1 Evidence based practice - EBP‘The aim of evidence based practice is to help professionals to base their practice on the best evidence’ - DoH 1998 ‘EBP refers to a body of scientific knowledge defined usually by reference to research methods and designs about a range of service practices …EBP is a shorthand term denoting the quality, robustness or validity of scientific evidence as it is brought to bear on these issues’ Hoagwood 2003
2 Background: grown since 1990s in health / medical area Cochrane collaboration – Oxford Campbell collaboration – USA EPPI centre London – for education policy and practice DfES support for EBP Evidence based medical practices, social care, mental health etc What about for education?
3 Hierarchy of evidence Several systematic reviews of randomised controlled trials RCT Systematic review randomised controlled trials Randomised control trial Quasi-experimental trials Case control and cohort studies Expert consensus option Individual opinion
4 practice Research evidence evidence Evidence based cycles
5 Hourglass model Innovations, initial practices based on single cases Rigorous experimental type designs Questions about generalisation, variations (from Salkoviskis in Frederickson)
6 Some key questions Can it work ? – efficacy question – controlled conditions Does it work? – effectiveness question – in field setting, practical realities Is it worth it ? - cost-benefit question – are the benefits worth the costs?
7 Comments and criticisms:Philosophical points: - How could professionals not use evidence to base their practices on ? Taken for granted that they would use scientific knowledge Pring EBP is a slogan with rhetoric intention to discredit opposition - Hammersley move from evidence-based to evidence-informed to suggest that other evidence than scientific knowledge informs practice too
8 Limits of RCTs: How applicable are controlled trials applicable to service situations? 1. Co-variation (or co-morbidity) of presenting difficulties - how apply principles that apply to ‘pure’ cases 2. Cultural variations of clients 3. Cost of intervention 4. How practical to design and undertake? 5. Are there ethical issues?
9 Issues for teachers I am practitioner not a researcher research evidence is contradictory research hierarchy is inappropriate schools/ classrooms do not operate on EBP model my professional expertise is based on experience not research
10 testimony From archives + documents Personal Evidence observationexperience Evidence observation Research Nomothetic research Poor quality Nomothetic research Thomas (2004) Good quality Nomothetic Research RCT etc
11 Wider issues with EBP -- Hammersleyi. Practices involve multiple goals - Same activity have different consequences - Can be uncertainty about ‘what works’ - What works for some goals, might not for other - Limits to rational – linear model - Prof practice – various goals, tacit judgements, local knowledge and skill ii. EBP and systematic reviews - downplay illuminative qualitative research - qualitative research seen as untrustworthy
12 Wider issues continued:summarising process in reviews can over-simplify evidence Ignore research frameworks and assumption How combine reviews with thinking of practitioners? What if there is conflicting conclusions from professional experience and reviews? Ultimately rely on judgement
13 Socio-political aspects of EBPDrive for EBP related to moves towards more transparency of professional practice greater public confidence Linked to new performance management in public services EBP serves ideological function – is about power and knowledge
14 Socio-political aspects of EBP (continued)role in move from independent professionalism to more state accountable version actual use of systematic reviews shows that policy decisions precede reviews – Lit Strategy example - indicates that EBP can be used to legitimise policies rather than inform them
15 Debate about EBP relates to research paradigmsnomothetic v idiographic Schon: espoused theories v. theories-in-action technical rationality v. knowledge-in-action Professionals work in indeterminate areas where flexibility is critical Simons practice-based evidence rather then EBP - naturalistic or situated generalisations rather than abstract generalisations
16 Concluding comments: Fenstermacher (see Norwich, 2000) practical argument relates technical rationality with reflection-in-action practical argument is coherent chain of reasoning from expression of desired end state, through premises to an intention to act in particular way
17 2 types of premises: situational empirical – link to empirical research of various kinds Practical argument assumes active thinking professional weighing up various kinds of research and situation factors to practice intention - inescapable judgement and uncertainty
18 Enlightenment model of relationship between research and policy/practiceResearch influence on policy/practice is indirect: - questioning assumptions, - providing alternative perspectives and - indicating consequences 2. Loose (not tight sequence) – takes long time 3. Implications drawn not always predictable 4. Impact can depend on research in context, not research itself Hammersley (2002)
19 Attitude questionnaire: the bases for teaching and learningThere are 10 statements below about perspectives to teaching and learning. Please read them all to start and then decide to what degree you agree-disagree and to what extent for each statement. Tick the relevant cell. agree strongly agree disagree disagree strongly 1 There can be valid generalisations about ‘good’ teaching and learning across different settings 2 Teachers as professionals should decide how best to teach 3 There is authoritative general knowledge about what teaching approaches result in the best quality learning 4 It is important that teachers reflect on their own practices to develop appropriate knowledge about how to teach 5 There are causal factors that have and can be identified which influence the kind and level of learning. 6 There are too many interacting causal factors that influence teaching and learning to identify what works in teaching 7 It is important to develop authoritative general knowledge about what techniques work in teaching 8 There are too many different perspectives about teaching and learning to decide what ‘really works’ 9. Teachers should be expected to respect and use research based teaching techniques and strategies 10 All teaching and learning is different and defies generalisations across situations.
20 Scoring and interpreting details Score each response as follows: Agree strongly 4; Agree 3; Disagree 2; Disagree strongly 1 Insert your scores in the table below. Add the scores in each column to get a total score for pro and anti-science attitudes Interpretation of scores: Total scores in the range = high score Total scores in range= mixed score Total score in 5-10 range= low score Topic Pro-scientific evidence based Statements Score Anti-scientific evidenced based statements Epistemology (nature of knowledge): generalities v particulars 1.There can be valid generalisations about ‘good’ teaching and learning across different settings 10.All teaching and learning is different and defies generalisations across situations. Epistemology (status of knowledge): objective v. relative truth 3. There is authoritative general knowledge about what teaching approaches result in the best quality learning 8.There are too many different perspectives about teaching and learning to decide what ‘really works’ Ontology (causality): linear v interacting causality 5. There are causal factors that have and can be identified which influence the kind and level of learning. 6.There are too many interacting casual factors that influence teaching and learning to identify what works in teaching Practical rationality: teaching v. reflective practice 7.It is important to develop authoritative general knowledge about what techniques work in teaching 4.It is important that teachers reflect on their own practices to develop appropriate knowledge about how to teach Professionalism: Respect for authority v. autonomy 9.Teachers should be expected to respect and use research based teaching techniques and strategies 2.Teachers as professionals should decide how best to teach Total