The notion of evidence-based practice emerged in the early 1990s, first emerging in medicine but spreading across a range of practitioner professions (such as social work and education) (Mullen, 2008). To a large extent consideration of evidence and practice has lagged behind much more prominent and extensive consideration of evidence-based policy, which was paid considerable attention when New Labour entered government in 1997. Nowadays the concept of being informed by, rather than based on, evidence is more widely accepted, as this recognises the numerous influences on practice (and policy), and the importance of these (public opinion, capacity, local context, individual needs etc). Perhaps the terminology is ready for further development however; for instance Nick Andrews (from the All Wales Academic Social Care Research Collaboration) recently referred to ‘evidence-enriched practice’, which seems to be an even better way to express the desired relationship between evidence and practice.
Despite the inevitable evidence gaps (the irony!) there is some evidence about activities which have potential to improve the use of evidence in practice:
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Strengthen links and relationships between practitioners, researchers, citizens, service users and policy makers – who all bring different evidence and different types of evidence. Personal contact is key to strengthening evidence use.
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Nurture active collaborations where people are involved in actually doing something together (inquiring, thinking, reflecting, planning, doing). Again potentially involving a mix of practitioners, researchers, citizens, service users, policy makers, and more…
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Produce evidence together, involving practitioners, researchers and others, coming together at the earliest possible stage.
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Strengthen evidence dissemination by developing targeted messages focused on key audiences in their language, walk in their shoes and reach out to them in ways that best meet their needs. Think about dissemination as opening up further exploration and engagement rather than being an end in itself, so ensure methods support the development of links.
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Provide opportunities to “try out” evidence, perhaps particularly where evidence challenges current attitudes or behaviours.
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Support evidence role models, identify evidence champions, support them and raise awareness of their activities. Champions need to be credible and although champions are required at all levels of the organisation it is particularly helpful if leaders champion evidence use.
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Incentivise evidence use for practitioners and the creation of useful evidence for researchers. This can be done through making evidence use/usefulness a required component in documentation (business cases, project plans etc), as a component in job description and as criteria for promotion.
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Designate evidence responsibilities within organisations, tasking people to interpret or synthesise evidence and develop relationships between evidence and practice.
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Set aside evidence time to consult, reflect and discuss evidence, perhaps within team meetings or existing structures.
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Nurture a culture of self-challenge and evaluation, personally value and demonstrate these behaviours, and champion them throughout your organisation.
(this list draws heavily on: Nutley, 2003; and is informed by Lavis, 2002; Buckley 2009; and personal experience)
This list is not comprehensive, and there is a variation in the strength of evidence supporting these activities. It is also worth reflecting on whether behaviours and attitudes matter more than any particular activity. This is suggested by Landry and colleagues’ study of 1000 Canadian social science scholars, which identified that the behaviour of researchers and research users had more impact on the use of research than any specific product (Landry et al, 2001). In terms of specific attitudes and behaviours, the importance of enthusiasm in particular has been identified as having significance for supporting evidence use (Nutley, 2003). My experiential evidence also suggests that factors such as being able to think from someone else’s perspective, being understanding and patient of difference, and demonstrating this in your actions, may also have a significant impact. I’d be interested to know if others have evidence that supports or contradicts this…
So, this blog is intended as a space to share and reflect on evidence and practice, and to share what improves the relationship between them. We would love to hear from you and particularly welcome guest posts if you have something to share.
References and links
Buckley, H. and Whelan, S. (2009) Putting Research Evidence to Work: Key Issues for Research Utilisation in Irish Children’s Services (CAAB Research: Report No.2) http://www.srsb.ie/Publications/PDFs—Publications/PREW/PREW-Full-Report.aspx
Landry, R., Amara, N. And Lamari, M. (2001) ‘Utilisation of social science research knowledge in Canada’, Research Policy, 30: 33-349
Lavis, J., Robertson, D., Woodside, J., McCleod, C., Abelson, J. (2003) ‘How Can Research Organisations More Effectively Transfer Knowledge to Decision Makers’ Milbank Quarterly, 81: 221-248
Mullen, E., Bledsoe, S., Bellamy, J. (2008) ‘Implementing Evidence Based Social Work Practice’, Research on Social Work Practice, 18: 335-338
Nutley, S. (2003) Increasing research impact: early reflections from the ESRC evidence network, ESRC UK Centre for Evidence Based Policy and Practice: Working Paper 16