Research That Matters (January 17 - 20, 2008)

Regency Ballroom Wings (Omni Shoreham)

Skeptics of Ebp: a Qualitative Analysis of Open Ended Responses from a National Survey of MSW Faculty

Danielle Parrish, MSW, University of Texas at Austin.

Background and Purpose: The term evidence-based practice (EBP) has been used both liberally and inconsistently in the social work literature. Some have described it as the development and use of practice guidelines (Rosen & Proctor, 2002), while others have proposed a more contextual view of EBP that recognizes it as a process with several operationalized steps (Thyer, 2004). Still others use this term without reference to either of the preceding definitions. A recent national survey of MSW faculty in schools of social work reflected this variability —whereby faculty were greatly divided on their definition of EBP (Rubin & Parrish, 2007). Similarly, MSW faculty reported variability in their criteria for considering an intervention as to be “evidence-based.” While these findings provide a preliminary understanding of the perspectives of social work faculty, they do not convey the deeper and nuanced feelings of faculty regarding EBP, especially those who are ambivalent about the EBP movement. It is essential to understand these perspectives in order to create a healthy dialogue about the strengths and limitations and potential adaptation of the EBP model for the social work profession.

Methods: A national online survey assessed the views of 973 faculty members in MSW programs regarding their receptivity toward, definition of, and views of disparate sources of evidence relevant to evidence-based practice (EBP) and the teaching of evidence-based practice. While the quantitative results have been disseminated, this study focused primarily on the qualitative open-ended data provided by respondents utilizing the other response category for two survey items: 1) Which of the following is consistent with your definition of evidence-based practice? and 2) [Identify] the response for each source of support that would be sufficient in influencing you to deem an intervention to deserve special recognition as being empirically supported (respondents were provided the option to enter additional sources of evidence). An inductive content analysis (qualitative and quantitative) approach was used to analyze the data (N=140) with a focus on counting and communicating major themes.

Results: While the first question solicited definitions of EBP, many of the responses reflected a skepticism of EBP rather than a definition. Frequently respondents shared their perceptions that EBP relies on reductionistic forms of evidence, that the nature of the research hierarchy favors certain interventions that are easier to operationalize, and that EBP oversimplifies client problems. With regard to views about various evidentiary sources, many respondents emphasized the importance of considering a combination of these sources, of practice experience as a form of evidence, and the promulgation of additional research that considers race/culture.

Conclusions and Implications: Skeptics of the EBP model in social work raise important considerations of this approach to practice, many of which have been addressed by proponents of the EBP process . For example, the EBP process values reliance on clinical expertise, the best available evidence and client values/culture when making clinical decisions. Further dialogue is needed to disseminate the conceptual definition of the EBP process, and to further discuss issues important to its implementation in social work practice.