All Professionals Should Use an Evidence-Based Approach

Standard

“WHAT IS AN EVIDENCE-BASED APPROACH
Evidence-based approaches to practice involve combining individual practitioner expertise with the best available external evidence from published research in order to make decisions about what to do in response to a presenting problem from a client. …which involves a number of stages:

  • Asking answerable questions about the problem;
  • gathering and critically appraising evidence required to answer the questions
  • applying this evidence to the actions that are then taken.

Introduction
… the practice of evidence-based medicine as “integrating individual clinical expertise with the best available external clinical evidence from systematic research” in making decisions … evidence-based medicine is “a process of life-long, self-directed learning… in which we:

  1. convert these information needs into answerable questions;
  2. track down, with maximum efficiency, the best evidence with which to answer them…;
  3. critically appraise that evidence for its validity and usefulness;
  4. apply the results of this appraisal in our clinical practice; and
  5. evaluate our performance”.

It is important to note that evidence-based practice does not mean acting only on the basis of good evidence: Rather it is about combining what the practitioner already knows from their previous training, experience and current understanding of the particular context in which they are operating with the best available external evidence about the issues they are dealing with.

..For example, from an evidence-based perspective a ‘presenting problem’ …would lead to many other questions for which answers in the form of evidence could then be sought: Is the turnover ‘high’?  Compared to what? Exactly who is leaving? What does the available evidence suggest about why it is a problem?  What does the best evidence suggest about the causes of turnover?  How can that evidence be applied in this situation and this context? What does evidence suggest about interventions to reduce turnover?  Do they have costs as well as benefits? How well might these interventions work in this situation?

.evidence-based practice concerns finding out about the best available evidence and that where good direct evidence is not available other more indirect sources must be used…

The evidence-based approach to practice is therefore relevant to any area of practice which is based on and/or can draw on external evidence to help inform decisions about which tools, techniques and interventions to use.

Ten possible reasons why we need an evidence-based approach to practice in occupational psychology?
Reason 1: New evidence is constantly being generated which, in many cases could and does change practice if and when it is known and understood.
Reason 2: Although this new evidence is needed to inform day-to-day practice, most practitioners do not get this evidence.
Reason 3: As a consequence of Reason 1 and Reason 2 the performance of practitioners is likely to deteriorate over time….practitioners progress through their careers they are subject to many of the same constraints which make access to and use of evidence in practice more difficult. There may, for example, simply be less time for updating knowledge as managerial responsibilities and workloads increase. At the same time, particular techniques may become favoured by practitioners out of habit or familiarity rather than for their effectiveness. Given these similar constraints, it may be that similar changes in performance would also be observed in practitioners.
Reason 4: Traditional forms of continuing professional development do not improve practitioner performance. : Research…suggests that continuing professional development (CPD) in the form of traditional instructional training has little impact on the performance of medical practitioners…opportunities for CPD seem to be relatively rare and where they do exist usually do take the form of traditional instructional training often around the use of particular techniques or psychometric tests. While this may improve technical knowledge about specific products it seems unlikely that this contributes to the overall expertise of practitioners in making informed decisions.
Reason 5: A different approach to practitioner learning (an evidence-based one) has been shown to keep practitioners up-to-date.
Reason 6: An evidence-based approach would help to distinguish practitioners from others in similar fields and would consolidate their unique position.
Reason 7: ‘Educating’ clients: The notion that clients need to be ‘educated’ about the problems or issues they face is common to many areas of professional practice…such an ‘education’ may involve persuading the client about the importance of initial assessment, the use of the best available external evidence, making informed decisions about the tools and techniques which should be used, and the importance of evaluating any intervention. Each of these is fundamental part of an evidence-based approach to practice.

Implications of an evidence-based approach for occupational psychology

  • Presenting Problem or Symptoms – Initial examination: What’s going on here that is causing harm?
  • Diagnosis What are the possible different causes of the problem?
  • Diagnostic tests What kinds of assessment would be needed to establish the cause of the problem?
  • Prognosis – What is likely to happen over time to this problem?
  • Treatment – What interventions could be used?
  • Prevention – How can such problems be prevented and identified early?
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