Skills for evidence-informed practice:Interactive workshop

Dartington Hall, Devon

2 April 2009

First, a little about ripfa…

We work to promote and support evidence-informed practice in adult health and social care

We do this through:

learning events

publications

our network, including a busy discussion forum

change projects

the website, www.ripfa.org.uk

joint work with research in practice

What we can achieve today

A one-day introduction to key aspects of evidence-informed practice

Focusing on the role of individuals as opposed to teams and organisations

Practical guidance on core skills needed for evidence-informed practice

Using groupwork and real examples to help messages stick

Being evidence-informed – key steps

What is evidence-informed practice?

What it means to be evidence-informed, and the case for EIP

Being evidence-informed – key steps

What is evidence-informed practice?

Put most simply, evidence-informed practice means that your decisions are informed by:

The best available research evidence

Your own professional experience

The views and preferences of service users

It is different to evidence-based practice (EBP), because ‘evidence does not take decisions, people do’

To be evidence-informed, we need to:

Ask challenging questions about practice

Reflect on our experiences in order to learn from them

Listen to service users’ feedback

Measure the impact our work is having for users

Know how and where to find research

Understand messages from research

Be explicit about how research, experience and user views have informed decisions

Share knowledge and best practice

The case for evidence-informed practice

Research evidence can help identify where need is greatest and where specific interventions may be most effective – it’s central to outcomes-focused support

Being evidence-informed can help us to have greater confidence in our own decisions, and give service users greater confidence in the support they receive

What is assumed to be good policy and practice is not always supported by the evidence – EIP encourages us to ask questions

Discussion point

What counts as evidence?

Where is evidence needed?

Identifying gaps and knowing what to ask

Being evidence-informed – key steps

Identifying need for evidence

Choosing a topic Related to day-to-day work; important for decision

making in individual case or service level

‘Controversial’; area of work where people have different views or debate about

Service user informed; one that service users ask or want to know more about

Realistic; area in which it is likely to find evidence

Policy led

Being evidence-informed – key steps

Developing a specific question

The importance of having a specific question

Start the question with: ‘How…’, ‘What…’, ‘Why…’, ‘Who…’, etc.

Effectiveness questions, exploratory questions and service users’ views questions

Question’s ‘elements’: client group, setting/service, approach/intervention, outcome

Be specific!

Develop your own questions

Exercise

How do you find the evidence you need?

Where to look and how

Being evidence-informed – key steps

Discussion point

Where would you find evidence on

your topic?

What can we cover today?

Unravelling some of the jargon you will hear

The best places to find research evidence on your topic

How to carry out a straightforward online search

Some legitimate shortcuts!

Finding the evidence you need – routes you can take

Ask around!

Carry out a

search

Do your own

research

Colleagues Librarians

ripfaTopic

experts

Existing reviews

and summaries

Original papers and

journal articles

Carrying out an online search

Decide on your search terms

Develop a search string

Decide on any limits

Consider where you want to look

Deciding on your search terms

Look at the specific question you developed earlier

Pick out the main words or phrases that describe what you’re looking for

For each, think of as many alternative terms as possible with the same or similar meaning

Ask friends and colleagues for suggestions

You can add other terms later on – some of the first articles and websites you find might give you other ideas

Discussion point

Brainstorm search terms for Autistic

Spectrum Disorder

Develop a search string

Combine your search terms into a string using Boolean searching

Using AND limits your search

e.g. Autism AND services

Using OR broadens your search

e.g Autism OR Asperger Syndrome

Using brackets can help you combine lots of terms

e.g. (Autism OR Asperger Syndrome) AND (Support OR Services)

Think about your limits

Placing limits can make the number of articles you find more manageable to deal with

It can also ensure greater relevance

For example, are you only interested in:

Studies from the UK?

Studies written in English?

Studies published in the last five years?

Studies about adults?

Where will you look?

ORGANISATION WEBSITES

e.g. DH, SCIE, ripfa

ONLINE DATABASES

e.g. Social Care Online, SSCI,

ASSIA

INTERNET SEARCH ENGINES

e.g. Google

LIBRARIES

In-house, local, university

Social Care Online – www.scie-socialcareonline.org.uk

Is the evidence good enough?

Appraising and understanding research

Being evidence-informed – key steps

Appraise the evidence What counts as good evidence?

Information on the Web: the double-edged sword

Appraising research (journal articles and books)

Is the purpose of the research stated clearly?

Who funds it?

Clear research questions and defined concepts

Is the choice of research methods justified?

Are the participants (the sample) chosen appropriately?

Is the data analysis sound?

Have ethical considerations been paid attention to?

Advanced research appraisal – comparing research projects

Exercise

Please identify strengths and

weaknesses of the evidence presented in

the articles

Being evidence-informed – key steps

How relevant is the evidence?

Bias is not a ‘dirty word’; what is your bias?

Always look at the counter-arguments

Opposing evidence sometime tell more than commonality in evidence

Appraising the relevance: client group, context, interventions, outcomes

Who is in a position to make these judgements?

How do you make a change?

Translating key messages and influencing practice

Getting evidence into practice

Do you want to: Change your own practice? Encourage others to change their practice? Suggest a change to the way a service is provided?

Only you can change your own practice – but support from colleagues and managers can help

Remember EIP is also about sharing information

So whether you are suggesting large-scale change or simply changing the way you do things yourself, the following exercise may be useful…

Presenting your evidence effectively:The SCAM model

Source – who delivers the message?

Channel – how are you sending the message?

Audience – who are you sending the message to?

Message – what is your message?

One final exercise…

Using the evidence you have found today, make a proposal for a change to a service or an aspect of practice

- The change you are proposing can be at any level

- YOU decide whether you are practitioners, service users, someone else, or a mixture

- YOU decide who your audience is – perhaps a service-user organisation, management group, or team meeting?

Thank you.

Please contact us if you need any further information:

naomi@ripfa.org.uk01803 860097

todor@ripfa.org.uk01803 869758