|
Building on principles of social scientific
inquiry and basic research methodology covered in T6501, this course will
reinforce and extend understanding of a scientific, analytic approach to
building knowledge for practice and evaluating service delivery.
Students are expected to draw on previously acquired knowledge about problem
formulation, measurement, and research design as they learn to formulate and
analyze research questions using methodologies relevant to clinical practice.
Core themes:
- Understanding
principles of clinical research methodology
- Critical
thinking skills needed to formulate research questions
- Use
of data reported in published sources to examine these research
questions
- Understanding
of procedures and technologies for data analysis in clinical research
- Ability
to communicate findings to clients, colleagues and others to advance
mutual learning and decision making
Strict adherence to ethical standards of
scientific inquiry will be emphasized, with particular attention to
protecting and promoting the wellbeing of vulnerable and oppressed
populations. An analytic approach to knowledge building and evaluation
relevant to clinical practice is reinforced by other advanced curriculum
areas. These include clinical practice courses (T7113 & T7114), practice
platform courses, electives and fieldwork. Learning to use advanced clinical
research methods will reinforce and extend advanced content.
Upon
successful completion of this course, students are expected to be able to:
- Gain access to and critically read research
literature
- Understand the strengths and limitations of
research methods used in clinical research
- Identify obstacles that may be encountered
in clinical research and know how to deal with these obstacles
- Identify the probable benefits and costs of
conducting and using research in clinical practice
- Understand distinctions between using
research findings for clinical practice decision making, using research
methods to learn from one's own practice, and using research methods to
conduct research to answer research questions
- Use computer based resources for locating
relevant clinical research findings
- Communicate findings from research to
facilitate clinical practice decision making and advance understanding
of clinical issues
- Understand ethical guidelines pertaining to
clinical research
- Use appropriate methodologies to evaluate
clinical practice
- Avoid biases in clinical research with
clients with varying ethnic, age, gender, sexual orientation,
socioeconomic, physical and/or mental ability characteristics, and/or
from high-risk, vulnerable and other disadvantaged groups.
This section of T7501
takes an evidence-based practice approach to teaching and learning of
clinical research methods. Accordingly, this section focuses on the
development of specific research competencies needed to engage in
evidence-based practice. Competencies #1 through #5 and # 8 listed below are
the focus of this course. Competencies #6, #7 and #9 are taught in practice
courses rather than in the research course (marked with asterisk). The 9 core
evidence-based practice competencies are as follows:
- Ability to examine a case
situation and to identify uncertainties
or dilemmas about how best to assess, intervene or monitor.
- Ability to make a judgment
about each uncertainty:
- Relative importance to
achieving outcomes of importance to client – how important is it to
address & resolve the uncertainty to achieving an outcome of
importance to the client?
- How typical is the
uncertainty among cases seen at the agency? – uncertainties that occur
frequently in practice may be ranked more important to address &
resolve
- How likely is it that the
uncertainty can be resolved to your and the client's satisfaction by:
i.
Asking your supervisor to provide you with the
best resolution
ii.
Asking a consultant to provide you with the
best resolution
iii.
Asking professional colleagues at the agency
to provide you with the best resolution
iv.
Reviewing conceptual-theoretical discussions
pertaining to the area of uncertainty
v.
Adopting whatever resolutions traditionally
used at the agency for such uncertainties
vi.
Using your common sense and intuition
vii.
Reviewing empirical research reports
pertaining to the area of uncertainty
- Ability to transform those
areas of uncertainty where appropriate into answerable evidence-based
practice questions (not all areas of uncertainty can be resolved
empirically).
- Ability to locate information
pertinent to each evidence-based practice question.
- Ability to critically
evaluate the information located and to weigh the information relevance
to each evidence-based practice question.
- Ability to integrate the
evidence located from all sources.*
- Ability to make a decision
with client about how best to proceed with the uncertainty (considering
possible alternative courses of action) taking into account client
values and preferences, resources, and preferred outcomes.*
- Ability to monitor what
happens when the intervention is implemented.
- Ability to modify the chosen
intervention based on the information gained through the monitoring
process.*
For a discussion of core evidence-based practice competencies
see the statement by the Evidence-based Behavioral Practice Council.
|
|
Topic:
Introduction to Course
|
Class Plan:
- Review
of course objectives, syllabus, resources, and assignments.
- Defining
evidence-based practice in social work as described by Leonard Gibbs.
- The
importance of forming clinically relevant questions of importance to your
client as a first step in evidence-based practice - COPES questions.
- Taking
a multidisciplinary view of evidence-based practice and defining evidence-based behavioral
practice.
- Defining
the steps of evidence-based
practice.
- Review of anticipated
evidence-based practice competencies to be
attained by clinicians as viewed from an interdisciplinary
perspective.
- Review of anticipated EBP
Competencies taught in this course and where training is
provided in the social work curriculum for other competencies
(PowerPoint file below in files section).
- Discussion of how this
course builds on the foundation research course and links with other
second year courses.
- Review of clinical research
in social work – current emphases including evidence-based practice as
a new organizing framework.
- Discussion of the following
questions: (1) Why is it important for social work students to learn
evidence-based approaches?; (2) What are some of the benefits to the
field and to clients or populations that social workers work
with?; (3) How is EBP
viewed in allied disciplines? (4) Why is it
important for students to know how to critically
assess research evidence?
- The class will watch an
example of evidence-based practice selected from one of the following:
(1) Hospital Interactive Team Thinking exercise (HITTT) from Gibbs, L. E. (2003); (2)
School-based Clinical Practicum project from REACH-SW CD-ROM; (3)
Women's Shelter Clinical Practicum project from REACH-SW CD-ROM; (4)
Task Force on Mental Health and Aging project from REACH-SW CD-ROM
(the REACH-SW CD-ROM beta version is on reserve for subsequent
viewing).
Break-out Teams:
- Time will be made available
for students to circulate and to engage in team formation. Teams
should be composed of approximately 6 members each and formed around a
common interest such as field of practice, population or problem area.
These teams will work together throughout the semester.
- Following team formation
teams should discuss the case video: (1) Identify the steps
the practitioners went through to reach a decision; (2) What EBP
competencies did the practitioners demonstrate; (3) If you were the
social worker what would you have done, if anything, to improve the
decision-making process?
- Regroup & report to
class your answers to #1 & #2.
|
Assignments Due:
- Completion of in-class team oral reports (time
permitting)
- Completion of a one page team report on the
in-class assignment to be posted on the CourseWorks Discussion
section under todays topic to be submitted before the beginning of
next class.
- Completion of quiz prior to next class (on-line
quiz in the Test & Quiz section of CourseWorks available for
completion from after today's class until the beginning of next
week's class; failure to complete the quiz during this time period
will result in 0 points for this quiz). The quiz will be based on
material covered in today's class as well as required readings and
web material.
|
|
Required Readings:
· Rubin (2007),
Preface, chapters 1 & 2 :
· Gibbs, L. E.
(2003). Chapter 1. :
· Evidence-based
Behavioral Practice Project white paper entitled Definitions and
Competencies of Evidence-Based Behavioral Practice :
· Evidence-based
Behavioral Practice Project white paper entitled An Inter-Professional
Model of Evidence-Based Practice :
|
|
Recommended
Readings:
· Straus, S.E., et.
al. (2005). Preface & Introduction : .
· Roberts & Yeager
(2006). Chapters 1,2 & 3. :
· Evidence-based
Behavioral Health Project at Northwestern University web site videos of
experts talking about EBBP http://www.ebbp.org/index.html :
· Danya
International, Inc REACH-SW beta CD-ROM : On restricted library
reserve for this class's use only.
|
|
Files:
· An Inter-Professional Model of
EBP
· Defining EBP Powerpoint
· EBP Competencies
|
|
|
|
Session 2
|
|
Topic:
Forming questions of importance to your client's welfare & making
decisions about services
|
Class Plan:
- While the EBP process typically begins by forming
a question emerging from practice there is an even earlier process
that needs to be considered, namely, identification of some
"uncertainty" or "lack of knowledge" aboutt a
case situation that needs to be resolved to provide effective
service to the client. Once the uncertainty is understood and stated
then a question can be formed that if answered will dimension or
resolve the uncertainty and provide guidance to practitioners and
clients about how to proceed to provide effective services.
Information from research can help to answer some questions but
others can best be answered through other means such as consultation
with a supervisor. An important competency is the ability to
identify uncertainties and related questions followed by an ability
to determine the best way of answering these questions, especially
knowing which questions can be answered by looking to research
evidence. The class will begin with a discussion of the importance
of being able to identify uncertainties in practice that result in
dilemmas about how to proceed with clients.
- Possible ways to resolve
these dilemmas will be reviewed.
- Qualities of
uncertainties that lend themselves to resolution through examination
of research evidence will be discussed.
- The class will discuss
how to convert uncertainties into answerable questions which can
structure an evidence search.
- Videos of cases
demonstrating identification of uncertainties in practice and
subsequent problem formulation will be viewed from the REACH-SW Video Case
Studies CD-ROM (continued from last class) and from the Evidence-based Behavioral
Practice Training Modules web site.
- Teams will meet to begin
work on the in-class assignment.
At the end of this class students will have gained knowledge
about how to formulate COPES/CIAO/PICO questions.
|
Assignments Due:
(1) One to two page team reports due
prior to next class posted in the CourseWorks Discussion section. These
reports should address the following five questions.
The
evidence-based practice process begins with identification of an
uncertainty or dilemma and formulation of a practice question of
practical importance to a problematic situation that practitioners face
with specific clients. This class examines how such questions can be
formed. Also, EBP requires motivation to engage in such practice as
well as organizational support.
Answer the following questions about the cases shown in
today's video clips.
- What were the
uncertainties and resulting questions identified in those cases?
Discuss and identify these uncertainties and questions in your
group.
- Did the practitioners
appear to be motivated to engage in EBP? What things shown in the
videos suggest to you that they were or were not motivated?
- Did the practitioners
appear to have the necessary organizational support to engage in
EBP? What things shown in the videos suggest to you that they were
or were not motivated?
- What type of questions
did the practitioners formulate? Remember that evidence-based
practice questions can be:
·
1.
About what intervention might have the
best effect with a client? - Effectiveness and prevention
questions.
2. About what factors might best predict desirable or
undesirable outcomes with a client? - Prognosis and risk questions.
3.
About what a client is experiencing
(what is it like to have had the client's experiences)? -
Descriptive questions.
4.
About what assessment tool should be
used to gather information about a client's characteristics or
condition? - Assessment questions.
- Formulate four
additional questions that your team thinks could have been asked
based on any of the cases shown in the video-clips. Form an
effectiveness/prevention question; a prognosis/risk question; a
descriptive question; an assessment question.
(2) Completion of quiz prior to next
class (on-line quiz in the Test & Quiz section of CourseWorks
available for completion from after today's class until the beginning
of next week's class; failure to complete the quiz during this time
period will result in 0 points for this quiz). The quiz will be based
on material covered in today's class as well as required readings and
web material.
|
|
Required
Readings:
· Rubin, A.
(2007). Chapters 2 & 3 :
· Gibbs, L. E.
(2003). Chapters 2 & 3 :
|
|
Recommended
Readings:
· Straus, S. E.,
Richardson, W. S., Glasziou, P., & Haynes, R. B. (2005).
(Introduction & chapter 1) :
· Guyatt, G.,
& Rennie, D. (2002). (Front Matter & 1A) :
· R. M. Grinnell
& Y. A. Unrau, Chapter 25 :
· Danya
International, Inc REACH-SW CD-ROM : On restricted library
reserve for this class's use only.
|
|
Files:
· Background and Foreground
Questions
· Uncertainties
|
|
|
|
Session 3
|
|
Topic:
Evaluating Practice Outcomes
|
Class Plan:
In today's class
we will:
- Review key concepts in
the readings about monitoring in EBP
- Watch a 15-minute video
of an EBP case presented in the REACH-SW video pertaining to a
women's shelter for abused women.
- Work in break-out teams
to assess and propose a monitoring plan for this case.
Review of
Methods for Evaluating Practice Process & Outcomes
As we have seen
the last step (5th step) in the EBP process is evaluation. We
think this is such an important step that we present it as second to
problem formulation, and use this class to examine the role and methods
of evaluation in EBP. Students should be anticipating from the start
how they will evaluate their evidence-based practice process and
outcomes. This class will discuss how evaluation has been proposed
in evidence-based medicine and in social work.
(1)
Self-evalution & reflecting on how one is doing as an evidence-based
practitioner (based on Strauss, et al, 2005, chapter 8)
- How am I doing in
asking answerable questions?
- How am I doing is
searching for evidence?
- How am I doing in
critical appraisal of the evidence?
- How am I doing in
integrating evidence and client values/preferences?
- Is our practice
improving?
- Is our practice
becoming more evidence-based?
- How am I doing sharing
what I have learned from the practice with others in my team?
(2) Monitoring
Client Progress & the Practitoner Friendly Designs (based on Rubin,
2007, chapter 12.
(3) Evaluationg
Practice Outcomes & Single-System Designs (based on Thyer &
Myers, 2007, chapters 1, 2, & 3).
Break-out Team
Assignment
Teams will work
on in-class assignment.
|
Assignments
Due:
(1) One to two page team reports due
prior to next class posted in the CourseWorks Discussion section.
These reports should address the following questions.
Answer the
following questions about any one of the cases shown in the
video clips presented during today's class or in the first
two classes ( you need to answer these questions for only one of
the cases and you may select any one of the three):
- What evaluation plans
were used or proposed by the practitioners in the video clip?
- If you were one of
these practitioners what evaluation plan would you have been
comfortable proposing? Describe this plan for any one of the
cases.
(2) Completion of quiz prior to next
class (on-line quiz in the Test & Quiz section of CourseWorks
available for completion from after today's class until the beginning
of next week's class; failure to complete the quiz during this time
period will result in 0 points for this quiz). The quiz will be based
on material covered in today's class as well as required readings and
web material. Since the Thyer & Meyer book is not yet on reserve
the quiz will not include content in that text not covered in the
class lecture.
|
|
Required
Readings:
·
Rubin (2007), Chapter 12 :
·
Straus, Richardson, Glasziou & Haynes (2005), Chapter
8. : Although this is written for physicians the treatment
of this topic is easily adaptable for social workers.
|
|
Recommended
Readings:
·
Thyer & Myers (2007), Chapters 1-3 :
This material should already be
familiar to you since it would typically have been presented in the
first year research course. You may wish to read the entire book to
refresh yourself on this topic. It is a brief and easily readable
treatise on the topic of evaluating practice outcomes for social work
practitioners.
|
|
Files:
· Figure 12 from Rubin Text
·
Monitoring in EBP PowerPoint
|
|
|
|
Session 4
|
|
Topic:
Locating evidence to answer your question
|
Class Plan:
Introduction
to Locating Evidence
Following
formulation of a practice question the next EBP step is to locate
relevant evidence by searching internet sources as well as published
and unpublished reports of evidence. This class provides
opportunity to discuss methods for conducting such searches as well
as some of the more useful sources with special attention to
internet-based sites which publish systematic reviews, meta-analyses,
guidelines, reviews of assessment instruments, and individual
research study reports. The skills you develop for locating evidence
will be used by the teams to locate articles to complete team
in-class assignments for classes 5 through 14.
Topics
examined will include:
- Types of evidence
sources (computerized decision support systems; synopses such as
found in journal abstracts written for practitioners; syntheses;
individual studies as discussed by Strauss, et all (2005),
chapter 2)
- Major databases
available through the CU library for locating evidence &
some suggests for efficient searching
- Designing search
strategies to achieve sensitive and specific results including
specification of key concepts, limiting terms and quality
control filters.
Break-out Team
Assignments
Teams will
break-out to work on the in-class assignment.
|
Assignments
Due:
(1) During the in-class break-out
each team should identify an evidence-based practice
question relevant to one of the members current cases.
Each team should then design a search strategy for locating
evidence to answer the question. The strategy should include the
databases to be searched and the search terms to be used including
any quality control filters and limiting terms.
(2) One page team reports due prior
to next class posted in the CourseWorks Discussion section. These
reports should address the following tasks:
- Describe in one
paragraph the key elements of the case you have selected
(remember the four components of evidence-based questions).
- Present the
evidence-based question formed by the team for this case.
- Identify the
databases that you would use for this search.
- Describe the search
terms including key concepts, limiting terms and quality
control filters.
(3) Completion of quiz prior to next
class (on-line quiz in the Test & Quiz section of CourseWorks
available for completion from after today's class until the
beginning of next week's class; failure to complete the quiz during
this time period will result in 0 points for this quiz). The quiz
will be based on material covered in today's class as well as
required readings and web material.
|
|
Required
Readings:
·
Rubin (2007), Chapter 2, pp. 20-27 :
·
Gibbs (2003), Chapter 4 & Web Site :
Gibbs'
book web site (select the
tabs for plan a search, access a database, and access a database -
the forms on this web site can be used for this
assignment)
|
|
Recommended
Readings:
·
REACH-SW Module 2
:
·
Evidence-based Behavioral
Practice Project Training Resource Module on Searching for Evidence
:
·
Grinnell & Unrau (2007), Chapter 22. :
·
Straus, et al (2005). Chapter 2 :
·
Greenhalgh (2001). Chapter 2 :
·
Petticrew & Roberts (2006). Chapter 4 :
·
Littell, Corcoran & Pillai (2008). Chapter 3 &
Appendix D :
|
|
Files:
·
5 "S" Evolution
of Information Services
·
Examples of Search
Strategies
·
PowerPoint Instructions
for Planning Evidence Search Strategy
|
|
|
|
Session 5
|
|
Topic:
Critically Appraising Effectiveness Questions: Criteria for Inferring
Effectiveness
|
Class Plan:
The next
five classes are designed to provide opportunity to develop
critical assessment skills for articles that report evidence about
effectiveness questions typically using various experimental
and quasi-experimental designs. Today's class provides opportunity
for discussion of criteria for inferring effectiveness which are
common to all of the subsequent designs discussed in the following
4 classes. Topics for consideration in today's class include:
- Internal Validity
(Threats to Internal Validity, Selectivity Bias, Random
Assignment)
- Measurement Issues
- Statistical Chance
- External Validity
- Effect size
measures including risk, absolute risk reduction, relative
risk reduction, number needed to treat, number needed to harm
as well as measures of difference (e.g., standardized and
unstandardized mean differences), measures of association
(correlations), and, measures of differences between
non-continuous, catagorical data (e.g., odds ratios).
Break-out
Team Assignment
|
Assignments
Due:
(1) During
the in-class break-out each team should develop a plan and
make team member assignments for tasks needing to be completed
for the remaining classes. The remaining classes will be used to
learn critical appraisal skills need to assess reports of research
studies using a wide variety of designs (look ahead on the
syllabus to see what designs will be examined).
- Beginning with
next class each team is required to bring one article
to class which reports a study using the design for that
classes' topic. For example, the topic for next class is
skills needed to critically assess studies reporting the use
of an experimental design. For the next class search the
internet for articles reporting the use of experimental
designs and bring these articles to the next class (or view
them on-line if you all have computers and can access
full-text articles).
- During the
break-out session for next class (and the remaining
classes) each team should use the time to critically
assess the articles and prepare a written report on one of
the articles.The Rubin text provides guidelines for
assessing most types of designs that we will be examining.
In addition the assignments section of CourseWorks for this
class includes guidelines for each type of design that we
will be examining and the team can use these guidelines for
the team assessment.
- Use today's
break-out team time to develop a plan for how your team will
allocate responsibility among team members and to specify
tasks so that these assignments can be completed to
everyone's satisfaction. For example, does your team want to
select a topic such as a specific evidence-based
practice concern of mutual interest and search for
articles that relate to that topic? Or, would you rather
just search for interesting practice-relevant articles
related to a broad topic? Once you have decided on your
focus then allocated team member responsibilities. For
example, will one or two members take responsibility for
locating articles for each of the remaining class and become
the lead reviewer for each class (specialize by design
type)? Or, will all team members conduct a search for every
class and then let the team select the article from the
batch that you want to work on for the assignment?
(2) One
page team reports due prior to next class posted in the
CourseWorks Discussion section. These reports should describe the
team plan for completing the remaining in-class assignments
including specification of the topic (or topics) and team member
tasks.
(3) Completion of quiz prior to
next class (on-line quiz in the Test & Quiz section of
CourseWorks available for completion from after today's class
until the beginning of next week's class; failure to complete the
quiz during this time period will result in 0 points for this
quiz). The quiz will be based on material covered in today's
class as well as required readings and web material.
|
|
Required
Readings:
·
Rubin, A. (2007). Chapter 4 :
·
Gibbs, L. (2003). Chapter 5 :
·
CONSORT Statement :
Because
there has been great variation in how researchers have reported
the results of random controlled studies examining effectiveness
questions an evidence-based minimum set of reporting has been
published specifying what should be included in such reports.
This can be found at the home page for the CONSORT group at: http://www.consort-statement.org/QUOROM.pdf .
CONSORT, which stands for Consolidated Standards of Reporting Trials,
encompasses various initiatives developed by the CONSORT Group to
alleviate the problems arising from inadequate reporting of
randomized controlled trials (RCTs).
·
Thyer & Myers (2007). Chapter 4 :
|
|
Recommended
Readings:
·
Straus, S. E. (2005). Chapters 5 & 6, cards 3A
& 3B, 8A & 8B :
·
Guyatt, G., & Rennie, D. (2002). 1B, 1B1, 1B2 :
·
Shadish, Cook & Campbell (2002) :
Experimental
and Quasi-experimental Designs for Generalized Causal
Inference is an
advanced, authoritative resource for experimental and
quasi-experimental designs. If you have questions that are not
addressed in the required reading browse this text for answers.
|
|
Files:
·
PowerPoint Dr Lin Fang
|
|
|
|
Session 6
|
|
Topic:
Effectiveness Questions: Critically Appraising Experiments
|
Class
Plan:
This class
will provide opportunity to discuss effectiveness questions and
to develop knowledge and skills for critically appraising
articles that report studies using experimental designs. Designs
and issues for discussion include:
- Classic
Pretest-Posttest Control Group Design
- Posttest-Only
Control Group Design
- Solomon
Four-Group Design
- Alternative
Treatment Designs
- Dismantling
Designs
- Placebo Control
Group Designs
- Experimental
Demand and Experimenter Expectancies
- Obtrusive Versus
Unobtrusive Observation
- Compensatory
Equalization and Compensatory Rivalry
- Resentful
Demoralization
- Treatment
Diffusion
- Treatment
Fidelity
- Practitioner
Equivalence
- Differential
Attrition
Break-out
Team Assignment
|
Assignments
Due:
(1)
During the in-class break-out each team should review the
articles located for this classes' team assignment (as planned
at the last class).
(2) Team
reports due prior to next class posted in the CourseWorks
Discussion section. These reports should present the team's
critical appraisal of one of the articles examined in
today's class using the guideline posted in the Assignment section
of CourseWorks for this design type.
(3) Completion of quiz prior to
next class (on-line quiz in the Test & Quiz section of
CourseWorks available for completion from after today's class
until the beginning of next week's class; failure to complete
the quiz during this time period will result in 0 points for
this quiz). The quiz will be based on material covered in
today's class as well as required readings and web material.
|
|
Required
Readings:
·
Rubin, A. (2007). Chapter 5 :
·
Gibbs, L. (2003). Chapter 5 :
|
|
Recommended
Readings:
·
Straus, S. E. (2005). Chapters 5 & 6, cards 3A
& 3B, 8A & 8B :
·
Guyatt, G., & Rennie, D. (2002). 1B, 1B1, 1B2
:
|
|
Files:
·
Experimental Designs
Lecture_A. Kapadia
·
PowerPoint Overview of
Critically Appraising Articles on Effectiveness Question
Experimental Designs
·
PowerPoint Overview of
Experimental Designs
·
Today's Lecture
PowerPoint
|
|
|
|
Session 7
|
|
Topic:
Effectiveness Questions: Critically Appraising Quasi-Experiments:
Non-equivalent Comparison Groups Designs
|
Class
Plan:
This
class continues the discussion of effectiveness questions. This
class provides opportunity for developing knowledge and skills
for critically assessing articles that report studies using
nonequivalent comparison group designs. Designs and issues for
consideration include:
- Nonequivalent
Comparison Groups Designs (Are the Groups Comparable?
Grounds for Assuming Comparability)
- Additional
Logical Arrangements To Control For Potential Selectivity
Biases (Multiple Pretests, Switching Replications,
Nonequivalent Dependent Variables)
- Statistical
Controls for Potential Selectivity Biases (When the Outcome
Variable is Categorical, When the Outcome Variable is
Quantitative)
- Pilot
Studies
Mid-semester class evaluation
How is the course going for each of you?
What should we continue doing that has worked for you? What
should we change to improve learning opportunities?
Break-out Team Assignment
|
Assignments:
(1)
During the in-class break-out each team should review
the articles located for this classes' team assignment.
(2)
Team reports due prior to next class posted in the
CourseWorks Discussion section. These reports should present
the team's critical appraisal of one of
the articles examined in today's class using the
guideline posted in the Assignment section of CourseWorks for
this design type.
(3) Completion
of quiz prior to next class (on-line quiz in the Test &
Quiz section of CourseWorks available for completion from
after today's class until the beginning of next week's class;
failure to complete the quiz during this time period will
result in 0 points for this quiz). The quiz will be based on
material covered in today's class as well as required
readings and web material.
|
|
Required
Readings:
· Rubin, A. (2007).
Chapter 6 :
· Gibbs, L. (2003).
Chapter 5 :
|
|
Recommended
Readings:
· Straus, S. E. (2005).
Chapters 5 & 6, cards 3A & 3B, 8A & 8B :
· Guyatt, G., &
Rennie, D. (2002). 1B, 1B1, 1B2 :
|
|
Files:
· Experimental
Designs_A. Kapadia
· Guideline for
Assessing Nonequivalent Comparison Group Studies
· PowerPoint for
Today's Class
|
|
|
|
Session
8
|
|
Topic:
Critically Appraising Quasi-Experiments: Time-series Designs
|
Class
Plan:
This
class provides opportunity for developing knowledge and
skills for critically assessing articles that report studies
using time-series designs. Designs and issues for
consideration include:
- Simple
Time-Series Designs
- Multiple
Time-Series Designs
Break-out
Team Assignment
|
Assignments
Due:
(1)
During the in-class break-out each team should review
the articles located for this classes' team assignment.
(2) Team reports due prior to next class
posted in the CourseWorks Discussion section. These reports
should present the team's critical appraisal of one of
the articles examined in today's class using the
guideline posted in the Assignment section of CourseWorks
for this design type.
(3) Completion of quiz prior to next class
(on-line quiz in the Test & Quiz section of CourseWorks
available for completion from after today's class until the
beginning of next week's class; failure to complete the
quiz during this time period will result in 0 points for
this quiz). The quiz will be based on material covered in
today's class as well as required readings and web
material.
|
|
Required
Readings:
· Rubin, A. (2007).
Chapter 7 :
· Gibbs, L. (2002).
Chapter 9 :
|
|
Recommended
Readings:
· Guyatt, G., &
Rennie, D. (2002). 2B1 :
· Straus, S. E. (2005).
page 172-175 :
|
|
Files:
· Guide for
Assessing Articles Reporting Studies UsingTime-series or
Single-case Designs
· PowerPoint on
Critically Assessing Time-Series & Single-Case Designs
|
|
|
|
Session
9
|
|
Topic:
Critically Appraising Quasi-Experiments: Single-Case Designs
|
Class
Plan:
This
class provides opportunity for developing knowledge and
skills for critically assessing articles that report
studies using single-case designs. Designs and issues
for consideration include:
- Single-Case
Designs
- N=1 RCTs
|
Assignments
Due:
(1)
During the in-class break-out each team
should review the articles located for this classes'
team assignment.
(2) Team reports due prior to next class
posted in the CourseWorks Discussion section. These
reports should present the team's critical appraisal
of one of the articles examined in today's
class using the guideline posted in the Assignment
section of CourseWorks for this design type.
(3) Completion of quiz prior to next class
(on-line quiz in the Test & Quiz section of
CourseWorks available for completion from after today's
class until the beginning of next week's class; failure
to complete the quiz during this time period will result
in 0 points for this quiz). The quiz will be based on
material covered in today's class as well as required
readings and web material.
|
|
Required
Readings:
· Rubin, A. (2007).
Chapter 7 :
· Thyer & Myers
(2007). Chapter 3 :
|
|
Files:
· Single-Subject
Designs: Bledsoe & Bellamy
|
|
|
|
Session
10
Open for Discussion
|
|
|
|
|
Session
11
|
|
Topic:
Critically Appraising Systematic Reviews & Meta-Analyses
|
Class
Plan:
The
most efficient and comprehensive method for locating
evidence about a clinical practice question is to locate a
high quality systematic review of relevance to your
question.
This class provides opportunities to discuss systematic
reviews. Relevant topics include:
- Advantages
Of Systematic Reviews And Meta-Analyses
- Risks In
Relying Exclusively On Systematic Reviews And
Meta-Analyses
- Where to
Start?
- What To
Look For When Critically Appraising Systematic Reviews
(Bias, Cochrane and Campbell
Collaborations, Inclusion
and Exclusion Criteria, Does the Review Critically
Appraise the Quality of Included Studies?,
Comprehensiveness, Transparency)
- What
Distinguishes A Systematic Review From Other Types Of
Reviews?
- What to
Look for When Critically Appraising Meta-Analyses
(Effect-Size, Correlating Effect Size with Other
Variables)
- Statistical
& Clinical Significance
Specific
Plan for Today's Class:
- Instuctor
will provide brief overview of topic & comment on
class resources & PowerPoints
- We will
look at PubMed section on Clinical Queries as an
example of how to find systematic reviews that are
clinician friendly
- We will go
to the Campbell Collaboration web site to view
available systematic reviews in social work and social
welfare, criminal justice and education http://www.campbellcollaboration.org/index.asp .
- We will
look at a Campbell Collaboration systematic review
protocol (Risk of child maltreatment: A systematic
review of the predictive validity of instruments
by Aron Shlonsky, aron.shlonsky@utoronto.ca,
University of Toronto, Canada, Mike Saini, and Ulla
Jergeby View Documents
- We will
look at a completed Campbell Collaboration systematic
review:
Multisystemic therapy for
social, emotional, and behavioral problems in children and
adolescents aged 10-17 by Julia H. Littell, jlittell@brynmawr.edu,
Bryn Mawr College, USA, Melanie Popa, and Burnee Forsythe
View Documents
- Break-out
team work on in-class assignment.
|
Assignments
Due:
(1)
During the in-class break-out each team
should review the articles located for this classes'
team assignment.
(2) Team reports due prior to next class
posted in the CourseWorks Discussion section. These
reports should present the team's critical appraisal
of one of the articles examined in today's
class using the guideline posted in the Assignment
section of CourseWorks for this design type.
(3) Completion of quiz prior to next class
(on-line quiz in the Test & Quiz section of
CourseWorks available for completion from after today's
class until the beginning of next week's class; failure
to complete the quiz during this time period will result
in 0 points for this quiz). The quiz will be based on
material covered in today's class as well as required
readings and web material.
|
|
Required
Readings:
· Rubin, A. (2007).
Chapter 8 :
· Gibbs, L. (2003).
Chapter 6 :
|
|
Recommended
Readings:
· Greenhalgh T. (1997)
:
How
to read a paper: Papers that summarise other papers
(systematic reviews and meta-analyses). BMJ
1997;315:672-5.
· Littell, J. H.,
Corcoran, J., & Pillai, V. (2008). :
Systematic
reviews and meta-analysis. New York: Oxford. (Written
for social work applications)
· Petticrew, M. &
Roberts, H. (2006). :
This
is a very readable overview of systematic review methods
as applied to the social sciences including social work.
|
|
Files:
· Article on the
Role of Systematic Reviews in EBP
· Article Presenting
a Guide for Assessing Systematic Reviews in Context of
EBP
· Guide for
Assessing Articles that Report Systematic Reviews
· PowerPoint on
Advanced Meta-analysis Methods
· PowerPoint on
Meta-analysis Basics
· PowerPoint on
Various Methods for Synthesizing Evidence in Systematic
Reviews
|
|
|
|
Session
12
|
|
Topic:
Critically Appraising Descriptive-Background Questions:
Predictors of Risk; Prognosis; Etiology; Experiential
|
Class
Plan:
This
class provides opportunity to examine how to critically
assess evidence about descriptive questions. Descriptive
questions ask about what is known about characteristics
of people like your client. These include questions about
predictors or risk & protective factors of
social problems or conditions like the one's
experienced by your client. They include prognostic
questions which ask about what you might expect to
occur with your client's problem, need or situation if no
intervention is provided. They also include questions
about the etiology of problems or conditions like
those experienced by your clients. They also include questions
about how clients like yours may be experiencing
something in their lifes including how they might be
experiencing the interventions that you or another
professional are providing. Sometimes these are called background
questions (in the medical literature). Basically,
these questions do not ask about the effects or outcomes
of interventions that you might consider but rather seek
answers to questions that come up when you engage in an
assessment of the client's condition, situation or
problems. The study designs generally are prospective or
retrospective correlational designs although experimental
designs may be used as well (such as in a control
condition). Experience questions often used qualitative
designs which we will examine later in the semester.
Typical designs and issues to be examined are:
- Surveys
- Cross-Sectional
and Longitudinal Studies (Cohort Studies and Panel
Studies; Case-Control
Studies)
-
- Reporting
Guidelines
STROBE - reporting of
observational studies in epidemiology
EQUATOR Network - collection of
reporting guidelines
|
Assignments
Due:
(1)
During the in-class break-out each team
should review the articles located for this
classes' team assignment.
(2) Team reports due prior to next class
posted in the CourseWorks Discussion section. These
reports should present the team's critical appraisal
of one of the articles examined in today's
class using the guideline posted in the Assignment
section of CourseWorks for this design type.
(3)
Completion of quiz prior to next class (on-line quiz in
the Test & Quiz section of CourseWorks available
for completion from after today's class until the
beginning of next week's class; failure to complete the
quiz during this time period will result in 0 points
for this quiz). The quiz will be based on material
covered in today's class as well as required readings
and web material.
|
|
Required
Readings:
· Rubin, A. (2007).
Chapter 9 :
· Gibbs, L. (2003).
Chapter 8 : Gibbs' chapter also
includes a discussion of qualitative research which we
will discuss later in the semester
|
|
Recommended
Readings:
· Straus, S., et al.
(2005). Chapter 4 & card 7A :
· Guyatt, G., &
Rennie, D. (2002). 1D :
· Op-Ed Contributor:
The Bad News First :
An interesting op-ed about the use of
prognoses in medical practice:
OPINION | August 24, 2007
By NICHOLAS A. CHRISTAKIS
For reliable prognoses to become a routine
part of medical care, they must become a priority of
medical research and education.
|
|
Files:
· PowerPoint
Surveys, Cohorts, Case-Control
· Student
Example Cohort Study
· Student
Example Survey Study
|
|
|
|
Session
13
|
|
Topic:
Critically Appraising Qualitative Studies for All
Questions
|
Class
Plan:
This
class provides opportunity for consideration of
articles that report qualitative research findings
relevant to clinical practice questions. Increasingly
researchers are using both qualitative and quantitative
methods to examine clinical practice questions. These
methods are complimentary. Qualitative research methods
can inform all four types of evidence-based practice questions
but these designs are especially useful for descriptive
questions. Topics for considerations include:
- Qualitative
Observation
- Qualitative
Interviewing (Life History, Focus Groups)
- Qualitative
Sampling
- Grounded
Theory
- Frameworks
for Appraising Qualitative Findings (Empowerment
Standards, Social Constructivist Standards,
Contemporary Positivistic Standards)
Break-out
Team Assignment
|
Assignments
Due:
(1)
During the in-class break-out each team should review
the articles located for this classes' team
assignment.
(2) Team reports due
prior to next class posted in the CourseWorks
Discussion section. These reports should present the
team's critical appraisal of one of the articles
examined in today's class using the guideline posted
in the Assignment section of CourseWorks for this
design type.
(3)
Completion of quiz prior to next class (on-line quiz
in the Test & Quiz section of CourseWorks
available for completion from after today's class
until the beginning of next week's class; failure to
complete the quiz during this time period will result
in 0 points for this quiz). The quiz will be based on
material covered in today's class as well as required
readings and web material.
|
|
Required
Readings:
· Rubin, A.
(2007). Chapter 10 :
· Gibbs, L.
(2003). Chapter 8 :
|
|
Recommended
Readings:
· Greenhalgh T,
Taylor R. (1997) :
How
to read a paper: Papers that go beyond numbers
(qualitative research) . BMJ 1997;315:740-3.
· Cochrane
Qualitative Research Methods Group Web Site :
Review
the resources at this web site. Especially check out
the tab for "Tools to Assist Qualitative
Researchers". For today's topic #3
"Critical Appraisal of Qualitative Studies"
tab includes several relevant readings that can be
downloaded.
|
|
Files:
· Guide to
Assess Qualitative Studies
· PowerPoint
for Critically Appraising Qualitative Research
|
|
|
|
Session
14
|
|
Topic:
Critically Appraising & Selecting Assessment &
Diagnostic Instruments
|
Class
Plan:
This
class provides opportunity to examine how to critically
assess evidence about assessment and
diagnostic questions. These questions ask about
the soundness and relevance of various instruments
that you might consider using to assess your client's
needs or characteristics. Typical designs and issues
to be examined are:
- Reliability (Internal
Consistency Reliability; Test-Retest
Reliability; Interrater (Interobserver)
Reliability)
- Validity (Face Validity,
Content Validity, Criterion Validity, Construct
Validity)
- Sensitivity (including
Cultural Sensitivity)
- Specificity
- Likelihood Ratios
- Positive and Negative
Predictive Values
- Pre-test and Post-test
Probabilities and Odds
- Feasibility
- Sample Characteristics
- Locating Assessment and
Diagnostic Instruments
Break-out Team
Assignments
|
Assignments Due:
(1) During the in-class break-out each
team should review the articles located for
this classes' team assignment.
(2) Team reports due
prior to next class posted in the CourseWorks
Discussion section. These reports should present
the team's critical appraisal of one of
the articles examined in today's class using
the guideline posted in the Assignment section of
CourseWorks for this design type.
|
|
Required Readings:
·
Rubin, A. (2007). Chapter 11 :
·
Gibbs, L. (2003). Chapter 7 :
|
|
Recommended
Readings:
·
Greenhalgh T. (1997) :
How to read a paper: Papers that
report diagnostic or screening tests . BMJ
1997;315:540-3.
·
Straus, S., et al. (2005). Chapter 3
& card 1A&B, 2A&B :
·
Guyatt, G., & Rennie, D. (2002). 1C
:
|
|
Files:
·
Cochrane
Diagnostic Test Accuracy Guidelines
·
Cochrane
Diagnostic Test Accuracy Plots
·
PowerPoint
on Measuring Instument Assessment
|
|
|
|
Session
15
|
|
Topic:
Evaluating Process & Outcomes and Monitoring
Client Progress
|
Class Plan:
The previous classes have focused on
helping you develop knowledge and skills for
critically appraising research studies for
evidence-based practice questions. Based on what
you find it is expected that these appraisals will
be used by you in an evidence-based practice
process with clients. It is important that when you
use your appraisals in practice you monitor what
happens with individual clients. What was found to
work in the research literature may not work with
your individual client! You need to monitor
implementation and use what you and your clients
find to modify your subsequent interventions. These
skills will contribute to your EBP competiences:
- Competency: Ability to
monitor what happens when the intervention is
implemented.
- Competency: Ability to
modify the chosen intervention based on the
information gained through the monitoring
process.
Also, practitioners can contribute to
practice knowledge by evaluating their work with
clients and reporting the results to others.
Single-case and group designs can be used for this
purpose.
In this class we review a few
skills for monitoring client progress and for
evaluating process and outcomes of
interventions. Topics include:
- Practitioner Friendly
Design: The B+ Design
- Feasible Assessment
Techniques (What to Measure?, Who Should
Measure?, With What Measurement Instrument?
When and Where to Measure?)
- Single-case designs
(revisited)
- Group designs (revisited)
Class evaluation
We will use time at
the end of class to evaluate how the class went for
each of you. What was good and what should be
changed for future classes? Did you learn what you
had hoped to learn? Do you feel that you have
achieved the competencies we set for this course?
|
|
|
|
|
|
|
|
|
|
|
|
|
|
