Skills for evidence-informed practice: Interactive workshop

1. Skills for evidence-informed practice:Interactive workshop Dartington Hall, Devon 2 April 2009

2. 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

3. 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

4. Being evidence-informed – key steps

5. What is evidence-informed practice? What it means to be evidence-informed, and the case for EIP

6. Being evidence-informed – key steps

7. 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’

8. 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

9. The case for evidence-informed practice • Research evidence can help identify where need is greatestand 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

10. Discussion point What counts as evidence?

11. Where is evidence needed? Identifying gaps and knowing what to ask

12. Being evidence-informed – key steps

13. 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

14. Being evidence-informed – key steps

15. 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!

16. Exercise Develop your own questions

17. How do you find the evidence you need? Where to look and how

18. Being evidence-informed – key steps

19. Discussion point Where would you find evidence on your topic?

20. 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!

21. Finding the evidence you need – routes you can take Colleagues Librarians Ask around! Topic experts ripfa Existing reviews and summaries Original papers and journal articles Carry out a search Do your own research

22. Carrying out an online search • Decide on your search terms • Develop a search string • Decide on any limits • Consider where you want to look

23. 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

24. Discussion point Brainstorm search terms for Autistic Spectrum Disorder

25. Develop a search string Combine your search terms into a string using Boolean searching Using ANDlimits your search e.g. Autism AND services Using ORbroadens 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)

26. 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?

27. ORGANISATION WEBSITES e.g. DH, SCIE, ripfa INTERNET SEARCH ENGINES e.g. Google Where will you look? LIBRARIES In-house, local, university ONLINE DATABASES e.g. Social Care Online, SSCI, ASSIA

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

29. Is the evidence good enough? Appraising and understanding research

30. Being evidence-informed – key steps

31. 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

32. Exercise Please identify strengths and weaknesses of the evidence presented in the articles

33. Being evidence-informed – key steps

34. 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?

35. How do you make a change? Translating key messages and influencing practice

36. 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…

37. 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?

38. 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?

39. Thank you.Please contact us if you need any further information: naomi@ripfa.org.uk 01803 860097 todor@ripfa.org.uk 01803 869758