Evidence Based Practice in Social Care Introduction This chapter aims to introduce students to the concept of evidence-based practice and how it might be used in social care practice. However, it is important to bear in mind that as future professional practitioners you need to be mindful of adopting a critical and inquisitorial approach to research or more importantly evidence. This chapter aims to encourage you to develop a „research-mindedness‟ approach to your future practice. How did you do that and why did you do it that way? If you have asked those question or been asked those questions then you have engaged in research. We often think of research and those who undertake it as a ponderous activity carried out by serious-minded people removed from the hustle and bustle of „reallife‟. Research can be seen as a remote activity, particularly by those at the „coal-face‟ of practice. Yet many practitioners are engaged in the research process even if they don‟t realise it. Every time you read a study, a report, a journal article, a review document you are consuming research. If there were no readers there would be no research, thus you are an invaluable link in the research
process
chain.
However,
as
well
as
being
consumers
of
research;
practitioners can and indeed should be producers of research.
What is Evidence Based Practice? There is nothing new about the idea that policy and practice should be informed by the best available evidence. Evidence based practice was first introduced in medicine and allied health professions. More recently it (EBP) has been advocated in social work as an alternative to "authority based practice," or practice that was based solely on the expertise and experience of practitioners (Edmond et al. 2006). Gibbs & Gambrill (2002 p. 452) define evidence-based practice as „the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of clients‟. Evidence-based practice has become a byword for better, more appropriate and efficient practice. In essence an evidence-based approach asks that practitioners use the best available evidence to guide and inform their practice. However, we need to ask ourselves what constitutes best evidence and how do we choose between one source of evidence over another (Sheppard 2004)? In addition, we also need to unpack the term Evidence Based Practice particularly as it relates to the area of social care.
1
Appleby et al‟s (1995) definition of evidence base practice belies its medical origins noting that it represents a shift in healthcare decision making. Evidence based practice represents a move away from opinion, past practice and precedent towards a decision making framework that relies on greater use of research and evidence. The basic principles underlying the „evidence-based‟ practice movement are that there is a hierarchy of evidence and that modern informatics can make the evidence available to practitioners at the point of care.
Why an Evidence Based Approach to Social Care?
The
Department
Children
and
principles
of
Families:
that
perspective,
Health
should
principle
&
Children‟s
Exploring
Good
underpin
child
number
three
(2004)
policy
Practice‟ and
stresses
outlines
family the
document:
seven
services.
need
for
„Working
for
management
From
an
EBP
practitioners
and
managers to „ensure that their practice and its supervision are grounded in the most up-to-date knowledge‟ (DOHC 2004 p. 15). In addition to relevant empirical research,
evidence
should
be
drawn
from
local
statistical
data;
national
policies, evaluations and audits and the lessons learned from case reviews (DOHC 2004).
Williams (2000) argues that the benefits of an evidence based approach for social care work are: 1. More Effective Social Care Interventions 2. Improved Resource Efficiency 3. Improved Analytical Practice 4. Raising the Status of Social Care Professionals 5. Improved Public Confidence in Social Care
Marsh & Fisher (2005:3-4) make some very strong arguments for the adoption of a research evidence based approach and these are summarised in table 1. Table 1 Reason Impact on the immediate chances of service users
Impact on the long-term chances of service users
Argument life
life
In extreme cases e.g. child protection decisions may influence life or death situations, practitioners should be as informed as possible Decisions made may well effect long term life chances such as educational outcomes, mental health; practitioners should be as informed
2
as possible Challenge to assumptions about social care
fundamental
Providing users
to
safeguards
service
Encourage and facilitate a more informed public Informed service user and carer communities, and individuals
Evidence may produce a shift in the way practitioners, service users, the public and other allied professions see social care work There are substantial areas of social care where professionals have strong powers, or where the courts may make decisions regarding major aspects of people‟s lives… best available evidence is an important component of processes of control of this power An informed public can engage better with relevant debates about services …it is right that citizens have access to the best evidence Direct involvement in services and engagement with the development of services requires access to the best evidence
Few if any would argue that social care interventions should not be as effective as possible. The argument goes that the use and application of new and/or existing interventions should be informed by evidence.
Issues in adopting an Evidence Based approach to social care practice Whilst the arguments for the adoption of an evidence based approach may be convincing it should be noted that locating and utilising research, particularly relevant quality research is not always easy. Stevens
et
al‟s.
(2007)
review
of
the
research
priorities
of
practitioners
working with children in social care highlighted a number of important issues with regard to the expansion of the use of evidence based practice. The study found that social care workers make limited use of research findings in practice. The barriers to using research included: a lack of time, lack of research skills and research resources, and an underdeveloped culture of research use within many organisations. Another problem highlighted was the range of target groups within social care; practitioners work with a wide range of clients, family support, elderly, children and people with disabilities and so on thus making it more difficult to adopt a unified approach to research. Rosen
(2003
p.
199)
identifies
five
categories
of
implementation of evidence-based practice. These are: 1. Characteristics of the knowledge to be used
3
the
factors
that
impede
2. Characteristics of the practice situation and setting 3. Attributes of the medium through which the knowledge is communicated 4. Characteristics of the practitioner 5. The social-cultural context in which utilisation takes place Activity When
you
have
characteristics
finished above
reading
and
this
consider
chapter the
return
extent
to
to
Rosen‟s
which
(2003)
practitioners
five are
constrained from engaging in an evidence-based approach to practice.
What constitutes Evidence/Knowledge? Utilising research in social care requires the integration of different types of knowledge. Pawson et al.’s (2003) review of the types and quality of knowledge in social care provides a useful system for the classification of the sources social care knowledge.
Table 2 Type Organisational knowledge Practitioner knowledge User knowledge Research knowledge
Policy knowledge
community
Source knowledge gained from organising social care, through governance and regulation activities knowledge gained from doing social care, which tends to be tacit, personal and context-specific Knowledge gained from experience of and reflection on using social care services, which again is often tacit. knowledge gathered systematically within a planned strategy, which is mostly explicit and provided in reports, evaluations and so forth knowledge gained from the wider policy context and residing in the civil service, ministries, think tanks and agencies
Pawson et al. (2003:22) This is system of classification should not be taken to imply that all sources of knowledge are equally regarded; research or empirical knowledge generally appears to be held in higher esteem than other sources of knowledge. Furthermore, not all research is regarded equally; health care, for example, has a well established „hierarchy of evidence‟. At the top of this hierarchy are randomised experiments and systematic reviews; conversely studies employing observation are regarded as having less rigour and credibility (Davies and Nutley, 1999). This
dichotomy
in
sources
of
evidence
is
frequently
characterised
by
the
conceptual shorthand of the terms quantitative and qualitative approaches to research.
4
The
label
qualitative
is
a
generic
term
incorporating
a
range
of
different
methodologies (Flick et al. 2004). Whilst these methodologies differ somewhat in their object of investigation and methodological focus they all share a number of defining characteristics. Bryman (2004 pp. 19/20) states that the qualitative approach
is
a
„research
strategy
that
usually
emphasizes
words
rather
than
quantification in the collection and analysis of data‟. From this perspective the social world is not the same as the natural world, human beings react differently in
different
situations
appropriate.
therefore
scientific
positivist
methods
are
not
This approach rejects the practices and understandings of the
natural scientific model that is positivism, rather it emphasises the ways in which individuals interpret and construct reality (Bryman 2004). Research methods (or tools) associated with this approach often include: observations, diaries and interviews. Quantitative
research,
as
its
name
suggests
„is
a
research
strategy
that
emphasizes quantification and analysis of data‟ (Bryman 2004 p. 19). As with qualitative research, this approach also incorporates a number of methodologies that share a number of commonalities. This approach incorporates the practices and norms of the scientific or positivist model with its understanding that social
reality
2005).
This
is
type
an of
external, research
objective
is
and
characterized
measurable by
the
reality
tight
(Sarantakos
control
of
the
variables under investigation, protocols for measurement and intervention and the use of statistical testing to establish levels of confidence in the results (Houser 2008). Research methodologies associated with this approach often include quasi and natural experiments and surveys. From
the
perspective
of
becoming
an evidence
based
practitioner
it
must
be
acknowledged that the two research approaches are not necessarily regarded as being of equal value, consequently different sources of research evidence may be regarded to a greater or lesser extent. With its presumed adherence to
superior
procedural rigour and validity it is argued that quantitative studies „produce some of the strongest evidence for the benefits of an intervention‟ (Houser 2008 p. 38).
Conversely, qualitative research is sometimes accused of being too
impressionistic and subjective and very difficult to generalize the findings (Bryman 2004). However, this „either or‟ dichotomy should be treated with some degree of caution and scepticism. Layder (1993) argues that this debate is no longer useful, going as far as to suggest that it is a false distinction with no real merit. Punch (1998) argues that being at loggerheads about which approach is better
misses
the
point;
the
argument
should
simply
be:
what
is
the
most
appropriate method to answer the research question posed? and not some rigid adherence
to
one
approach
over
another.
5
Plath
(2006
p.
64)
argues
that
„effectiveness research becomes more complex than deciding between qualitative and quantitative approaches‟.
Nonetheless, regardless of the research approach
used, the knowledge produced by empirical studies
is frequently regarded as
superior to the knowledge produced by users and practitioners.
How do I critique Evidence? There is sometimes a tendency to overestimate the quality of a piece of research, particularly if the reader is less than familiar with the topic in question and/or inexperienced in evaluating research. Simply because a study has been published does not necessarily mean it is good quality research. Becoming an evidenced
based
practitioner
requires
the
adoption
of
a
critical
stance
to
research.
However, it should be borne in mind that being critical does not mean
criticising by simply pointing out the limitations of the study (Burns and Grove 1997).
Critiquing
a
piece
of
research
is
about
undertaking
the
methodical
appraisal of the strengths and weaknesses of the study in order to determine its credibility (Coughlan et al. 2007). The key word in this instance is methodical; we need to adopt a step-by-step process or framework that will enable us to make an informed judgement about the quality of the evidence offered. The informed practitioner does not just know what the research says about the topic, they are also able to judge the quality and the relevance of the research (Sheppard 2004).
Table
3
offers
a
framework
that
employs
a
set
of
questions
that
adopts
a
journalistic approach to understanding the details behind a story; these are: who, what, why, when and where? broad
types
of
research:
As noted in the evidence section there is two
qualitative
and
quantitative
each
with
their
own
theoretical and methodological approaches and considerations. Nonetheless there are a number of common questions that can be applied to either type of research; where there is a notable difference I have adapted the question/s to take account of these differences. Table 3 Critiquing Research: An Introductory Framework Who
Who are the authors, are they practitioners and/or academics? What qualifications and experience do they have? Are they noted in their field of expertise? Who commissioned the study? There may be an issue of funding bias; quite simply he who pays the piper may call the tune. Who was the target population of the study? Are they so dissimilar to the group that you work with that lessons may be difficult to apply? Who is the study aimed at? Is it meant for general readership, academic, policy makers and/or
6
Where
Why
When
What
practitioners? Where is the study published? A Peer-reviewed journal? A government report? Peer-reviewed journals generally adopt a more rigorous approach and consequently the study‟s integrity and reliability Where was the study conducted? If the location is very different can the findings be applied? For example the study in question focussed on interventions in a residential setting and you work in a community setting. Why was the study undertaken? Is it part of a postgraduate programme? Was it undertaken to evaluate an intervention or initiative? Why did the author adopt one research method in preference to another, is this justified and consistent with the overall research approach either qualitative or quantitative? Do the methods chosen add to the general credibility and reliability of the study and were they carried out in an appropriate manner? When was the study carried out? How recent is the publication? Has the context changed much over time? What operational definitions were employed? For example if the study is about investigating poverty what definition of poverty is being employed? What ethical safeguards were put in place? Were participants fully informed about their rights such as confidentiality and anonymity; being able to withdraw at any time? What was time-frame? Was it a longitudinal or a cross-sectional study? A cross-sectional study simply provides a once-off „snap-shot‟ of a phenomena or event which can be useful but it is understandably limited to a degree. What is the research question? Is this question clearly stated? Qualitative type studies are interested in understanding not testing thus they will simply have a question while quantitative type studies employ testable hypotheses to either proves or disproves. What size was the sample and how was the sample selected? In quantitative studies sample sizes are required to be at least 30 in order to be considered statistically significant. In addition probability or randomly selected samples are considered to be more appropriate. Qualitative studies are less concerned with probability and minimum sizes, rather they are concerned with providing a greater depth and rich understanding of the topic. What is the strength of the link between the evidence and the conclusions and recommendations? Has the author made a logical and believable argument?
This framework is not intended to be wholly comprehensive; in fact few frameworks can make such a claim. What is does offer is a useful toolbox through which you can begin the process of critiquing articles, reports and studies.
7
Activity Pick a published research article and try to work your way through the set of questions. Don‟t worry if you cannot answer all the questions; where necessary try different strategies to answer a question. For example, when trying to determine the standing of the author; articles will often give the name of the author‟s employer such as a research centre or university. However, in all likelihood it will not give any indication of the number of previous publications they have authored. In this case simply try an Internet search to ascertain such things as academic positions, professional bodies, advisory groups, books, studies, reports and so on that they may have been or are currently involved in. Remember you will get better with practice
Utilising the Internet as a source of Research The vast majority of searches are now undertaken using electronic sources which in reality means using the internet. However, it is important to realise and understand
the
researcher.
range
Students
of or
search
facilities
practitioners
who
open
have
to
access
the to
practitioner an
online
and
library
facility can remotely retrieve a vast range of journals through databases such as EBSCO, Ingenta, ERIC, Cinahl and MEDLINE. For the hard pressed practitioner (or student), the availability of the internet has provided a very powerful research tool providing as it does remote access to a wealth of material. Search engines have become an increasingly important part of the online experience for the majority of internet users. Well known providers such as Google and Yahoo dominate the market providing a quick and easy to use search tool. A recent addition to the Google site is the „scholar‟ option which allows users to access a wide range of academic papers; however, this is still quite limited as it will often only provide a link to a title and an abstract rather than full text. Nonetheless it provides a relatively quick way to search a wide range of academic sources and provide a starting point in the search for evidence. Another recent phenomenon that has provided a source of reference for countless students throughout the world is the world's leading online encyclopaedia Wikipedia. However, as with all sources of evidence it is important to exercise caution
and
judgement.
The
problem
with
judging
the
trustworthiness
of
information „on the World Wide Web is becoming increasingly acute as new tools such as wikis and blogs simplify and democratize publications‟ (Dondio et al. 2006 p. 362). On Wikipedia, the various topics are edited by the users, allowing any user to contribute information on a topic, but the sites also rely on other
8
users to correct errors found on the site. Whilst there have been a number of stories that highlighted the vulnerability of Wikipedia to hoaxes (Parfitt 2006); there have also been studies that argue that Wikipedia is generally reliable. As a source of information to help clarify or introduce a topic Wikipedia is useful, as a source of definitive evidence upon which to base practice; the best advice is the Latin phrase: „caveat emptor‟ or „buyers beware‟. Whichever source is used it is vital that clear search terms are used. Gossett & Weinman (2007 p. 147) provide a useful step-by-step guide to using electronic sources for locating evidence: STEP ONE – Converting Client Needs into Answerable Questions. Questions that lend themselves to searching for the best evidence must be specific enough to generate an answer in an electronic search. STEP TWO – Locating the Best External Evidence to Answer the Question. This step requires access to bibliographic databases such as the Cochrane Database and Campbell Collaboration. In addition to database access, the skills to effectively navigate the various sources are important. STEP THREE – Critically Evaluating the Evidence. The framework in table three can be employed as a useful starting tool. When critically evaluating the evidence, Gibbs (2003) recommended using a rating form, such as the Quality of Study Rating Form, which can be located in his book: Evidence-Based Practice for the Helping Professions1. Whichever framework or analysis tool is employed the important feature is that it is a systematic approach. Where can I find critiqued research? No one framework can be considered to be exhaustive and this framework is no different, nonetheless it provides the novice researcher a useful guide with which to begin the process of evaluating empirical evidence. As a practitioner becomes more adept at evaluating research, they may wish to enhance their range of research sources. However, sifting through a series of research documents can be time consuming particularly so for practitioners. What the hard-pressed practitioner needs is some form of clearing house for research. Luckily there is such an organisation; the Campbell Collaboration. Based on the protocols developed by its older sister organisation: the Cochrane Collaboration;
the
Campbell
Collaboration
(C2)
maintains
a
large
group
of
members, reviewers and contributors who undertake systematic reviews in the areas 1
In addition to the book there is also a companion website available at:
http://www.evidence.brookscole.com/index.html
9
of crime & justice, social welfare and education. With its emphasis on the systematic review of randomised control trials in the biomedical arena, the Cochrane
Collaboration
may
be
of
less
use
to
social
care
practitioners;
nonetheless it can provide some useful material with regard to certain topics such as mental health and health promotion. Systematic reviews are an extensive and rigorous literature review that focuses on a single question with the aim of identifying, appraising and summarizing research studies in order to derive guidelines that can inform practice (Houser 2008). From the practitionersâ€&#x; perspective, a systematic review can take a lot of the drudgery and guesswork out of finding and evaluating a wide range of studies. The following scenario provides an example of how using a systematic review can aid evidence based practice. Scenario: You are a social care worker in a childrenâ€&#x;s residential unit. One of the children (a 13 year old girl) has a history of being sexually abused. In preparation for her next case review meeting the unit manager has asked that you investigate possible interventions to be included as part of the forthcoming discussions. In addition to your own and co-workers knowledge and experience and some locally sourced research you are keen to explore the range of available interventions. Thus you undertake the following search: 1. Access
the
Campbell
Collaboration
(C2)
website:
http://www.campbellcollaboration.org/index.asp 2. You now have two options (a) access the social welfare tab and click on side menu for protocols, reviews and related papers and scroll down the webpage looking for possible suitable reviews or (b)click on the link for the C2-RIPEâ€&#x;s Report Generator. This method has the advantage of doing the search for you providing you give specify the criteria. 3. Through
the
search
a
promising
review
is
identified:
Cognitive-
behavioural interventions for children who have been sexually abused (Macdonald et al. 2006). In investigating the efficacy of cognitive behavioural
approaches
(CBT)
this
review
synthesises
ten
studies
involving 847 children into one accessible and comprehensible document. 4. The reviewers note that CBT offers some positive possible outcomes but that the evidence offered only enable a tentative conclusion to be drawn. In reality you would need to undertake a more comprehensive search; nonetheless this one brief example demonstrates how you as a practitioner can access a wide
10
range of well reviewed research material that in turn can be used to inform your practice. However, it is very important to note that despite the huge advantages that the internet presents to the researcher/practitioners, other mediums are and continue to be of great importance. Books, theses, print journals, conference proceedings amongst
others
practice.
should
Moreover,
also
a
be
used
systematic
as
and
sources
of
critical
evidence
approach
that
should
can be
inform
employed
regardless of the source of evidence (Tremblay & Downey 2004). Practitioners as Researchers Social care is essentially a practice – based discipline; consequently there remains
the
potential
difficulty
in
reconciling
the
relationship
between
empirical scientific knowledge and the knowledge derived from experience and practice. As previously noted it has been the empirical scientific forms of knowledge that have taken precedence over experiential practice-based knowledge (Brechin & Siddell 2000), a model referred to as „technical rationality‟ by Donald Schon (1983).
The philosopher Gilbert Ryle (1963) suggests that it is the
prepositional or „knowing that‟ knowledge that “precedes and informs „knowing how‟ that we must first learn the theory before applying it to practice” (Rolfe, et
al.
2001:
6).
If
this
is
the
case
then
it
can
be
appreciated
how
the
scientific theories or the „knowing that‟ knowledge came to be seen as having pre-eminence over experiential „knowing how‟. The former Director of Research at the Joseph Rowntree Foundation, Janet Lewis writing in 2001 offers a more balanced view of the knowledge base for social care: Knowledge = evidence + practice wisdom + service user and carer experiences and wishes. As you can see from this formula there is no hierarchy; knowledge is the equal combination of all three components: evidence (empirical research), the practice wisdom or practitioner knowledge and the users and carers experiences and wishes. Thus, this formula argues that the producers of knowledge and hence evidence are practitioners as well as researchers. Taking this perspective it is can be argued that as well as using knowledge to become evidence based practitioners; these same
practitioners
can
produce
knowledge
practice.
11
and
thus
inform
others
in
their
Engaging
in
research
is
widely
accepted
as
being
one
of
the
defining
characteristics of a profession. Tripodi (1974) argued that many of the processes and skills used in professional practice transfer easily and support the tasks required to undertake research. For example, in social work, practitioners are required to make an initial assessment whilst the researcher is required to formulate
a
question;
the
social
worker
is
then
required
to
design
an
implementation plan whilst the researcher is required to design a strategy that will enable the collection of the data and so on.
In essence, research and
practice are about applying a methodical approach to solving a problem. In fact, some of you may have begun the process of becoming research-minded already, without being necessarily aware of the fact. When starting a research project where do you begin? Table 4 provides some suggested three entry points for beginning research (adapted from the Research Mindedness Virtual Learning Resource 2005):
Table 4 A problem in practice - an idea to test
A gap in available data
the
Service Evaluation
Research
can
involve
A number of social care workers have reported the effectiveness of Therapeutic Crisis Intervention (TCI) with children in residential care longer than two years appears to markedly drop, why might this be so? The child protection team has produced local guidelines to help indicate whether an injury to a child might be non-accidental. However, there appears to be no such guidelines to draw upon for the elder care team. Surely such guidelines must exist: could these be sourced and presented to the team? Your family support unit has introduced summer camps as a pilot project. Anecdotal evidence seems to indicate success but you need to evaluate the effectiveness if you are to seek continued funding.
a
large
team
with
plenty
of
resources
and
focussing a large number of people. However, it can focus on one or two people and be carried out by a lone researcher. Simply because the focus of a piece of research may be small and may have little widespread applicability does not mean that undertaking that study is not worthwhile. The relationship between research, policy and practice
12
Although the need to translate research messages into policy and practice
has
relationship
been
recognised
continues
to
be
and
improved,
complex.
Policy
this
tripartite
makers
often
want
research messages that are unequivocal and relevant to current and impending issues. In Gaffney and Harmon‟s (2007) overview of the proceedings of the National Economic and Social Forum (NESF) conference on evidencebased policy making they note that whilst it is not the role of the research community to design policy; it does have a role to “assist in
the
perhaps
design
of
policy,
challenging
the
evaluation policymaker
of …
its
effectiveness,
based
on
the
and,
available
evidence” (2007:8). At the same conference, the then Taoiseach Mr. Bertie Ahern TD noted the importance of an evidenced-based approach noting
that
“the
better
quality
information
we
have,
the
better
founded our beliefs and working models will be” (Ahern, 2007:13). A Cautionary Note Whilst there are apparent benefits to the adoption of an evidence based practice, it should be noted that there have been a number of concerns raised. These can be summarised as:
Critics that question the appropriateness and validity of the scientific
or
positivist
approach
to
the
generation
of
evidence
Critics that question the genuineness of the motives behind the adoption of an evidence based approach, notably if the move
is
really
about
improving
services
or
simply
a
managerialist push for efficiencies Plath (2006 p. 57) argues: the association of evidence-based practice with a scientific or positivist paradigm can produce tension for social workers who recognise the importance of reflective, interpretive and humanist responses to the personal and social conditions encountered in practice This tension can result in the marginalisation of the esoteric and aesthetic elements of care work such as intuition and reflection as they cannot easily be reduced to quantifiable measurable constructs and
hence
they
do
not
lend
themselves
easily
to
positivistic
reductionism. As previously noted by Williams (2000) one of the arguments for introducing
an
EBP
approach
is
13
that
it
should
bring
improved
resource efficiencies. However, the pursuit of greater efficiencies can
only
be
resources. honest
carried
Adoption
appraisal
to of
of
a
a an
finite EPB
number
limit,
approach of
agencies to
issues,
need
practice
not
adequate
requires
least
an
an
agency‟s
ability to implement new regimes or ways of operating. Fundamental issues
such
as
staff
workload,
physical
resources
and
staff
qualifications also need to be considered. However attractive it may be to adopt a more evidenced based approach to practice the mundane issues
also
need
to
be
attended
to:
„EBP
will
not
overcome
structural issues like caseload size‟ (Blome & Steib 2004 p. 612).
Conclusion A formalised evidence based approach to social care practice remains largely underdeveloped. Nonetheless it should be acknowledged that many
practitioners
are
engaged
in
practice
that
is
informed
and
reflective. There is a lot of research available that focuses on the topics
of
interest
to
social
care
practitioners:
childhood,
addiction, intellectual disability and so on. The amount of this research
that
constitutes
„quality
evidence‟
remains
debatable.
Social services are by their very nature fluid and dynamic, as such practitioners need to be mindful of adopting a dogmatic approach. Sheppard (2004 p. 23) argues that practitioners should be „looking at information
that
can
help
provide
guidance,
and
better-informed
judgements, but not certainty‟ (italics in original). Perhaps the term research-informed practice might be a more applicable term than research-based.
References Ahern, B. (2007) Opening Address at Evidence-based Policy Making: Getting the Evidence, Using the Evidence and Evaluating the Outcomes, Conference Proceedings. Dublin: National Economic Social Forum (NESF) Appleby, J., Walshe, K. & Ham, C. (1995) Acting on the Evidence. Research Paper No. 17. London, National Association for Health Authorities and Trusts Blome, W. & Steib, S. (2004) Whatever the problem, the answer is “evidence-based practice” – or is it? Child Welfare, Vol. LXXXIII (6), 611-615 Brechin, A. & Siddell, M. (2000) Ways of Knowing in Gomm, R. & Davies, C. (eds) Using Research in Health & Social Care. London, Sage Publications.
14
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