Academic journal article Journal of Social Work Education

From the Editor: Evidence-Based Practice: Sea Change or the Emperor's New Clothes?

Academic journal article Journal of Social Work Education

From the Editor: Evidence-Based Practice: Sea Change or the Emperor's New Clothes?

Article excerpt

There are many lenses through which to explore the history of a profession. * One is in relation to reactions to new developments originating either outside or within the profession. What will be the reactions of the social work community to evolving developments in evidence-based health care as described in original sources such as Sackett, Richardson, Rosenberg, and Haynes (1997) and Gray (1997)? Evidence-based practice originated in health care as an alternative to authority-based practice (for example basing decisions on uninformed opinions). Origins suggested by Gray (2001) include: (1) the study of variations in service decisions and clinical practice, (2) gaps between practice-related research findings and what was done, (3) economic pressures, (4) the knowledge revolution including the evolution of the systematic review and description of flaws in traditional modes of dissemination such as peer review and texts (e.g., Egger, Smith, & O'Rourke, 2001), and (5) the web revolution which increased accessibility of information and permitted timely, routine updating of systematic reviews. He also notes the appeal of evidence-based practice (EBP) to both clinicians and clients.

EBP offers practitioners and administrators a philosophy that is compatible with obligations described in our professional code of ethics and educational accreditation policies and standards (e.g., for informed consent and to draw on practice and policy-related research findings) as well as an evolving technology for integrating evidentiary, ethical, and practical issues. Related literature highlights the interconnections among evidentiary, ethical, and application concerns in making decisions and suggests specific steps that can be taken (a technology) to decrease gaps among them in all professional venues including practice and policy (e.g., drawing on related research as required in professional codes of ethics), research (e.g., preparing systematic reviews and clearly describing limitations of studies), and professional education (e.g., exploring the value of problem-based learning in developing practitioners who are life-long learners). Transparency and honesty regarding the evidentiary status of services is a hallmark of this philosophy. The uncertainty associated with decisions is highlighted not hidden.

Social workers, educators, and researchers, make choices about how accurately to describe new ideas and related technology and how carefully to consider how they may contribute to closing troubling gaps, for example, between ethical obligations and current practices including obligations of researchers and academics to be honest brokers of knowledge and ignorance and what we see in the professional literature (e.g., inflated claims of knowledge). Choices made so far show that the term "evidence-based practice" is being used mostly as the emperor's new clothes, authoritarian practices including inflated claims regarding the evidentiary status of services and ignoring ethical obligations to clients. The philosophy and technology of EBP described in health care is typically not described in the social work literature even by those who use the term "evidence-based practice."

Current State of Affairs: Troubling Gaps Among Ethical, Evidentiary, and Application Concerns

Although interlinked in professional codes of ethics and accreditation standards, ethical and evidentiary issues are often far apart in practice. Consider gaps between obligations described in the Code of Ethics of the National Association of Social Workers (1996) and everyday practice regarding informed consent and drawing on practice and policy-related research. For example, research findings suggest that social workers do not draw on practice-related research findings (e.g, Rosen, 1994; Rosen, Proctor, Morrow-Howell, & Staudt, 1995). The survey conducted by Sheldon and Chilvers (2000) found that 18% of the total number of social workers surveyed (n=2,285) had read nothing related to practice within the last 6 months. …

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