EVIDENCE-BASED PRACTICE & PRACTICE GUIDELINES©
General Course Information
EDWARD J, MULLEN
Willma & Albert Musher Chair Professor
School of Social Work
1255 Amsterdam Ave
New York, New York 10027
This course is a 7 week social work practice course offered to students in their final semester of the two year master’s of social work program. This course satisfies one of the two fourth semester practice elective requirements. The course is open to doctoral students and other students within the University with the instructor’s permission.
This course aims to introduce practitioners to principles of evidence-based practice and policy, practice guidelines, and information utilization for practice modeling. Increasingly, social work practitioners and policy analysts are presented with new information about recent findings from research and professional consensus statements regarding best-practices and practice guidelines. This information pertains to practice assessment, intervention and the evaluation of outcomes. Social work agencies, accrediting and standard setting organizations, and funding bodies both pubic and private are encouraging social workers to engage in best-practices using guidelines and to provide evidence of cost-effective outcomes. However, as autonomous practitioners, social workers are expected to make judgments about this evidence and to individualize services rather than to adopt this new information uncritically, out-of-context and on a wholesale basis. This course focuses on preparing students to engage in evidence-based practice, providing the skills needed to critically evaluate new information that is available from research findings and professional consensus statements. Furthermore, the course provides skills for integrating this new information into the students own, personalized approach to practice. The general process of assessing and integrating new information into an individual practitioner’s approach to practice is called personal practice modeling.
The specific objectives are to:
Upon completion of the course, students should have:
Method of Instruction
The course will be conducted as a seminar. Readings and internet sources will be assigned pertaining to each topic. The sessions will be used to critically discuss the readings. In addition the class sessions will provide assistance to each student in the formulation of practice problems, search strategies, and evaluation methods.
Assignments & Method of Evaluation
In addition to the reading and internet assignments students will submit a final paper. The final paper will present the student’s practice questions formed during the course, including:
This paper should be no more than 10 pages, double spaced and written according to APA format. The course grade will be based on work conducted during the class sessions (50%) and the final paper (50%).
Gibbs, L. E. (2003). Evidence-based practice for the helping professions: A practical guide with integrated multimedia. Pacific Grove, CA: Brooks/Cole-Thompson Learning.
Brief Treatment and Crisis Intervention, 2004, 4(numbers 2&3). Special issues on evidence-based policy and practice.
Gray, J. A. M. (2001). Evidence-based healthcare (2 ed.). New York: Churchill Livingstone.
Roberts, A. R., & Yeager, K. R. (Eds.). (2004). Evidence-based practice manual: Research and outcome measures in health and human services. New York: Oxford University Press.
Roberts, A. R., & Yeager, K. R. (Eds.). (2006). Foundations of evidence-based social work practice. New York: Oxford University Press.
Rosen, A., & Proctor, E. (Eds.). (2003). Developing practice guidelines for social work intervention: Issues, methods, and a research agenda. New York: Columbia University Press.
Straus, S. E., Richardson, W. S., Glasziou, P., & Haynes, R. B. (2005). Evidence-based medicine: How to practice and teach EBM (3rd ed.). Edinburgh: Churchill Livingstone.
Additional Relevant Readings:
Gambrill, E. (1999). Evidence based practice: An alternative to authority-based practice. Families in Society: The Journal of Contemporary Human Services, 80, 341
Gambrill, E. Evidence-based practice and policy: Choices ahead. Research on Social Work Practice. May 01, 2006; 16: 338-357.
Gambrill, E. Social work: An authority-based profession. Research on Social Work Practice. Mar 01, 2001; 11: 166-175.
Gibbs, L.E., & Gambrill, E. (2002). Evidence-based practice: Counterarguments to objections. Research on Social Work Practice, 12, 452-476.
Gilgun, J. F. The four cornerstones of evidence-based practice in social work. Research on Social Work Practice. Jan 01, 2005; 15: 52-61.
Howard, M. O., McMillen, C. J., & Pollio, D. E. Teaching evidence-based practice: Toward a new paradigm for social work education. Research on Social Work Practice. Mar 01, 2003; 13: 234-259.
Mullen, E. J., Bellamy, J. L., & Bledsoe, S. E. (2007). Best practices. In T. Mizrahi & L. Davis (Eds.), Encyclopedia of Social Work (20 ed.). New York: Oxford University Press.
Mullen, E. J., Bellamy, J. L., & Bledsoe, S. E. (2007). Evidence-based social work practice. In R. M. Grinnell & Y. A. Unrau (Eds.), Social Work Research and Evaluation: Quantitative and Qualitative Approaches (8 ed.). New York: Oxford University Press.
Mullen, E. J., & Streiner, D. L. (2004). The evidence for and against evidence based practice. Brief Treatment and Crisis Intervention, 4(2).
Proctor, E. K. (2004). Leverage points for the implementation of evidence-based practice. Brief Treatment and Crisis Intervention, 4(3).
Shlonsky, A., & Gibbs, L. (2004). Will the real evidence-based practice please stand up? Teaching the process of evidence-based practice to the helping professions. Brief Treatment and Crisis Intervention, 4, 137-153.
Thyer, B. A. (2004). What is evidence-based practice? Brief Treatment and Crisis Intervention, 4(3).
Howard, M. O. & Jenson, J. M. Clinical practice guidelines: Should social work develop them? Research on Social Work Practice. May 01, 1999; 9: 283-301.
Class Session Outline
Introduction to Evidence-based Practice, Policy & Guidelines
Students will complete a brief questionnaire pertaining to initial knowledge and practices.
Gibbs, L. E. (2003). (Chapter 1).
Mullen, E. J., & Streiner, D. L. (2004)
Straus, S. E., Richardson, W. S., Glasziou, P., & Haynes, R. B. (2005).(Introduction)
Gray, J. A. M. (2001). (chapters 1 & 2)
Forming questions of importance to your client’s welfare & making decisions about services
The evidence-based practice & policy process begins with a policy or practice question which is of practical importance to a problematic situation that you are facing. This session examines how such questions can be formed from your practice or policy experience. Evidence-based practice requires motivation to engage in such practice as well as organizational support.
During this session students will be asked to:
At the end of this class students should have:
Students should begin to formulate a practice or policy question of relevance to their field work experience. These questions can be used by the class throughout the remaining sessions so as to gain experience in following the evidence-based practice & policy process.
Gibbs, L. E. (2003). (chapters 2 & 3)
Straus, S. E., Richardson, W. S., Glasziou, P., & Haynes, R. B. (2005). (chapter 1)
Gray, J. A. M. (2001). (chapter 3)
Locating evidence to answer your question
Following formulation of a practice question of importance to policy or practice the next step is to locate relevant evidence by searching internet sources as well as published and unpublished reports of evidence. This session introduces some proposed 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.
Prior to this session each student should:
Gibbs, L. E. (2003).(chapter 4)
Straus, S. E., Richardson, W. S., Glasziou, P., & Haynes, R. B. (2005). (chapter 2, card 8B)
Gray, J. A. M. (2001). (chapter 4, appendices 1, 2, 3)
Course bibliography list of internet sites :
· Students are advised to become familiar with the various internet sites commonly used to search for evidence. These are listed in the readings as well as on the bibliography.
· Each of the required and recommended books has internet sites with evidence sources listed.
· Students are advised to access the internet sites through the University library web site since the University subscribes to most electronic databases. Accordingly, registered students have free access so long as these sites are accessed through the University.
Evaluating the evidence about effectiveness of interventions
This session examines practical ways that can be used to evaluate the quality, importance, and relevance of the evidence that is presented in reports of research studies found in the search for evidence. Common measures used in evidence-based evaluations are introduced such as for:
Students should evaluate the evidence found in their respective searches using some of the techniques reviewed in this session.
Gibbs, L. E. (2003).(chapter 5)
Straus, S. E., Richardson, W. S., Glasziou, P., & Haynes, R. B. (2005) (chapter 5)
This books web site has excellent resources providing simple explanations of some of the technical methods used to assess evidence (e.g., number needed to treat, odds ratios, risk).
Gray, J. A. M. (2001). (chapter 6, appendix 3)
Systematic reviews & meta-analysis
The most comprehensive way to gather evidence about a policy or practice question is to locate systematic reviews of relevance to the question.
Systematic reviews are comprehensive “reviews” of all available research pertaining to a topic area that meet specified criteria.. They are conducted according to explicit, rigorous search processes and evaluation methods.These reviews summarize findings, assess the quality of the evidence, and, at times, propose policy or practice guidelines thought to flow from the review. Learning how to locate and evaluate systematic reviews is central to evidence-based policy and practice. This session examines the systematic review process, including meta-analysis (which is a quantitive method used to combine results from more than one study).
Students should search for systematic reviews and meta-analyses pertaining to their respective questions.
Gibbs, L. E. (2003). (chapter 6)
Borenstein, M., & Rothstein, H. (2006). Comprehensive meta-analysis: A computer program for research synthesis. Englewood, NJ: Biostat, Inc. http://www.meta-analysis.com/ (Browse for future use)
Cooper, H. & Hedges, L.V. (Eds). (1994). The handbook of research synthesis. New York: Russell Sage Foundation.
Higgins J. P. T. & Green S., (editors). Cochrane handbook for systematic reviews of interventions. 4.2.5 [updated May 2005]. In: The Cochrane Library, Issue 3, 2005. Chichester, UK: John Wiley & Sons, Ltd. (Available on-line at: www.cochrane.org/resources/handbook/).
Lipsey, M. W. & Wilson, D. B. (2001) Practical meta-analysis. Thousand Oaks: Sage.
Mullen, E. J. (2006). Choosing outcome measures in systematic reviews: Critical challenges. Research on Social Work Practice, 16(1)
National Health Service Centre for Reviews and Dissemination. (2000). Undertaking systematic reviews of research on effectiveness. York, England: University of York. (Available at: http://www.york.ac.uk/inst/crd/report4.htm).
Evaluating assessment & risk studies
In addition to questions pertaining to the outcomes of interventions social work practitioners and policy analysts have questions about how to evaluate the needs and conditions of individuals, groups, and communities so as to plan prevention and treatment interventions. This session examines some ways to evaluate the studies:
· Applicability of such measures.
Students should formulate an assessment question and use some of the methods discussed in this class to critically appraise research evidence pertaining to the assessment question.
Gibbs, L. E. (2003). (chapter 7)
Straus, S. E., Richardson, W. S., Glasziou, P., & Haynes, R. B. (2005). (chapter 3)
Gray, J. A. M. (2001). (chapter 8)
Student Presentations & Formulation of Beginning Personal Practice Models
The last class will provide each student with opportunity to present the results of their work over the semester. Over time an evidence-based practitioner and policy analyst will find answers to many questions. The results of these numerous searches for evidence, the evaluations of the evidence, and the identification of action plans (guidelines) would be wasted if not organized in a manner suitable for future use and future revision-refinement. Student presentations should include three inter-related ways that previously collected evidence can be preserved and refined for future use.
The final assignment is due at the end of this class. The final assignment should be a personal practice model incorporating the one, two, or more questions and evidence examined during the course of this class. It is a beginning personal practice model (only a modest beginning).
Gibbs, L. E. (2003). (chapter 9)
Mullen, E. J., & Bacon, W. F. (2003).
Straus, S. E., Richardson, W. S., Glasziou, P., & Haynes, R. B. (2005).(chapters 7 & 9)