Gallaudet University
School of Social Work
Edward J Mullen
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9:00 – 10:30
10:30 – 10:40
10:40 – 12:00
12:00 – 1:00
1:00 – 2:30
2:30 – 2:40
2:40 – 4:00
Evidence Based Practice:
Definitions, History, &
Competencies
Break
Finding Evidence: Evidence-based
Practices
Lunch
Resources & Curriculum
Implications for Teaching &
Learning
Break
Break-out Group Discussion:
Applications to Classroom & Field
Curriculum
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Definitions
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Conceptual Frameworks
Process Skills
Question Types
Evidence
History
◦ Bridging Research & Practice in Social Work
◦ Evidence-based Medicine (EBM)
◦ Translating EBM into Social Work Contexts
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Competencies
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How can EBP concepts, skills, & competencies
be taught in the Gallaudet University School
of Social Work Curriculum?
How can class and field teaching & learning
be integrated around EBP?
How can EBP content be infused into current
course syllabi?
How can EBP problem-based learning be
fostered?
How can EBP critical thinking & EBP critical
assessment skills be enhanced in the
curriculum?
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Evidence-based Policy Practice
Evidence-based Management Practice
Evidence-based Direct Practice
Evidence-based policy is concerned with
problems about how best to achieve group or
population goals.
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For children with mental health problems is it
best to:
◦ provide remedial treatment services in residential
treatment facilities
◦ Or
◦ in community-based programs that allow children
to remain at home?
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Is it best to provide adults with severe and
persistent mental disorders:
◦ sheltered work programs
◦ Or
◦ supportive services aimed at securing employment
in the community?
Evidence-based management deals with
problems about how best to organize, finance
& implement services to populations.
How best to create & sustain an organizational
environment so as to move the organization toward
policy-based outcomes?
How best to create and sustain a learningbased organization?
1.
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Deals with problems of specific client units
Problems are those of identifiable clients in
need of some type of:
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4.
3.
Assessment
Intervention
Prevention
Evaluative service
Questions have to do with here-and-now
practice choices that must be made for
specific clients
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EBP is integration of
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Research evidence
◦ Best research evidence
◦ Practitioner expertise
◦ Client values
◦ Practice relevant research from:
 Basic sciences
 Client-centered practice research about:
 Accuracy & precision of assessment tests & interview procedures
 Power of prognostic markers;
 Efficacy & safety of therapeutic, rehabilitative, & preventive
regimens.
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Expertise
◦ Ability to use skills & experience to rapidly identify each client’s:
 Unique psychosocial state & problems or needs
 Individual risks & benefits of potential interventions
 Personal values & expectations.
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Client values
 Unique preferences, concerns, & expectations of client that must
be integrated into intervention decisions to serve client
Placing client’s benefits FIRST
 Practitioners adopt LIFELONG learning
 CONTINUALLY ASKING specific
questions
◦ of direct practical importance to
clients
 SEARCHING objectively & efficiently
◦ for current best evidence
 Taking appropriate action GUIDED by
evidence (Gibbs, et al., 2003).
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Best available
research
evidence
DecisionMaking
Client/population
characteristics,
state, needs,
values, &
preferences
Resources
including
practitioner
expertise
Evidence-based Behavioral Practice Council, EBBP.ORG
Newest Trans-disciplinary View of EBP
Evidence-based Behavioral Practice Council, EBBP.ORG
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Professional decision-making process in which social workers &
their clients systematically make intervention choices using
practitioner expertise to identify:
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client conditions, needs, circumstances, preferences and values;
best evidence about intervention options including potential risk &
benefit likelihoods;
contextual resources & constraints bearing on intervention options.
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how to assess client conditions & circumstances;
how to provide services;
how to evaluate the process & outcomes of services.
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Intervention choices refer to action options about:
Clients can be individuals, families, groups, communities or
large populations.
Best evidence includes findings from scientific studies as well
as from other reliable sources considered to be of highest
quality, strength, & relevance.
Using this decision-making process social workers themselves
provide the selected interventions or they link clients to others
who can provide the interventions.
Together with their clients, practitioners monitor & evaluate the
process & outcomes of services provided making changes in
response to what is learned & sharing this information with
others to benefit future clients.
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Ask well formed important questions about the care
of individuals, communities, or populations.
Acquire the best available evidence regarding the
question.
Appraise the evidence for validity & applicability to
the problem at hand.
Apply the evidence by engaging in collaborative
shared decision-making with the affected
individual(s) and/or group(s). Appropriate decisionmaking integrates the context, values & preferences
of client, as well as available resources, including
professional expertise.
Analyze change & adjust practice accordingly.
Assess outcome (process & intervention) &
disseminate results.
Because the evidence-based process informs future questions & practice, it is
useful to imagine it as a cycle:
Five steps of evidence-based practice.
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Assessment skills:
 Competency appraising client & community characteristics, problems,
values & expectations, & environmental context
 Practitioner’s competency to assess own expertise level:
 to implement interventions
 outcomes of those techniques once implemented
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Process skills:
 Competency performing 5 EBP process steps:
ask well-formulated questions
acquire best available research evidence
appraise evidence for quality & relevance
apply evidence by engaging in shared decision-making with those who will
be affected
 analyze change & adjust practice accordingly
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Communication & collaboration skills:
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Engagement & intervention skills:
Competency in motivating interest, constructive involvement, &
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 Competency to convey information clearly & appropriately
 Competency to listen, observe, adjust, & negotiate as appropriate to
achieve understanding & agreement on a course of action
positive change
Competency in provision of EBPs which vary in degree of training
& experience required
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In Social Work (Gibbs – handout 5)
◦ Client Oriented Practical Evidence
Search (COPES)
 In Medicine
 Patient Oriented Evidence that Matters
(POEM)
 Patient (or Problem), Intervention,
Comparison, Outcome (PICO)
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Client Oriented
◦ Questions from daily practice, posed by
practitioners, that really matter to client’s welfare
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Practical
◦ Concern problems that arise frequently
◦ Concern agency mission
◦ Knowing answer could impact decision
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Search Oriented
◦ Specific enough to guide electronic evidence
search
Client characteristics
 Client problem
 What practitioner is considering doing
 Alternative course of action against
which contemplated action is to be
compared
 What practitioner seeks to accomplish
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 If
delinquent youth
 Are exposed to
A residential based program
 Or
A community based program
 Will the former result in fewer
delinquent behaviors?
 If
families of latency aged boys
with conduct disorder
 Receive parent management
training
◦ Or
 No formal training
 Will the former exhibit lower
externalizing behavior problems?
 If
disoriented aged persons
residing in a nursing home
 Are given
◦ Reality orientation therapy
 Or
◦ Validation therapy
 Which will result in better
orientation to time, place, person?
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If sexually active high school students at
high risk for pregnancy
Are given
◦ A problem exercise
 (Baby-Think-It-Over)
 Or
◦ Didactic information
 (material on use of birth control
methods)
Will the former have fewer pregnancies
during the year?
 Among
adolescents at risk for
pregnancy
 Will a sex education program that
stresses abstinence
◦ Or
 One that provides birth control
information
 Result in the lowest pregnancy
rates?
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adolescents at risk for violence
 Receive school based violence
prevention programs
◦ Or
 No formal violence prevention
training
 Will the former display lower rates
of violence and aggression?
If aged residents of a nursing home
who may be depressed or may have
Alzheimer’s disease or dementia
 Are administered
◦ Depression Screening Tests
 Or
◦ A Short Mental Status Examination
Tests
 Which measure will be the briefest,
most inexpensive, valid and reliable
screening test to discriminate between
depression and dementia?
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If children & adolescents in my caseload
Are administered a computerized brief
depression scale
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Are screened by a staff psychiatrist
Will the former detect childhood depression
as frequently as the latter?
◦ If family members of children
diagnosed with a learning
disorder
◦ Meet in a support group to
receive information and support
from staff and other families
◦ What aspects of the support
group will they find most
helpful?
 Among
children who are cared for
by a primary caregiver diagnosed
as having a depressive disorder
◦ Compared with
 Children whose caregiver has no
diagnosed mental disorder
 Will the former children be more
frequently diagnosed as having a
behavioral or emotional disorder?
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If crisis line callers to a battered women
shelter
Are administered
◦ A risk assessment scale by telephone
 Or
◦ We rely on practical judgment unaided by a risk
assessment scale
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Will the scale have higher reliability and
predictive validity regarding future violence?
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Background Questions Ask for General
Knowledge about a Condition or Thing
◦ What Causes AIDS?
◦ How Does Neighborhood Violence Affect
Probability of Delinquency?
◦ Among children who are cared for by a
primary caregiver diagnosed as having a
depressive disorder compared with children
whose caregiver has no diagnosed mental
disorder will the former children be more
frequently diagnosed as having a behavioral
or emotional disorder?
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Foreground Questions Ask for Specific
Knowledge to Inform Decisions or Actions
◦ If children and adolescents in my caseload are
administered a computerized brief depression
scale or are screened by a staff psychiatrist
will the former detect childhood depression
as frequently as the latter?
◦ If adolescents at risk for violence receive
school based violence prevention programs
or no formal violence prevention training will
the former display lower rates of violence and
aggression?
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Enhances quality of decisions about individual
clients
Fosters skills to:
◦ Gather and appraise client’s stories, symptoms,
signs
◦ Incorporating values and expectations in alliance
Fosters generic skills for finding, appraising,
implementing scientific evidence
Provides educational and self-directed life-long
learning framework
Identifies knowledge gaps leading to new research
Provides common interdisciplinary language
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EBP moves practitioners away from
authoritarian practices & policies
EBP enhances opportunities to honor ethical
obligations to clients & students
◦ Helping clients develop critical appraisal skills
◦ Involving clients in design and critique of practice and
policy related research
◦ Involving clients as informed participants who share in
decision making
◦ Recognizing client’s unique knowledge in terms of
application concerns
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EBP promotes transparency & honesty
EBP encourages systemic approach for
integrating practical, ethical & evidentiary
issues
EBP maximizes flow of knowledge &
information about knowledge gaps
Gambrill, 2003
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EBP originated in medicine in 1990’s
EBM has been transferred into other health
disciplines over last 10-15 years
EBP is now widely accepted in health
disciplines
A major factor stimulating EBP development
is research showing that research findings
flow into practice at an extremely slow pace:
◦ Uptake of scientific discoveries into clinical
practice: 14% after 17 years (Balas & Boren,
2000)
◦ Only 15% of clinical practices based on evidence
(IOM, 1985; Eddy 2005).
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EBM was first introduced into American social
work in late 1990’s (Gambrill 1999)
Earlier models for integrating research & practice
did exist (e.g., the empirical practice movement
& scientific practitioner model)
Evidence-based social work practice is, however,
qualitatively different from these earlier efforts &,
like EBM, has been seen as a paradigm shift
The adoption of EBP has been facilitated by an
increase in practice research as well as by
mechanisms for evidence dissemination.
EBP is now required for accreditation of social
work training programs
Use of research evidence for professional practice
is required by the code of ethics for social work
Acquiring evidence as 3rd step of EBP
process
 What are evidence-based practices
(EBPs)?
 What qualifies as “evidence”?
 How are EBPs & EBP related?
 How can EBPs & “evidence” be found?
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Remember 5A’s which form process steps or
skills of EBP (next slide)
Recall that 2nd step is ACQUIRING evidence
needed to answer question ASKed in 1st step.
This step requires practitioners to conduct an
evidence search to answer questions
◦ Translate question into search terms
◦ Search relevant evidence sources
◦ Best done with assistance of reference librarian
Because the evidence-based process informs future questions & practice, it is
useful to imagine it as a cycle:
Five steps of evidence-based practice.
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Busy practitioners typically do not have time or skills to:
◦ Conduct searches for individual research studies which have
examined their EBP question.
◦ Synthesize the research evidence from these individual studies
Practitioners should first search for evidence summaries
Evidence summaries are rapidly becoming available in
online systems & clearinghouses
These online systems/clearinghouses frequently do the
work of:
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Locating research studies
Systematically reviewing & summarizing study findings
Assessing quality, strength, & relevance of evidence
Publishing practice guidelines, model programs, best practices, or
other forms of evidence-based recommendations
ONLY in absence of evidence systems, summaries,
synopses, or syntheses & ONLY WHEN EBP QUESTION IS
IMPORTANT should practitioners conduct searches for
individual research studies
Systems
Summaries
Synopses
Syntheses
Studies
Reproduced from: Haynes, R Brian. 2006. Of studies, syntheses, synopses,
summaries, and systems: the “5S” evolution of information services for
evidence-based health care decisions. ACP Journal Club 145 (3):A-8 - A-9.
EBBP.org
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If evidence search is conducted of individual
research studies practitioners will need to use
their knowledge of research methods to
critically appraise individual study validity &
relevance
If an evidence search is conducted of sources
that have already summarized evidence then
practitioners need to be able to critically
appraise trustworthiness & relevance of those
sources
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Efficacy studies: Many interventions of
relevance to social work are now known to be
efficacious based on efficacy studies
◦ Effects have been found in controlled research studies
often under the best conditions with careful
administration to control for possible confounds.
◦ This research not well-suited to testing if intervention
will work in real world
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Effectiveness studies: Carried out in everyday
contexts to test intervention under commonly
experienced circumstances
◦ Intervention may be efficacious but may not be
effective
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Related terms
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Empirically supported interventions (ESIs)
Empirically supported treatments (ESTs)
Evidence-based programs (EBPs)
Empirically Informed practices
Practice guidelines
Model Programs
Best practices
No single definition of EBPs
Unlike EBP which is a well-defined process, EBPs
are interventions considered to have some
degree of research support
When considering the use of EBPs or teaching
EBPs important to investigate who is labeling
intervention as an EBPs & what standards/criteria
used
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Interventions for which there is
consistent scientific evidence
supporting their use
◦ Assessment tools with good
reliability, validity, sensitivity &
specificity
◦ Descriptive measures of good
reliability & validity
◦ Interventions showing that they
improve client outcomes
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Evidence-based practices
◦ Skills, techniques, & strategies that can be used
by a practitioner individually or in combination
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Cognitive behavior therapy
Systematic desensitization
Token economy motivation systems
Social skills teaching strategies
Evidence-based programs
◦ Groups of practices that seek to integrate a
number of intervention practices within a specific
service delivery setting & organizational context
for a specific population
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Assertive Community Treatment
Functional Family Therapy
Multisystemic Therapy
Supported Employment
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Step 2 in 5A’s process = ACQUIRING
evidence so when intervention decisions
are made practitioners & clients are
AWARE of evidence for alternate
intervention choices
◦ Quality
◦ Strength,
◦ Relevance
 may be little evidence & choices made
with this knowledge
In step 2 EBPs may be found & these can
then be critically appraised & considered
by practitioners & clients in decisionmaking
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Research evidence
Practice relevant research from:
Basic behavioral & social sciences
Client-centered practice research about:
Accuracy & precision of assessment tests &
interview procedures
Power of prognostic markers;
Efficacy & safety of therapeutic, rehabilitative, &
preventive regimens.
Empirical observation about relation between events
 This includes unsystematic observations of individual
practitioners which can lead to profound insights but
are limited because of potential bias & small sample
sizes
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Evidence alone is never sufficient for making practice
decision
 Practitioners & clients weigh potential benefits & risks,
inconvenience, & costs of alternative interventions & factor
in client values & preferences
In EBP there is a hierarchy of evidence for making practice
decisions
 Different evidence hierarchies are proposed for different
types of decisions
 Effectiveness of interventions (prevention, treatment,
rehabilitation)
 Assessment (e.g., instrument validity, sensitivity,
specificity, relevance)
 Risk assessment or prognosis
 Problem causation
 Describing conditions & experiences
A
practitioner may wish
to know whether one
intervention has better
outcomes than another
EBP has a hierarchy of
evidence for
effectiveness questions
N = 1 Randomized Controlled Trial
Systematic Reviews of Randomized Trials
Single Randomized Trials
Systematic Reviews of Observational Studies Addressing
Client Important Outcomes
Single Observational Studies Addressing Client Important
Outcomes
Descriptive diagnostic studies
Unsystematic clinical observation
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EBSWP typically begins with assessment of client
circumstances, condition, need, values,
preferences.
Practitioner may wish to determine mental status
of a client & formulate a question asking about
reliability, validity, sensitivity & specificity of
assessment instrument
Evidence would come from:
Cross-sectional surveys in which alternative
measures are compared
Reliability or validity studies
Focus group designs & qualitative methods
can be used with groups of clients to explore
client values & preferences
 Practitioners
may form questions about
causes of social problems that they
encounter frequently practice
Knowledge of causes can help
practitioners understand frequently
encountered problems as well as
provide basis for planning interventions
to either prevent future occurrences or
diminish a client’s problem by
removing or reducing causal agents
Evidence could come from:
Cohort or case-controlled studies
Epidemiological research
Case studies
 Practitioners
may encounter social
problems that are likely to resolve
themselves without intervention
 May work with groups where risk for
development of social problem varies
Some clients may be at high risk,
others at a low risk for developing
problem
Evidence can come from
longitudinal cohort designs
 Practitioners
may encounter social problems
in their practice that could have been
prevented if early signs had been measured
& action taken
In these circumstances can ask about
what available screening measures for
detecting early manifestations of social
problems or early warning signs
Evidence can come from cross-section
surveys involving large populations
 Prevention questions can ask about
outcomes of alternative prevention
interventions
Hierarchy of evidence for effectiveness
questions applies to such prevention
questions with preference for RCTs
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Since 1970 many reviews of research findings
about social work intervention outcomes
Narrative reviews
Systematic reviews including meta-analyses
Since mid-1990’s many groups have conducted
reviews & GRADED the quality, strength, &
relevance of evidence
These groups have graded, classified, and labeled
interventions based on evidence & other factors
These reviews & grading systems make ACQUIRING
evidence feasible for EBP practitioners
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Scientific Rating Scale
This scale rates strength of research evidence
supporting the practice
Child Welfare Relevance Rating Scale
This scale rates degree to which program or
model was designed for families served within
child welfare system
Needed as some well-researched practices may
never have been intended for child welfare
applications & research upon which the
scientific rating is made, may have little
relevance to child welfare environments
 Well
Supported = 20
 Supported = 29
 Promising = 64
 Evidence fails to demonstrate
effect = 1
 Concerning practice = 0
 Classify
psychotherapies into those for
which there is:
Clear evidence of efficacy = 31 therapies
Some but limited support for efficacy =
25
less than limited support
 Criteria
Replicated demonstration of superiority to
control or 1, high quality RCT
Clear description of intervention (e.g.,
manual)
Clear description of client group
Robert
Wood Johnson
Foundation consensus panel
Identified 5 evidence-based
psychosocial practices
for treatment of persons
with severe mental illness
A form of intensive, social and medical, team
based case management
Providing job and social supports to help individuals
obtain and retain jobs in real-world work
environments rather than in sheltered work
environments.
Teaching families about the illness, treatments,
options, and how to manage and provide support.
Educating patients/clients about their problems
and how to deal with their problems
Providing effective treatments for individuals with both
substance and mental disorders rather than limiting
intervention to just one or the other disorder.
Therefore, they could be reliably
taught and implemented
Without clear manuals or
guidelines they could not be
replicated with reliability
Therefore, effects could be
considered as due to
interventions rather than other
factors such as chance or
passage of time
Outcomes were not trivial nor
were they considered of little
value to those receiving
interventions
Outcomes were reliably & validly
established to have occurred
Possible bias of an advocate
research group was offset
by replication of outcomes
by another research group
 Practices
standardized through
manuals or guidelines.
 Practices evaluated with
controlled research designs.
 Important outcomes were
objectively measured.
 Research was conducted by
different research teams.
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In 2010 Congress funded Teen Pregnancy
Prevention Initiative
$75 million is for funding replication of
programs that have been proven effective
through rigorous evaluation
Mathematica Policy Research conducted
systematic evidence review
Criteria for study quality & evidence strength
were used to rate each intervention found in
evidence search
Based on these criteria, OHA set standards an
evaluation must meet in order for a program to
be considered effective & eligible for funding as
an evidence-based program
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Quality Rating
 High, moderate, or low based on rigor & execution of
research
 High rating
 RCTs with low attrition & no sample reassignment
 Moderate rating
 Quasi-experimental designs with well-matched
comparison groups at baseline
 Certain RCTs that did not meet all high-rating criteria
 Low rating
 Quasi-experimental & RCTs not meeting criteria for
high or moderate rating
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Evidence of Effectiveness Rating
Program had to be supported by at least one highor moderate-rated impact study showing a positive,
statistically significant impact on at least one
priority outcome (sexual activity, contraceptive use,
STIs, or pregnancy or births), for either the full
study sample or key subgroup (defined by gender
or baseline sexual experience).
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Programs rated high or moderate on quality &
receiving a rating of effectiveness (above)
were considered evidence-based (additional
criteria used for funding)
28 programs met the funding criteria
 Clinical
Evidence (online journal)
Ratings
Interventions that are:
known to be beneficial
likely to be beneficial
those where there is trade off of
benefits & harms depending on
client circumstances & priorities
unknown effectiveness
unlikely to be beneficial
likely to be ineffective or harmful
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Historically most influential in establishing &
disseminating Empirically Supported
Treatments (ESTs)
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APA task force identified 18 treatments as
“empirically supported” (e.g., cognitivebehavioral therapy for panic disorder) & 7 as
“probably efficacious” (e.g., exposure therapy
for social phobia) (Chambless, et al. 1996)
A later report listed sixteen ESTs that were
then widely disseminated to training
(Chambless, et al. 1998).
Clinical opinion
 Observation
 Consensus among experts
representing the range of use in the
field
 Systematized clinical observation
 Quasi experiments
 Randomized controlled experiments
or their logical equivalents
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 1.
Comparison with no-treatment control
group, alternative treatment group, or
placebo:
a) in a randomized control trial, controlled
single case experiment, or equivalent
time-samples design and
(b) in which EST is statistically
significantly superior to no treatment,
placebo, or alternative treatments or in
which EST is equivalent to treatment
already established in efficacy, & power is
sufficient to detect moderate differences
 2.
Studies must have been conducted with:
(a) a treatment manual or its logical
equivalent;
(b) a population, treated for specified
problems, for whom inclusion criteria have
been delineated in reliable, valid manner;
(c) reliable & valid outcome assessment
measures, at minimum tapping problems
targeted for change;
(d) appropriate data analysis
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3. Efficacious
Superiority of EST must have been shown in at least 2
independent research settings (sample size of 3 or
more at each site in case of single case experiments)
If conflicting evidence, preponderance of wellcontrolled data must support EST's efficacy
4. Possibly efficacious
One study (sample size of 3 or more in case of single
case experiments) suffices in absence of conflicting
evidence
5. Efficacious & specific
Shown to be statistically significantly superior to pill
or psychological placebo or to alternative bona fide
treatment
in 2 independent research settings
If conflicting evidence, preponderance of wellcontrolled data must support EST's efficacy &
specificity
 Practitioners
are to be concerned with both
efficacy & utility
Generality of effects across:
Varying & diverse patients, therapists,
settings & interaction of factors
Robustness of treatments across modes
of delivery
Feasibility which treatments can be
delivered in real world settings
Cost associated with treatments
Systematically developed statements to assist
practitioner & client decisions about
appropriate care for specific circumstances
 Professional organizations & governmental
agencies have formulated practice guidelines
for many conditions
 Guidelines prescribe how practitioners should
assess & intervene with clients
Sometimes guidelines are based on research
findings
Often research is not available
guidelines are based on professional
consensus
Rosen & Proctor (2003) provide a
comprehensive treatment of practice
guidelines in social work

 National
Guideline Clearinghouse™ (NGC) is
a public resource for evidence-based
clinical practice guidelines
http://www.guideline.gov/index.aspx
 U.S. Preventive Service Task Force conducts
scientific evidence reviews of a broad range
of clinical preventive health care services &
develops recommendations for primary care
clinicians & health systems. These
recommendations are published in the form
of "Recommendation Statements.“ U.S.
Preventive Service Task Force




Busy practitioners typically do not have time or skills to:
◦ Conduct searches for individual research studies which have
examined their EBP question.
◦ Synthesize the research evidence from these individual studies
Practitioners should first search for evidence summaries
Evidence summaries are rapidly becoming available in
online systems & clearinghouses
These online systems/clearinghouses frequently do the
work of:
◦
◦
◦
◦

Locating research studies
Systematically reviewing & summarizing study findings
Assessing quality, strength, & relevance of evidence
Publishing EBPs, ESI’s, practice guidelines, model programs, best
practices, or other forms of evidence-based recommendations
ONLY in absence of evidence systems, summaries,
synopses, or syntheses & ONLY WHEN EBP QUESTION IS
IMPORTANT should practitioners conduct searches for
individual research studies
◦ Acquiring evidence requires skills in using online
search terms & strategies (handouts 7-13)
◦ Online review of OBO-SW “Evidence-based Practice:
Finding Evidence” (handout)
http://oxfordbibliographiesonline.com/view/docum
ent/obo-9780195389678/obo-97801953896780043.xml?rskey=2Kk0JL&result=5&q=
◦ Online review of EBBP.org “Search for Evidence”
module http://www.ebbp.org/training.html
◦ Online review of Columbia University Musher
Program EBP resources for finding evidence
http://www.columbia.edu/cu/musher/EBP%20Reso
urces.htm
◦ CD-ROM review of REACH-SW “Finding Research
Evidence” module (handouts)
http://www.danya.com/reach/
Curriculum & Pedagogy of EBP
 Digital Resources for Teaching &
Learning EBP in Social Work
 Curriculum Implications



EBM was developed in 1990’s as a curricular
framework for training medical residents at
Department of Medicine, McMaster University,
Canada
Training program was organized to teach
residents:
◦ To develop an attitude of “enlightened
skepticism” toward application of diagnostic,
therapeutic, & prognostic technologies
◦ To be aware of evidence on which one’s practice
is based, soundness of evidence, & strength of
inference evidence permits
◦ To develop skills in what later was called 5A’s
 The
major text on EBM is focused
on both practicing & teaching EBM
◦ (Evidence-Based Medicine: How
to Practice and Teach EBM)
 Suggested methods are based on
collective experience of clinical
teachers of EBM
 “One solution for the problem of
obsolescence of professional
education is “problem-based
learning” or “learning by inquiry”.
That is, when confronted by a
clinical question for which we are
unsure of the current best answer,
we need to develop the habit of
looking for the current best answer
as efficiently as possible.” – Struas,
et al, 31.
 Role
model EBP
 Teaching practice using evidence
 Teaching specific EBP skills
◦ (Shown in table on next slide for teaching
clinical medicine residents)



“Standalone teaching improved knowledge
but not skills, attitudes, or behaviour
Clinically integrated teaching improved
knowledge, skills, attitudes, and behaviour
Teaching of evidence based medicine
should be moved from classrooms to
clinical practice to achieve improvements in
substantial outcomes.”
 Coomarasamy, A., & Khan, K. S. (2004)
 Much
has been written recently
about teaching & learning EBP in
social work
 EBP is now required by CSWE
Curriculum Policy & Accreditation
Standards
Teach students to be lifelong learners
Teach the skills & competencies of EBP
Teach students what is currently known &
not known about the efficacy &
effectiveness of social work practices &
programs
Teach students to be knowledgeable &
skillful with the empirically supported
practices in their area of specialty
Teach current practitioners new
knowledge & skills through evidencebased continuing education programs
 Handout
14

Online Review of Oxford
Bibliographies Online in Social Work
(OBO-SW) & Public Health (OBO-PH)
http://www.oxfordbibliographiesonlin
e.com/

Online Review of Columbia University
Willma & Albert Musher Program Web
Site: Evidence-Based Policy and
Practice & Outcomes Measurement
Resources
http://www.columbia.edu/cu/musher
/EBP%20Resources.htm
 CD-ROM
Review of DANYA
International Research & Empirical
Applications for Curriculum
Enhancement in Social Work
(REACH-SW) CD-ROM
http://www.danya.com/reach/
 Online
Review of EBBP.org
web site
http://www.ebbp.org/
 Implementation Module
Online Review of Evidencebased Practice for the Helping
Professions web site
http://www.evidence.brookscole.
com/




CSWE Curriculum Policy Statement Requires
EBP
Competencies Emphasis in CPS Fits with EBP
Competencies but Need to Figure Out Where
& How Competencies Can Be Integrated Into
Class & Field Curriculum
Faculty Needs Resources for Identifying ESIs
for Inclusion in Curriculum
Class & Field Instructors Need to be
Supported in Efforts to Make EBP an
Integrated Approach to Social Work Education