Evidence-Based Practice: Integrating Research, Professional and Family Wisdom & Values

1. Evidence-Based Practice: Integrating Research, Professional and Family Wisdom & Values Pam Winton & Sally Sloop Inclusion Institute August 2007 Chapel Hill, NC

2. Welcome and Introductions

3. Learner Outcomes • Identify definition and key features of EBP • Identify resources for identifying research-based practices that support inclusion • Apply evidence-based practice framework to real life vignette

5. What is the main source of knowledge guiding your practice?

6. Sources of Knowledge • Research • Wisdom & experience • Core values • Other?

7. What is your definition of evidence-based practice?

8. Evidence-Based Practice (EBP) a decision-making process that integrates the best available research evidence with family & professional wisdom & values (Buysse & Wesley, 2006; Snyder, 2006; Winton, 2006)

9. Why did EBP Emerge? • Evidence-based medicine

10. Evidence-Based Medicine The integration of the best available research evidence with clinical expertise and patient values. (Sackett et al., 2000)

11. Why did EBP Emerge? • Evidence-based medicine • Gap between research & practice

12. Why don’t practitioners do what the research says?Why don’t researchers study what really matters in practice?

13. Why did EBP Emerge? • Evidence-based medicine • Gap between research & practice • Accountability & standards movement

14. How the Accountability Movement Led to EBP • Government Performance & Results Act (1993) • Program Assessment Rating Tool (2002) • Head Start Act (1998) • No child Left Behind Act (2001) • Good Start, Grow Smart (2002)

15. Evidence-Based Education(Whitehurst, 2002) Integration of professional wisdom with the best available empirical evidence in making decisions about how to deliver instruction Whitehurst, G. J. (2002, October). Evidence-based education. Presentation at the Student Achievement and School Accountability Conference. Retrieved June 23, 2004 from www.ed.gov/offices/list/ies/director.html

16. Evidence-Based Practice • Integration of • Best-available research evidence • Professional & family wisdom and values • For the purpose of making informed decisions • Emphasize decision-making process (Buysse & Wesley, 2006)

17. Questions about EBP Definition?

18. Meet Tess…a success story in inclusion • Three-year-old with special needs • Enrolled in inclusive preschool • Teacher is working on language and literacy IEP goals during circle time, using a read-aloud storybook process • Tess has difficulties paying attention and learning during circle time • Tess’ mother and teacher want to solve this dilemma

19. Consider a 5-step Process Adapted from Evidence-Based Medicine • Pose an answerable question.

20. Practice Dilemma • How to make the reading instruction taking place during circle time more effective for Tess and supportive of her IEP literacy and language goals.

21. Consider a 5-step Process Adapted from Evidence-Based Medicine • Pose an answerable question. • Find best available research evidence. (Where?)

22. Where are resources for scientifically based practices? “… Scientifically based research means research that involves the application of rigorous, systematic, and objective procedures to obtain reliable and valid knowledge relevant to education activities and programs” (No Child Left Behind Act of 2001)

23. http://www.whatworks.ed.gov

24. Center for Early Literacy Learning http://www.earlyliteracylearning.org/

25. Consider a 5-step Process Adapted from Evidence-Based Medicine • Pose an answerable question. • Find best available research evidence. (Where?) • Appraise evidence quality & relevance. (Who? How?)

26. Appraising the Research • Transparency (e.g., how were conclusions reached) • Relevance (e.g., how similar is yourtarget child or group to the group described in the synthesis) • Quality (e.g., are sources used in the synthesis referenced)

27. Consider a 5-step Process Adapted from Evidence-Based Medicine • Pose an answerable question. • Find best available research evidence. (Where?) • Appraise evidence quality & relevance. (Who? How?) • Integrate the research evidence with professional and family wisdom & values. (How?)

28. What Constitutes Professional Wisdom? NAEYC Practice Guidelines from Professional Organizations? National Boards for Professional Teaching Standards for early childhood/generalist (NBPTS) State Standards & Licensure

29. What constitutes family wisdom? • Explore at the Beach Center Community of Practice on Early Childhood Family Support

30. What are the values of our field that guide practice decisions? Consider… • Professional Codes of Ethics • Philosophical orientations, such as family-centered practices, inclusion • Other

31. What about personal values? • Recent survey indicated that many physicians do not feel obligated to share information or refer patients for legal but morally controversial procedures • (Curlin et al, 2007, New England Journal of Medicine)

33. Consider a 5-step Process Adapted from Evidence-Based Medicine • Pose an answerable question. • Find best available research evidence. (Where?) • Appraise evidence quality & relevance. (Who? How?) • Integrate the research evidence with professional and family wisdom & values. (How?) • Evaluate effectiveness of steps 1-4 (How?)

34. Small Group Activity Using EBP Framework

35. Directions • Read the vignette (pink) • Read CELLnotes handout (cream) • Use the EBP Framework and 5-step process for guiding the discussion and making a recommendation (lavendar)

36. EBP Decision-Making Framework

37. Steps in Building a Research Question (PICO adapted from EB Medicine) • P: Characterize the person (child or family member) • I: What is the intervention being considered? • C: What are you comparing the intervention to (if relevant) • O: What is the outcome you are seeking?

38. Small Group Activity Using EBP Framework

39. Ultimate outcome…Success Story continues….

40. Factors that contributed to decision-making …. • Contextwithin which evidence is placed • Process for facilitating decision-making • Nature of the evidence itself

41. Available from Winterberry Press as a CD-ROM or downloadable file. Go to Winterberry Press website at wbpress.com and enter “Weaving” in the Search box (or go to page 2 of the Parenting category) Price: $19.95 plus S&H for CD-ROM (no S&H if downloaded)

42. Will the EBP movement make a positive impact on the quality of educational practices?

43. Eminence-Based Practice Making the same mistakes with increasing confidence over an impressive number of years. —O’Donnell, 1997, A Skeptic’s Medical Dictionary

44. Wrap Up • Remaining questions? • Quick write: • Take 3 minutes to write a “quick” response to the questions: • “How has your thinking about EBP evolved over this session?” • Evaluation • Thanks!

45. Contact Information Pam Winton FPG Child Development Institute University of North Carolina at Chapel Hill pam_winton@unc.edu Sally Sloop Family Support Network of NC University of North Carolina at Chapel Hill Sally_Sloop@unc.edu

46. Bridging the gap between what we know and what we do for the benefit of children and families