007 as the platform for
our web operations, including the management of all of our web sites, including Inside Brown,
our intranet which is home to our EBP online support system.
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In addition to serving as an efficient method of centrally managing web content, MOSS enables
access to organized and aggregated information in one central, web-based application. MOSS
2007 integrates with Microsoft Office applications, offers information search tools, and provides
web content management, as well as more specialized document and record management.
MOSS also offers Web 2.0 collaboration functionality like blogs, wikis and delivery of
information via RSS. MOSS is the platform that we are using for web-based collaboration
helping to facilitate interdisciplinary collaborative research among researchers at the Brown
School, across campus, and at other institutions.
Communications
Our Office of Communications provides school-wide support to ensure visibility for all facets
of the School’s teaching, research, and service mission. The office is comprised of an assistant
dean for communications, a communications coordinator specializing in graphic design, print
production, and copy editing; and a web content manager, who oversees content development
and editing for our intranet and main external web site, and provides training and consultation
to our research centers on the management of their web sites. A half-time media relations
specialist works with faculty to promote their research through print, broadcast, and online
news outlets. The office works closely with public affairs and media relations representatives
from across the University.
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Appendix A
Evidence-based social work practice: Abstracts of Brown School faculty
publications and articles under review
2008
Zayas, L. H., Drake, B., & Jonson-Reid, M. (under review). Consequences of Misapplying
Evidence-Based Practice in Social Work: Getting Ensnared in Category Fallacies and Looping
Effects.
Abstract: Current implementation of the evidence-based practice (EBP) model in social work
has focused heavily on the application of evidence from randomized clinical trials (RCT).
There has been far less attention to the two other core aspects of EBP: the importance of
practitioner judgment and client values. The present paper suggests that a narrow focus on
EBP as the promulgation of evidence derived from RCTs can result in category fallacies (i.e.,
problems defined and treatments created by holders of power) and looping effects (i.e., humans
institution transforming conceptual categories into social realities). Reasserting EBP’s focus
on clinical judgment and the centrality of clients’ experience will assist the practitioner in
recognizing the variety of human problems and suffering. This is especially important in
the context of globalization and the diversity of clients we serve. The result should be a
much more humble and clear-eyed view of EBP’s utility and a renewed focus on its abundant
potential.
Drake, B. & Jonson-Reid, M. (2008). Social Work Research Methods: From Conceptualization
to Dissemination, Allyn Bacon.
This is, to our knowledge, the first research methods textbook to integrate EBP content into
individual chapters through use of a set of extensive “EBP Modules”.
2007
Drake, B., Hovmand, P., Jonson-Reid, M & Zayas, L. (2007). Adopting and Teaching Evidencebased practice in Masters Level Social Work Programs. Journal of Social Work Education.
43(3), 431-446.
This article makes specific suggestions for teaching evidence-based practice (EBP) in the
master’s-in-social-work (MSW) curriculum. The authors use the model of EBP as it was
originally conceived: a process for posing empirically answerable questions, finding and
evaluating the best available evidence, and applying that evidence in conjunction with client
characteristics and practitioner judgment. The authors suggest that EBP, in its original
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form, is both sufficiently well operationalized and flexible to serve as a primary paradigmatic
component of social work education. Furthermore, EBP carries a series of distinct advantages
for MSW education that have not been widely recognized to date. These include the provision
of a structure for more explicitly recognizing client factors, bridging the micro-macro and
researcher-clinician divides, and emphasizing the professionalism of MSW-level practice.
Specific curricular components are proposed and discussed.
2006
Drake, B., Jonson-Reid, M., Hovmand, P. & Zayas, L. (In Progress, January 2006). Correcting
the Drift in Evidence-based practice.
Abstract: Evidence-Based Practice (EBP) is increasingly discussed as an approach to Social
Work Practice (Gambrill, 2001, 2004; Gilgun, 2005; Proctor, 2004, Thyer, 2004). As yet, few
writers in the United States have extended this discussion to the multiple dimensions of social
work outside clinical practice. This paper began as an attempt to extend thinking about EBP
to other aspects of social work-like case management, community development, program and
policy. Along the way it became evident that much of the difficulty in applying EBP was due to
a common misunderstanding of the original model as presented in Evidence Based Medicine
(Gambrill, 2005; Liberati, 2004; Michelson, 2004; Rosenfeld, 2004; Thyer, 2004). We assert that
the way to minimize the current problems and maximize the promise of EBP is to re-emphasize
Evidence Based Medicine’s (EBM) original focus on the practitioner as a critical consumer and
active synthesizer of various forms of evidence in the context of professional experience and
client context.
Drake, B., Jonson-Reid, M., & Hovmand, P. (In Progress, January 2006) The Pedagogy of
Evidence-based practice in Social Work
Abstract: This article is paired with the preceding article “Correcting the Drift in Evidencebased practice (Jonson-Reid, Drake, Hovmand, Zayas, In Progress) and should follow that
article. This article proposes a specific format for teaching EBP in Master’s level social work
education.
Edmond, T., Megivern, D., Williams, C., Rochman, E. & Howard, M. (2006). Integrating
evidence-based practice and social work field education. Journal of Social Work Education,
42, 2 (Spring/Summer), 371-390.
Abstract: Field instructors are a vital part of practicum education for the social work
profession. This paper reports the results of a survey that was conducted to deepen our
understanding of the views and attitudes that field instructors have toward evidence-based
practice, and the degree to which they appear to currently be in use within practicum sites. A
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49% response rate was achieved based on completed questionnaires from 283 field instructors
within 180 agencies. Most field instructors view EBP as a useful practice idea; a smaller number
actually implements these methods in their practice with any regularity.
Pollio, D. The Art of Evidence-Based Practice. Research on Social Work Practice, Vol. 16 No.
2, March 2006 1-9.
Abstract: The purpose of this article is to discuss evidence-based practice (EBP) from the
perspective of a self-identified evidence-based practitioner. Discussion of EBP includes
choosing an initial intervention and evaluation procedures, the iterative process of rechoosing
and refining an intervention over the treatment lifespan, the importance of evidence within the
specific clinical situation. Two illustrative case studies are presented. Practice principles include
(a) explaining EBP clearly, including an ability to deconstruct key elements; (b) creating an
evaluation that yields useful outcome data for practitioner and client and is realistic given the
characteristics of the client system; (c) refining intervention and evaluation efforts, based on
increased knowledge of the client system and as their willingness to participate changes; and
(d) understanding relevant evidence about specific techniques, incorporating evidence developed
as part of the intervention, and being critical consumers of both types of evidence in specific
situations with clients and client systems.
2005
McMillen, J.C., Proctor, E.K., Megivern, D., Striley, C.W., Cabassa, L.J., Munson, M.R., Dickey,
B. (2005) Quality of Care in the Social Services: Research Agenda and Methods. Social Work
Research, 29-3, 181-91.
Abstract: In an era of heightened accountability, remarkably little is known empirically about
the quality of social work services. This article applies insights from health services research
to propose a research agenda on the quality of care in the social services. The agenda calls
for studies that address the definition of quality service, variations in quality, the relationship
between quality service and outcomes, structural influences on quality, and ways to improve
quality. The article also details specialized research methods for implementing this agenda,
including the use of administrative data, risk-adjusted outcomes, case vignettes, standardized
consumers, and stakeholder preference assessments. Although social work is currently
underrepresented in quality research, social workers’ research skills, their traditional academicagency partnerships, and their accent on consumer experiences position the profession to make
quick strides in developing the information needed for quality improvement efforts.
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Proctor, E.K. (2005). Social work practice research: A question of questions. Paper
presented at the annual program meeting, National Association of Deans and Directors,
September 2005, San Antonio, TX and at the International Practice Research Symposium,
The University at Albany, June 2, 2005. Proceedings under review by Columbia University
Press.
Abstract: The paper explores the knowledge needs of social work as a profession, asserts the
primacy of five research questions whose pursuit can inform and improve the delivery of social
work services and demonstrate the profession’s social value. Those questions are: (1) what are
the practices in social work practice? (2) How does social work practice vary? (3) What is the
value of social work practice? (4) What practices should social workers use? And (5) how can
social work practice be improved? The pursuit of these questions in social work research is
encouraged as a means to strengthen the social work knowledge base.
2004
McMillen, J.C., Morris, L., Sherraden, M. (2004). Ending Social Work’s Grudge Match:
Problems versus Strengths. Families in Society, 85, 317-325.
Abstract: Some in social work have called for a paradigm shift away from a focus on problems
to a focus on strengths, empowerment, and capacity building. This call sets up an unnatural
dichotomy, asking social workers to identify with one side or another. In this article, we review
social work history to argue that the best social work practice has always maintained a dual
focus on both problems and capacity building. Throughout our history, those who championed
a problem-oriented practice also emphasized strengths and growing client capacity, and today’s
strength-based, capacity-oriented practitioners typically advocate for the solving of consumer’s
presenting problems.
Proctor, E.K. (2004). Leverage points for the implementation of evidence-based practice.
Brief Treatment and Crisis Intervention 4(3), 227-242.
Abstract: Adoption of evidence-based practice (EBP) is an increasingly advocated yet
formidable challenge. Much work on EBP has implied simplistic solutions: if researchers
would produce practice-relevant evidence-based approaches, practitioners would find, adopt,
and use them. Blaming researchers for problems in supply, and practitioners for resistance in
adoption, will only thwart progress at improving the quality of service. The dissemination
and implementation of evidence-based practice requires a more discerning analysis of
issues in agency, research, and professional cultures. Drawing on literature on knowledge
diffusion, innovation, and quality improvement, this paper proposes a conceptual framework
for the multiple tasks, participants, and leverage points required for the adoption of EBP.
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Evidence-based practice requires attainment of four intermediate outcomes—access, adoption,
implementation, and assessment—each with distinct interventions required for attainment. The
framework reveals action points and leverage points for researchers, agency administrators,
educators, and individual practitioners. Implementation of EBP requires supportive research,
training, and organizational infrastructures.
Proctor, E., & Rosen, A. (2004). Using empirically supported treatments in practice. In
A. Robert and K. Yeaker (Eds.), Evidence-based practice manual: Research and outcome
measures in health and human services (pp. 193-199). Oxford University Press.
Abstract: Recognizing the many challenges inherent in the application of evidence-based
practices in day to day practice, this chapter addresses four types of actions and decisions
required by practitioners: (1) identify potential empirically supported treatments (ESTs)
that are relevant to the outcomes for pursuit; (2) select the best-fitting intervention (EST) in
view of the client problems, situation, preferences, and outcomes; (3) supplement and modify
the EST as needed, drawing on practitioner experience and knowledge; and (4) monitor and
evaluate intervention effectiveness.
2003
Howard, M., Bricout, J., Edmond, T., Elze, D., & Jenson, J. (2003). Evidence-based practice
guidelines. Encyclopedia of Social Work, 19th Ed. (2003 Suppl.), Washington, DC: National
Association of Social Workers Press.
Abstract: Evidence-based guidelines have proliferated widely over the past decade. This review
examines the nature and methods of current guideline development activities in medicine
and allied health professions, factors contributing to the rapid growth of guidelines, desirable
attributes of practice guidelines, guideline effectiveness, dissemination and implementation
issues, strengths and limitations of guidelines, and barriers to guideline development in social
work.
Howard, M.O., McMillen, J.C., & Pollio, D.E. (2003). Teaching evidence-based practice:
Toward a new paradigm for social work education. Journal of Research on Social Work
Practice, 13, 234-259.
Abstract: The scientific literature relevant to social work practice has grown expansively
in recent years. Corollary developments, including the widespread availability of electronic
bibliographic databases, improved indexing services, and increased acceptance of systematic
reviews and evidence-based practice guidelines, have made research findings increasingly
accessible to practitioners. For the first time in the history of the profession, social work
educators are confronted with the challenges posed, and opportunities afforded, by this
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accumulating body of practice-relevant scientific information. Evidence-based practice is a new
paradigm that promotes more effective social interventions by encouraging the conscientious,
judicious, and explicit use of the best available scientific evidence in professional decision
making. Pedagogically, evidence-based practice involves teaching students the values and skills
they need to identify, critically appraise, and apply practice-relevant scientific evidence over the
course of their professional careers. This article describes the potential benefits of evidencebased social work professional education and ongoing efforts of the George Warren Brown
School of Social Work at Washington University to implement curriculum-wide changes
supportive of evidence-based professional practice education.
Proctor, E.K. (2003). Developing knowledge for practice: Working through “trench-bench”
partnerships (Editorial). Social Work Research, 27(2), 67-69.
Abstract: In many areas of biological and social sciences and in medicine, knowledge
development has traditionally developed from “bench to trench.” The academic setting has
been the “bench,” where hypotheses and research questions are formulated, rooted in theory
and prior published research. Practice or policy has been the “trench,” to which knowledge
dissemination is directed through “last” but all-too-often neglected, steps in the research
process. The sufficiency of this approach for social work is challenged by persistent evidence
that research findings have very little “uptake” by practice, and that new practices are rarely
sustained in agency after an intervention trial or prevention program ends. Academic practice
partnerships need to be cultivated, respected, and nurtured from the outset of the research
process.
Rosen, A., & Proctor, E.K. (Eds.). (2003) Developing practice guidelines for social work
interventions: Issues, methods, and research agenda. New York: Columbia University Press.
Abstract: Addressing the ultimate challenge of increasing the effectiveness of social
work practice, this book asserts that as a publicly sanctioned profession, social work has
responsibility to develop, elucidate, and organize in a manner accessible to practitioners
its practice knowledge. Practice guidelines constitute a set of systematically compiled and
organized knowledge statements designed to enable practitioners to find, select, and use
those interventions that are most effective and appropriate for a given practice challenge. The
content and structure of guidelines should reflect the uncertainty and tentativeness inherent
in a science-based profession. The book addresses the infrastructure and research challenges
of developing empirically based practice guidelines for social work. Contents include: “Practice
Guidelines and the Challenge of Effective Practice,” by Aaron Rosen and Enola K. Proctor;
“Precursors of Guidelines: Intervention Research and Evidence-Based Practice,” “Intervention
Research in Social Work: A Basis for Evidence-Based Practice and Practice Guidelines,” by
Mark W. Fraser; “Evidence-Based Practice: Implications for Knowledge Development and Use
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in Social Work,” by Eileen Gambrill; “Empirical Foundation for Practice Guidelines in Current
Social Work Knowledge,” by William J. Reid and Anne E. Fortune; “Practice Guidelines for
Social Work: Need, Nature, and Challenges;” “Clinical Guidelines and Evidence-Based Practice
in Medicine, Psychology, and Allied Professions,” by Matthew Owen Howard and Jeffrey
M. Jenson; “The Structure and Function of Social Work Practice Guidelines,” by Enola K.
Proctor and Aaron Rosen; “Social Work Should Help Develop Interdisciplinary Evidence-Based
Practice Guidelines, Not Discipline-Specific Ones,” by Bruce A. Thyer; “The Role of Diagnostic
and Problem Classification in Formulating Target-Based Practice Guidelines,” by Stuart
A. Kirk; “Constructing Practice: Diagnosis, Problems, Targets, or Transactions?,” by Mark
A. Mattaini; “Responsiveness of Practice Guidelines to Diversity in Client Populations and
Practice Settings: The Idiographic Application of Normative Generalizations;” “Accounting
for Variability in Client, Population, and Setting Characteristics: Moderators of Intervention
Effectiveness,” by Lynn Videka; “Service-Delivery Factors in the Development of Practice
Guidelines,” by Luis H. Zayas; “Performance Standards and Quality Control: Application of
Practice Guidelines to Service Delivery,” by Wilma Peebles-Wilkins and Maryann Amodeo;
“Practitioner, Organizational, and Institutional Factors in the Utilization of Practice
Guidelines;” “Practitioner Adoption and Implementation of Practice Guidelines and Issues of
Quality Control,” by Edward J. Mullen and William F. Bacon; “Organizational and Institutional
Factors in the Development of Practice Knowledge and Practice Guidelines in Social
Work,” by Jeanne C. Marsh; “Social Work Practice Guidelines in an Interprofessional World:
Honoring New Ties That Bind,” by Nina L. Aronoff and Darlyne Bailey; and “Advancing
the Development of Social Work Practice Guidelines: Directions for Research,” by Enola K.
Proctor and Aaron Rosen.
Rosen. A., Proctor, E.K., & Staudt, M. (2003). Targets of change and intervention in social
work: Empirically-based prototype for developing practice guidelines. Research on Social
Work Practice, 13(2), 208-233.
Abstract: Studies evaluating interventions were used as data to illustrate a rudimentary
prototype of practice guidelines comprising two components: taxonomy of outcome targets,
and their associated array of intervention. We use the data to discuss the adequacy of
intervention research in social work for contributing to practice guidelines. Data were all
the outcomes and their associated interventions investigated and reported in 13 social work
journals over a four and a half year period, totaling 126 studies. Results: The outcomes and
interventions were classified according to eight outcome target domains, yielding the practice
guidelines prototype. The research was unevenly distributed across the eight target domains,
and a pattern of ‘single outcome-single intervention’ design was evident across all target
domains. Data suggest insufficient attention to comparative evaluation of interventions and
to assessing effectiveness across client populations and service settings, and need for betterdesigned and prioritized intervention research overall.
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Zayas, L., Gonazalez, M., & Hanson, M. (2003). What do I do now? On teaching evidencebased interventions in social work practice. Journal of Teaching in Social Work, 23 (3/4).
Abstract: Recent advances made by medicine and psychiatry in the development of practice
guidelines and evidence-based interventions are spreading to social work and other helping
professions. As the movement toward evidence-based practice grows, more demands for
the use of tested interventions will be placed on practitioners. In this paper, we argue that
social work practice education must change to respond to this demand. Specifically, evidencebased interventions must be incorporated into the teaching of the middle phase of social
work practice more than it is now. Social work training has traditionally relied on untested
interventions that have come from the tacit knowledge of accumulated practice wisdom.
Although tacit knowledge has an important place in social work practice, instructing students
about evidence-based, empirically derived interventions provides them with critical knowledge
and skills they will need to enter the competitive world of social work practice. Moreover,
this approach amplifies the importance of launching practitioners with skills of evidencebased thinking; that is, the identification, evaluation, and selection of interventions with
demonstrated effectiveness.
2002
Pollio D.E. (2002) The evidence-based group worker. Social Work with Groups, 25(4), 57-70.
Abstract: This essay reflects on recent practice and educational trends contributing to the
current impetus for consistent incorporation of evidence into practice. Evidence-based group
work is defined as the conscientious and judicious use of evidence in current best practice.
In operationalizing this definition, the evidence-based group worker (a) appraises critically
systematically-collected evidence from all sources; (b) acquires knowledge through reading
professional journals, attending conferences and presentations, and writing/presenting
knowledge that he/she develops; (c) evaluate the outcomes of practice, using consistent
methods; (d) implements models, either existing or developed by the practitioner, consistently
and rationally; (e) attends to the impact of individual differences in making evidence-based
practice decisions; and (f) incorporates evidence in understanding group process, leadership,
and development. These principles lead to four behaviors associated with being an evidencebased group worker: (1) willingness to communicate evidence behind treatment decisions and
techniques chosen with group members; (2) building time to learn into practice; (3) practicing
from a developmental perspective, building knowledge through incorporating outside learning
and results of his/her own practice evaluations; (4) adapting existing evidence to each practice
situation. Implications for teaching group work are discussed.
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Rosen, A., & Proctor, E. (2002). Standards for evidence-based social work practice: The
role of replicable and appropriate interventions, outcomes and practice guidelines, In
A.R. Roberts and G.J. Greene (Eds.), Social workers’ desk reference (SWDR) (pp. 743-747).
Oxford University Press.
Abstract: The fundamental issue addressed by this chapter is how practitioners can best use
in practice the products of research in order to ensure effective practice. Social work has long
recognized the scientific method as the preferred basis for its knowledge and the source of
criteria for assessing the effectiveness of its practice. The essence of the scientific method
as applied to practice is that the appropriateness of interventions be ascertained on the basis
of evidence as to their effectiveness. Such evidence must consist of empirically demonstrated
linkages between interventions and the outcomes toward which they are directed.
2001 and earlier
Rosen. A., Proctor. E.K., & Staudt, M. (1999). Social work research and the quest for
effective practice. Social Work Research 23(1), 4-14.
Abstract: This article reports a study assessing the contribution of current social work journal
publications to a cumulative body of research that is capable of informing interventions.
Thirteen journals published from 1993 to mid-1997 were reviewed. Analysis was guided by
the view that the focus and design of studies should correspond to and supply the knowledge
needed to perform different practice tasks. Accordingly, journal research articles were classified
by their potential contribution to practice decisions requiring descriptive, explanatory, or
control knowledge. Research aiming at control knowledge, informing the selection and
implementation of interventions, was further evaluated by whether the interventions and
outcomes studied were sufficiently specified to permit reliable research replication and
application in practice. Very few of the published articles were found to report research on
interventions, and even fewer used designs that enable replication. Factors affecting the rate
and quality of research and interventions are also discussed.
Lawlor, E.F., & Raube, K. (1995). Social interventions and outcomes in medical effectiveness
research. Social Service Review, 69(3): 383-404.
Abstract:. The article focuses on the principles and approaches characteristic of medical
effectiveness research and the treatment of social factors in the current generation of studies.
A revolution in the design, administration, organization, and financing of health services
is underway. The “medical outcomes movement,” a national program of research, practice
guideline development, and administration, is radically reshaping the way health services are
understood, justified, and delivered. The development of practice guidelines--standardized
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protocols that indicate the appropriate practice given a set of clinical indications--will improve
quality of care, patient satisfaction, and clinical outcomes and ultimately reduce costs. In
its early stages, this movement focused on conventional and often high technology medical
interventions where there was evidence of high degrees of physician discretion and variability
in decision making. Now, research and guideline development are shifting to more intransigent
health problems that are not purely medical in nature.
Rosen. A.., Proctor E.K., & Staudt, M. (1995). Rationales for practice decisions: Variations in
knowledge use by decision task and social work service. Research on Social Work Practice,
54(4), 501-523.
Abstract: This article addresses social workers’ use of knowledge by studying the rationale
they provided for their actual practice decisions. Extent of knowledge use was compared across
four practice decision tasks and between medical and psychiatric social work services. Data were
obtained from the records of 297 clients treated by 34 experienced M.S.W. social workers in
medical and psychiatric services units of two mid-western hospitals. Workers were previously
trained in the approach and procedures of Systematic Planned Practice (SPP). Data were
obtained from SPP forms on which workers recorded their treatment decisions and rationale
for each decision. Data analyzed by repeated measures (MANOVA and ANOVA’s) revealed
that giving of rationales, and the types of knowledge it reflected, varied significantly by the
decision task and social work service. Intervention decisions were least likely to be supported
by rationales, and medical services workers provided fewer rationales than psychiatric services
workers. Conceptual rationales were the most frequently used, whereas rationales based on
practice experience, values, research, or client wish were very little used The implications for
practice, professional education, quality assurance, and for further research are discussed.
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Appendix B
Members of Brown School EBP Task Force Members – 2005-06
Enola Proctor (Chair), Professor & Associate Dean for Research
Tonya Edmond, Associate Professor
Peter Hovmand, Assistant Professor
Melissa Jonson-Reid, Associate Professor
Amanda Moore McBride, Assistant Professor
David Pollio, Associate Professor
Nancy Vosler, Associate Professor
Gautam Yadama, Associate Professor
James Herbert Williams, Associate Professor & Associate Dean for Academic Affairs
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Appendix C
References
Bloom, B. (1984). Taxonomy of Educational Objectives, Boston, Allyn Bacon.
Drake, B., Hovmand, P., Jonson-Reid, M., & Zayas, L. (2007). Adopting and teaching evidencebased practice in master’s level social work programs. Journal of Social Work Education,
43(3), 405-428
Evidence Based Medicine Working Group (1992). A new approach to teaching the practice of
medicine. JAMA, 268, 2420-2425
Gambrill, E. (1997). Social work practice: A critical thinker’s guide. New York: Oxford
University Press
Gambrill, E. (1999). Evidence-based practice: An alternative to authority-based practice.
Families in Society, 80, 341-350.
Gibbs, L. & Gambrill, E. (2002). Evidence-Based Practice: Counter-arguments to objections.
Research on Social Work Practice, 12(3), 452-456.
Rubin, A. (2006). Highlights of Symposium Papers. National Symposium on Improving the
Teaching of Evidence-based practice, UT Austin on October 16th-18th, 2006 (http://www.
utexas.edu/ssw/ceu/practice/papers/EBPRubinHighlights.pdf)
Rubin, A. & Parrish, D. (2007). Challenges to the future of evidence-based practice in social
work. Journal of Social Work Education, 43(3), 405-428
Sackett, D., Richardson, S., Rosenberg, W., Haynes, B. (1996). Evidence-Based Medicine: How
to practice and teach EBM David L Sackett, W Scott Richardson, William Rosenberg, R Brian
Haynes. Edinburgh: Churchill Livingstone. 1996. 250pp. ISBN 0-443-05686-2.)
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Appendix D
Members of Brown School Macro Work Group
Melissa Jonson-Reid (Chair), Associate Professor
Stephanie Boddie (2007-08), Assistant Professor
Yunju Nam, Assistant Professor
Shanta Pandey, Associate Professor
Ramesh Raghavan, Assistant Professor
Paul Shattuck, Assistant Professor
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Appendix E
Parish/Rubin Instrument
Evidence-Based Practice Knowledge Questions
Please read each statement and circle the letter next to the response that best represents your
answer.
ID#___________________
POSTTEST
**Please do not complete until after the training.
The posttest is comprised of two sections: 1) The EBP process scale and 2) the EBP knowledge
questions. Both sections are included in this handout. Please complete both sections. Thank
you!
EBP PROCESS ASSESSMENT SCALE
Purpose: The purpose of this scale is to assess your views about the Evidence-Based Practice
(EBP) process.
Definition: The EBP process includes considering the best research evidence available as part
of the basis for making practice decisions. It does NOT mean just providing an evidence-based
treatment; rather it means engaging in each of the following five steps in your practice: 1)
Formulating a practice question that can be answered by searching for research evidence; 2)
Tracking down the best research evidence to answer the question, 3) Critically appraising the
evidence, 4) Integrating the critical appraisal with practitioner expertise and client attributes to
guide your practice decision, and 5) Evaluating the outcomes of the practice decision.
Instructions: The scale contains five sections.
For the first three sections (I-III), please circle the response to the right that best fits how
much you agree or disagree with statements regarding the EBP process.
For the final section (IV), please circle the response that best fits the frequency with which you
intend to and currently engage in the EBP process.
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EBP is a relatively new concept. Therefore, like many other practitioners, you may know little
about it. Nevertheless, please answer all items, even if you are unsure of your answer or have
no opinion. Please circle N (Neutral) for every item for which you are neutral, uncertain, or feel
that you don’t know enough about EBP to respond in an informed manner.
All responses are anonymous; please answer each item according to how you really view the
EBP process and its feasibility in your practice.
Thank you!
Section I. Familiarity with the Evidence-Based Practice (EBP) Process
Level of Agreement
Statement
I know how to skillfully apply the steps of the EBP process.
I understand how to formulate questions about practice that can
be answered with research evidence.
I feel confident in my ability to find the best research evidence to
guide my practice decisions.
I know how to find systematic reviews.
I understand how to appraise the research evidence pertaining to
my practice question.
I can differentiate between very weak evidence and very strong
evidence.
I know what factors to consider in addition to the research
evidence when making practice decisions.
I understand how to evaluate the outcomes of my practice
decisions.
I understand what is meant by the term research-based practice
guidelines.
I know how to use the internet to facilitate my search for research
evidence.
Strongly
Disagree
Disagree
Neutral
Agree
Strongly
Agree
SD
D
N
A
SA
SD
D
N
A
SA
SD
D
N
A
SA
SD
D
N
A
SA
SD
D
N
A
SA
SD
D
N
A
SA
SD
D
N
A
SA
SD
D
N
A
SA
SD
D
N
A
SA
SD
D
N
A
SA
Please proceed to the next page.
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Section II. Attitudes About the Evidence-Based Practice (EBP) Process
Level of Agreement
Statement
Strongly
Disagree
Disagree
Neutral
Agree
Strongly
Agree
EBP is nothing more than a way to cut treatment costs.
SD
D
N
A
SA
EBP helps improve clients’ outcomes.
SD
D
N
A
SA
Engaging in EBP hinders the use of practitioner judgment.
SD
D
N
A
SA
SD
D
N
A
SA
SD
D
N
A
SA
SD
D
N
A
SA
SD
D
N
A
SA
SD
D
N
A
SA
SD
D
N
A
SA
SD
D
N
A
SA
SD
D
N
A
SA
SD
D
N
A
SA
SD
D
N
A
SA
SD
D
N
A
SA
Practitioners who engage in the EBP process show greater concern
for client well being than practitioners who do not engage in EBP.
Engaging in the EBP process makes practice too mechanistic.
The EBP process allows enough room for considering unique client
circumstances or preferences.
The judgment of esteemed colleagues or supervisors offers a better
basis than research evidence for improving practice effectiveness.
EBP helps clients meet their goals.
Engaging in the EBP process hinders the practitioner-client
relationship.
Trying to engage in EBP is more ethical than refusing to engage in it.
I know what is best for my clients without examining the research
evidence.
Experienced practitioners should disregard research evidence when
it conflicts with their intuition.
Engaging in the EBP process will improve one’s practice.
Engaging in the EBP process means using interventions that won’t
apply to the kinds of clients I see.
Please proceed to the next page.
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Section III. Feasibility for You to Engage in the Evidence-Based Practice (EBP)
Process
Level of Agreement
Statement
Strongly
Disagree
Disagree
Neutral
Agree
Strongly
Agree
I have enough time to engage in the EBP process.
SD
D
N
A
SA
I wish I had more time to engage in the EBP process.
SD
D
N
A
SA
I have enough access to the research literature to engage in EBP.
SD
D
N
A
SA
SD
D
N
A
SA
SD
D
N
A
SA
SD
D
N
A
SA
SD
D
N
A
SA
I am too busy to think about incorporating anything new into my
practice.
It is too much to learn more than one kind of intervention.
I have enough time to evaluate the outcomes of my practice
decisions.
The constraints of my practice setting preclude me from engaging
in the EBP process.
Please proceed to the next page.
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Section IV. Intentions to Engage in the Evidence-Based Practice (EBP) Process
Instructions: For this section, please circle the number to the right of each item that best
describes how often you intend to engage in the specified behavior.
Frequency
Behavior
I intend to use the internet to search for the best research evidence
to guide my practice decisions.
I intend to read about research evidence to guide my practice
decisions.
I intend to read research-based practice guidelines to guide my
practice decisions.
I intend to rely on research evidence as the best guide for making
practice decisions.
I intend to rely on the practice wisdom of esteemed colleagues or
supervisors as the best guide for making practice decisions.
I intend to inform clients of the degree of research evidence
supporting alternative intervention options.
I intend to involve clients in deciding whether they will receive an
intervention supported by the research evidence.
Never
Rarely
Some of
the time
Often
Very Often
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
I intend to stick to providing the interventions with which I am
more comfortable, even if research shows others to be more
effective.
I intend to evaluate the outcomes of my practice decisions.
1
2
3
4
5
I intend to engage in all steps of the EBP process
1
2
3
4
5
Please proceed to the next page.
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Evidence-Based Practice Knowledge Questions
Please read each statement and circle the letter next to the response that best represents your
answer.
1. Practitioners who engage in evidence-based practice will:
a. rely most heavily on the practice wisdom of supervisors and experts.
b. scientifically monitor client outcomes.
c. utilize one major theoretical framework and intervention strategy with most clients.
d. only select interventions that are on the list of empirically supported treatments.
e. Only b and d
2. The best scientific evidence might:
a. be only good enough to guide practice in a tentative manner.
b. not be relevant to a client.
c. indicate what not to do.
d. Only a and b
e. All of the above
3. Which of the following statements is/are true about applying the intervention supported
by the best research evidence?
a. Because it is the most effective, you should implement this treatment the best that you
can, even if you cannot get training or supervision.
b. Because it is the most effective, you should make the clinical decision to select this
intervention for your client.
c. If you decide to implement this intervention, you should monitor client progress with it.
d. All of the above.
4. In appraising the evidence to be strong in an outcome evaluation of the effectiveness of an
intervention, it is important to consider:
a. how the outcome was measured.
b. whether a control group was used
c. whether participants across different treatment conditions are really comparable to
begin with
d. All of the above
Please proceed to the next page.
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5. Which of the following statements is/are true about searching for and critically appraising
evidence?
a. You should critically appraise all research articles that relate in some way to your EBP
question.
b. It is okay to use keyword terms that limit the kinds of studies that come up to those that
are likely to be most useful to you.
c. It is okay to just read the study abstract as a basis for deciding whether the study is
sufficiently relevant to merit reading in its entirety.
d. Only b and c
6. A good systematic review:
a. fully discloses its search and inclusion strategy.
b. assesses the quality of selected outcome studies.
c. is done by someone within the field who has a vested interest in the findings of the
review.
d. All of the above
e. Only a and b
7. Which hierarchy of evidence below is the most accurate order from highest to lowest for
locating an effective intervention (assuming that all studies are implemented well with good
measurement and are unbiased)?
a. Experimental studies, quasi-experimental studies, meta-analyses, qualitative studies.
b. Quasi-experimental studies, meta-analyses, qualitative studies, experimental studies.
c. Meta-analyses, quasi-experimental studies, experimental studies, qualitative studies.
d. Meta-analyses, experimental studies, quasi-experimental studies, qualitative studies.
Please proceed to the next page.
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True/False Items:
8. You should avoid using an asterisk (*) in your search term because it will make the search
too narrow. T F
9. If a study has been published and it appears in a reputable literature base, you can be sure it
has been conducted objectively and rigorously. T F
10.When measuring client outcomes, it might be okay to develop your own individualized
rating scale instead of using an instrument that researchers have validated. T F
11.Evidence-based practice questions are restricted to asking about the effectiveness of
interventions, programs or policies. T F
Thank you for your time.
Please place this pretest in the anonymous drop box.
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Appendix F
Members of Brown School Curriculum Committee
Tonya Edmond, Chair, Associate Professor & Associate Dean for the MSW Program
Peter Hovmand (Foundations), Assistant Professor
Melissa Jonson-Reid (CYF), Associate Professor
Carolyn Lesorogol (SED), Assistant Professor
Timothy McBride (Health), Professor & Associate Dean for Public Health
Curtis McMillen (Mental Health), Professor
Nancy Morrow-Howell (Gerontology), Ralph and Muriel Pumphrey Professor of Social Work,
ex officio
Diane Beckerle O’Brien (Gerontology & Field Education), Associate Director of Field Education
Estelle Rochman, Director, Office of Student Affairs
Minchao Jin, MSW Student Representative
Kay McChesney, MSW Student Representative
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Appendix G
Members of Brown School Foundations Work Group
Brett Drake (Chair), Associate Professor & Reaffirmation Project Director
Lorien Carter, Lecturer
Tonya Edmond, Associate Professor & Associate Dean for Academic Affairs
Peter Hovmand, Assistant Professor
Barbara Levin, Program Coordinator, Alliance for Building Capacity
Amanda McBride, Assistant Professor
Yunju Nam, Assistant Professor
Sylvia Toombs, Library Director
Cynthia Williams, Director
Luis Zayas, Shanti K. Khinduka Distinguished Professor of Social Work
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Appendix H
Sample Syllabus from a foundation course
GEORGE WARREN BROWN SCHOOL OF SOCIAL WORK
WASHINGTON UNIVERSITY
Fall 2008
RESEARCH METHODS FOR SOCIAL WORK PRACTICE
S15-5005
CREDIT HOURS: 3
INSTRUCTOR:
GRADE: L/G
OFFICE:
ROOM: OFFICE HOURS:
TIME: 3 HOURS RECOMMENDED PHONE:
E-MAIL:
NOTE: All foundation courses are being revised this semester as part of a school-wide effort to better
incorporate Evidence-based practice. Due to this, all foundation (S15-XXXX) syllabi are subject to
revision.
I. COURSE DOMAIN AND BOUNDARIES
This course has three main goals:
1. Students will understand the basics of social research. Core research concepts are
presented including specification, design, measurement, qualitative and quantitative
research, clinical research (multisubject and single subject) use of computers in data
retrieval, data management and data analysis, research implementation, interpretation and
dissemination.
2. Students will understand how research is used in evidence-based practice. This
includes the ability to frame empirically answerable questions, locate data relevant to those
questions, critically evaluate such data and apply it to practice situations.
3. Students will develop a deeper understanding of the research process through
designing and executing a research project. “Tell me, I’ll forget. Show me, I’ll remember.
Involve me, I’ll understand.” – Chinese Proverb
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As core components of the course, values are explored and ethics are taught as they apply to
research, and the intertwined nature of diversity, social and economic justice, and research is
presented and explored.
II. COURSE COMPETENCIES
Competencies required in all foundation courses
1. Know and apply appropriate ethical codes (e.g. NASW, etc…) and laws (e.g. mandated
reporting)
2. Work through ambiguity in resolving ethical conflicts.
3. Recognize and manage personal biases and values so that professional values guide practice,
including issues of diversity
4. Apply ethical reasoning to reach decisions
5. Recognize global, social, economic, political and cultural factors which result in oppression
or advantage.
6. Understand how age, class, color, culture, disability, ethnicity, gender, gender identity and
expression, immigration status, political ideology, race, religion, sex, and sexual orientation
shape clients experiences and affects practice with those clients.
7. Can frame empirically answerable questions from needs/problems encountered in practice.
8. Can locate the best available empirical evidence of any type
9. Can critically evaluate empirical evidence
10.Can integrate and apply best available evidence with professional judgment, involved
persons, and social context.
Additional competencies taught in Research Methods:
11.Can critically analyze and select and implement practice models, including evidence
supported practices.
12.Can generate empirical data from own practice and evaluate own practice.
13.Can specify, design, execute, analyze and communicate empirical research at multiple levels.
(contribution to EBP data)
14.Can use practice experience to inform scientific inquiry
15.Can assess client systems, including strengths, and limitations
16.Can develop agreed upon intervention plans and goals.
17.Engages in practice which is as transparent as possible given the situation
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III.COMMON PEDAGOGICAL ELEMENTS
Pedagogical elements common to all sections of this course include:
1. This course includes in-class demonstrations of computerized information retrieval
systems. These are shown at general (e.g. Wikipedia and/or Google), scientific (e.g. Google
Scholar, PsychInfo), and specialty (e.g. Cochrane Collaboration, NGO) levels. Students will
complete assignments demonstrating mastery of the above kinds of search engines.
2. Instructors will demonstrate critical evaluation of existing research which is relevant to
social work practice. Students will complete assignments demonstrating their ability to
criticize existing research at a basic level.
3. Students will complete a research project (possibly in groups) demonstrating their ability
to formulate a question, choose and execute a design, implement the research, analyze
and interpret resultant data, and create a product in a format fit for dissemination (e.g.
PowerPoint, poster, paper, agency presentation, etc…)
4. Instructors will demonstrate/model the EBP process, showing how specific field-generated
questions can be (1) formulated and operationalized, (2) how best available evidence can be
located, (3) critically evaluated, and applied to practice. Main emphasis will be on steps 1 -3.
5. Instructors will provide students with examples of critical ethical failures in the history
of social research. Students will demonstrate compliance with ethical standards in their
assignments.
IV. TEXT/REQUIRED READINGS
Drake & Jonson-Reid (2008). How to do Social Research: From Conceptualization to Dissemination.
Drake & Jonson-Reid (2008). Student Workbook for How to do Social Research: From
Conceptualization to Dissemination.
V. ORGANIZATION OF THE COURSE
Course content will be covered through readings, individual and group exercises, lectures, and
discussions. Handouts will be provided in class where appropriate.
VI.ROLE OF INSTRUCTOR AND STUDENTS
Course Expectations: The instructor will: prepare and deliver course material; be available to
students during office hours, after class, and by appointment for consultation; and provide
timely and clearly explained feedback on student performance. The instructor expects students
to: attend each class on time; complete all assignments in a timely manner; come to class
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prepared, having read all assignments; participate in class discussions; seek any necessary
clarification regarding course expectations from the instructor; and provide the instructor
with feedback about the effectiveness of the course. Any problems with attendance, meeting
deadlines, or completing assignments should be discussed promptly with the instructor.
Special Needs: Students who have a learning disability, sensory or physical disability or
impairment, or English as a second language and need special assistance in lecture, reading
assignments, and/or testing should contact the instructor as soon as possible.
VII.ASSIGNMENTS AND GRADING CRITERIA
Weekly assignments (Weeks 2 through 7):
36 Points (6 Points each)
Class participation
32 Points
Final group product
32 Points
Grading Scale: 92-100:A,
90-91: A-,
88-89: B-, 82-87: B,
80-81: BIf your grade is lower than 80, we’ll have to talk and figure out what to do. I doubt this will
happen. I do not anticipate grading the group project harshly, so don’t be too worried about
being “dragged down” by your group.
VIII. COURSE OUTLINE
WEEK 1: “Hello” and Brief Introduction to Evidence Sources
Overview of course, introductions, familiarization with each other’s general areas of interest
(2 hrs). In-class demo on evidence/literature retrieval, includes introductions to Wikipedia,
Google, Google Scholar, PsychInfo and Guideline.gov (1 hr). This in-class literature retrieval
demonstration is preliminary, and is meant to provide students with an initial sense of the
various kinds of data available. As a final exercise, we will review an article I supply, and I will
get your views on if this is a good or a poor article to use as a basis for practice
WEEK 2: Values and Ethics, Defining Your Area of Research Interest
Detailed description of research values and ethics. Students are expected to begin to specify
general areas in which they might have questions or research interests. Students should pay
particular attention to the EBP module in Chapter 1 (pages 15-20), as we will focus on how the
skills learned in this class will be part of students’ everyday practice.
Readings to be completed before class session:
D&JR Preface, Chapters 1 and 2 and part of Chapter 3 (sections 3.1 and 3.2 only). Pages xix
through 41.
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Assignments due this week:
Workbook: Pages 4 (EBP), 5, 7, 8 & 24 (your project), 6, (general)
Videos: NOVA: The Deadly Deception (about the Tuskegee Syphilis Study) or or Quiet Rage
(regarding Zimbardo’s Stanford Prison Experiment) may be shown if time permits.
WEEK 3: Obtaining and Reviewing Literature
Last week you began to specify a general area of interest. This week, you will begin to learn
more about that area, and will spend some time locating at conceptual, review, and empirical
sources (see page 42). We will review the evidence/literature retrieval skills covered in the book
using in-class examples, and will pay particular attention to . Students will have the chance to
discuss their successes and failures in finding needed sources.
Readings to be completed before class session:
D&JR Chapter 3.3-3.5. Pages 41 through 55.
Read your own eight articles (workbook assignment on page 25)
Assignment due this week:
Workbook: Pages 10,11, 22,(EBP), 12, 13, 25 (your project), 10,11(general)
WEEK 4: Your Conceptual Framework
This week will build on last week’s session and feature the very difficult issue of how we begin
to formalize our conceptual framework. Notice that you are only assigned 14 pages of reading
this week. This is because I expect you to put a great deal of work into trying to nail
down your conceptual framework. I will be looking at your answers to the questions in the
workbook on pages 26 and 27 very carefully.
Readings to be completed before class session:
D&JR: Chapter 3.6 – 3.7. (pages 55-68)
Assignments due this week:
Workbook: Pages 23 (EBP) 26 ,27 (your project)
Lab Component (1 hr): We will help each other review our assignments. We will do this kindly
but critically to help you get used to taking the helpful (and painful) advice of others.
WEEK 5: Specifying Aims, Questions and Hypotheses: Introduction of Seven Key Dimensions
of Research, Introduction to Control, Subjects and Sampling
We will move from our conceptual frame work to specified aims, questions and hypotheses.
Readings to be completed before class session:
D&JR: Chapter 4, up to and including 4.24.
Your own nine articles (workbook page 25)
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Assignments due this week: (Staple it all together)
Redo the workbook assignments on page 26 and 27. If you are still pleased with these
assignments as you turned them in before, just resubmit with the phrase “no changes” written
at the top.
Do the workbook assignments on pages 53,54 & 55 (your project).
Redo the workbook assignment on page 25, finding 8 new articles.
WEEK 6: Timeframe, Data, Measurement, Internal Validity and External Validity
A number of issues will be covered this week, where we spend time learning the “nuts and
bolts” of how research is done, and what key threats exist to doing quality work.
Readings to be completed before class session:
D&JR: Chapter 4.25 up to and including 4.4., also Chapter 5.
Assignments due this week:
Workbook Pages 57, 58 (Exercise 1 only).
Redo the workbook assignments on page 26 and 27. If you are still pleased with these
assignments as you turned them in before, just resubmit with the phrase “no changes” written
at the top. This one is important, since it will form the basis for which projects are selected next
week.
WEEK 7: Organization of Group Projects and Mid-Semester Review.
We will spend the majority of the time selecting your semester project topics and assigning
you to groups. The projects will be discussed in detail, with prior course content being related
clearly to each. We will spend time reviewing the Littell & Schuerman article as a way of
reviewing core methods concepts and previewing next week’s content on experimental designs.
Readings to be completed before class session:
Littell, J., Schuerman, J., A Synthesis of Research on Family Preservation and Family
Reunification Programs. (http://aspe.hhs.gov/hsp/cyp/fplitrev.htm). If they’ve moved the darn
thing (again!) just find it online. You have the skills, Google the title and author’s names.
Classroom Component : We will decide which of your projects will be selected to be used for
the remainder of the class. Probably 4-5 will be chosen if we have 25 students. I may choose
them before class, or I may ask your input during class. It depends on how feasible your projects
are. There are plenty of really good ideas which just won’t work for this class, so don’t get
upset if you get eliminated (it’s sort of like “American Idol” or “Top Chef ”). We will break into
permanent groups, and each group will execute one of the projects during the remainder of
the semester.
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WEEK 8: In-Class Introduction to Excel, NVivo, and SPSS.
Instructor will demonstrate these databases consistent with material presented in Chapter 10.
Readings to be completed before class session:
D&JR, Chapter 10.
Assignment due this week:
Workbook, Pages 78 and 79 (Excel examples). Print out products from Excel and stable
together.
WEEK 9: Experimental and Quasi-Experimental Designs
Readings to be completed before class session:
D&JR: Chapter 4.4 through 4.6.
D&JR: Chapter 9 (Yuan and Kathy sections only)
DJ&R: Chapter 12 (Yuan and Kathy sections only)
DJ&R: Chapter 15 (Yuan and Kathy sections only)
Assignment due this week:
You need to increase compliance for visits (decrease no-shows) at your mental health clinic
(near this university) where you mainly treat people for depression. You find the following
article: “Effects of Group Psychoeducation (GPE) on Compliance with Scheduled Clinic
Appointments in a Neuro-Psychiatric Hospital in Southwest Nigeria: A Randomized Control
Trial (RCT)” at http://annals.edu.sg/PDF/36VolNo4Apr2007/V36N4p272.pdf. On one
double-spaced page, answer the following questions:
• What is your evaluation of the quality of this study? Address the sample, the design and if
you think the author’s conclusions are justified.
• Is this study useful to you based on the above-described circumstances? Why?
WEEK 10: Non-Experimental Designs
Readings to be completed before class session:
D&JR: Chapter 4.7
D&JR: Chapter 9 (Maria and Abigail sections only)
DJ&R: Chpater 12 (Maria and Abigail sections only)
DJ&R: Chapter 15
Assignment due this week: Your practicum site deals with eating disorders and just had
a pair of fatalities. People are not happy. This will not happen again. Your supervisor tells
you to find information which will help to prevent future fatalities. You find: “Mortality
in Eating Disorders: A Descriptive Study”. http://www3.interscience.wiley.com/cgi-bin/
fulltext/72500089/PDFSTART On one double-spaced page, answer these questions:
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• What is your evaluation of the quality of this study? Address the sample, the design and if
you think the author’s conclusions are justified.
• Is this study useful to you based on the above-described circumstances? Why? List two
recommendations you might make based on this study.
WEEK 11: Qualitative
Readings to be completed before class session:
D&JR: Chapter 6, 10.4. Also chapters 9,12 &15 (John’s sections of these three chapters only).
Assignment due this week: You are a student doing research for a local agency. This agency
has formerly done only marital counseling and youth counseling, but recently got a contract
to begin doing court-ordered treatment for sex offenders referred by the courts. Someone else
is tracking down what to actually do with these people, so don’t worry about that. The agency
director is very concerned that her staff might not be fully prepared to deal with these new
clients – that she be able to prepare her workers for the kinds of issues which might arise when
working with this population. You find the following article: “Working with Sex Offenders: The
Perceptions and Experiences of Professionals and Paraprofessionals” http://ijo.sagepub.com/
cgi/reprint/43/1/103. On a single double-spaced page, answer the following questions:
• What is your evaluation of the quality of this study? Address the sample, the design and if
you think the author’s conclusions are justified.
• Is this study useful to you based on the above-described circumstances? Why? List two
particular recommendations you might make based on this study.
WEEK 12: Generating Evidence in Clinical Settings
Readings to be completed before class session:
D&JR: Chapters 7 and 8
We will describe how research skills can be applied to individuals, caseloads or agencies in
clinical (micro practice or management - type) settings.
Assignment due this week: Each group will present for 10 minutes on their group’s progress.
WEEK 13: Implementation Issues
Readings to be completed before class session:
D&JR: Chapter 11. Also review Chapter 12 again.
Classroom component will cover above material. Discussion will center both on examples from
the book and on the experiences students are having as they get their own group projects
going. We will also revisit the article assigned in week 1 to see if your views of it have changed
in any way.
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Assignment due this week: Each group will present for 10 minutes on their group’s progress.
WEEK 14: Review of Statistical Tools
Readings to be completed before class session:
D&JR: Chapters 13 through 15. It is OK if Chapter 14 leaves you a bit confused. I just want
you to know that those approaches exist. If you get totally lost, chapter 15 will provide you
with sort of a guided tour of how this stuff works in practice and you can follow along.
Assignment/Classroom Activity:
Each team will bring in data from their projects (on a flash drive or otherwise available to the
classroom computer) and either (1) show what analyses they have completed and how they did
them or (2) show what they have and explain what problems they are encountering. A computer
will be set up with a projection screen so that we can manipulate the data live, in class.
WEEK 15: Presentation of Final Projects
Your team’s final project must include a packet with ALL of the following:
• An APA style paper (like Professor Kathy)
• A PowerPoint presentation (like Maria) – You will present this in class.
• An Agency Report (Like Yuan).
Readings to be completed before class session:
D&JR: Chapter 16. You will present your PowerPoint in class formally, as if you were at a
conference. You will also then engage the class in an informal discussion of what happened,
what went wrong, and what you learned.
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Appendix I
Members of Brown School EBP Steering Committee – 2008-09
Enola Proctor (Chair), Professor & Associate Dean for Research
Brett Drake, Associate Professor & Reaffirmation Project Director
Tonya Edmond, Associate Professor & Associate Dean for Academic Affairs
Curtis McMillen, Professor
Betul Ozmat, Assistant Dean for Strategic Initiatives
Ramesh Raghavan, Assistant Professor
Ellen Rostand, Assistant Dean for Communications
Michael Sherraden, Professor
Sylvia Toombs, Library Director
Cynthia Williams, Director of Field Education
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Appendix J
Members of Brown School National Council
B.A. Bridgewater, Jr. – Chairman
CEO (Retired) Brown Shoe Company
Washington University Trustee
Eugene S. Kahn
CEO, Claire’s Stores
Jo Ann Arnold
Consultant
Emerson Electric Company
Martha Korman
Executive Director - Premier Accounts
NGI Digital
Carol Ann Barnickol
Brown School Graduate
Community Volunteer
Charles Lowenhaupt
Lowenhaupt & Chasnoff, L.L.C.
Cynthia Brinkley
Senior Vice President - Talent Development
& Chief Diversity Officer
AT&T
Nicole Brueggeman
President, Brown School Alumni Assn.
Michael Bennett Kaufman
Marylen Mann
Founder and Chairman
The OASIS Institute
Sima Needleman
Medical Social Worker (retired)
Brown School Graduate
Carol Duhme
Roblee Foundation
Michael F. Neidorff
Chairman and CEO
Centene Corporation
Pastora Cafferty
Professor Emeriti
University of Chicago
Tim Noelker
Thompson Coburn, LLC
Richard F. Ford
Bonnie Orkow
Brown School Graduate
Marc Freedman
Founder and CEO
Civic Ventures
Glenn Sheffield
Former Mayor, Webster Groves, Missouri
Kathy Friedland
Brown School Graduate
David Habif
Bettie Schroth Johnson
Community Volunteer
Betty Sims
Program Director
Steve Spruth
Senior Lecturer
Carlson School of Management
University of Minnesota
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Donald M. Suggs
President & Publisher
St. Louis American
Norman J. Tice
Chairman Emeritus
MasterCard International
Barrett A. Toan
Chairman and CEO (Retired)
Express Scripts
Bernarda Wong
Founder and President
Chinese American Service League
Jay T. Youngdahl
Roma B. Wittcoff
Washington University Trustee
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Appendix K
Members of Dean’s Professional Advisory Council
Susan Stepleton, Chair
President & CEO
Parents as Teachers National Center
Jim Braun
President & CEO
Youth In Need
Kathleen E. Buescher
President & CEO
Provident, Inc.
Lewis Chartock
President
MERS/Goodwill
Beth Griffin
Theresa Dunn
Jean Neal
Barry Rosenberg
Executive Vice President
Jewish Federation of St. Louis
William Siedhoff
Director
Department of Human Services
City of St. Louis
Anna Crosslin
President & CEO
International Institute
Gary Dollar
President
United Way of Greater St. Louis
Flint Fowler
Executive Director
Herbert Hoover Boys & Girls Club
Paula Gianino
President & CEO
Planned Parenthood St. Louis Region
Dan Glazier
Executive Director
Legal Services of Eastern Missouri, Inc.
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