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Evidence-Based Management What is it? Why do we need it? How does it look like in practice? PhD Consortium of the 7th International Conference of the Dutch.

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Presentation on theme: "Evidence-Based Management What is it? Why do we need it? How does it look like in practice? PhD Consortium of the 7th International Conference of the Dutch."— Presentation transcript:

1 Evidence-Based Management What is it? Why do we need it? How does it look like in practice? PhD Consortium of the 7th International Conference of the Dutch HRM network

2  What is it?  Where does it come from?  Why do we need it?  What is stopping us?  How does is look like in practice? Postgraduate Course Evidence-Based Management

3 1.Evidence based management: What is it? Postgraduate Course

4 Four propositions Postgraduate Course  Research produced by management scholars could be useful to organizations  Drawing on available evidence (including research produced by academics) is likely to improve decisions  Managers and organizations do not appear to be strongly aware of nor use research findings  We need to increase awareness of and access to research findings

5 What is EBMgt? Postgraduate Course Evidence-based management is about making decisions through the conscientious, explicit, and judicious use of four sources of information: practitioner expertise and judgment, evidence from the local context, a critical evaluation of the best available research evidence, and the perspectives of those people who might be affected by the decision. (Briner, Denyer, Rousseau, 2009)

6 What is EBMgt? Postgraduate Course The problem is that management is not as evidence- based as it should be nor as it could be

7 What is EBMgt? Postgraduate Course  It is not a completely new idea – managers and organizations use evidence all the time  EBMgt is different because it’s about:  Increasing the types of evidence we use  Using it more thoughtfully and carefully (conscientious, judicious, explicit)  Its only purpose is to help us make better decisions through more and more systematic use of evidence

8 Who says it’s a problem? Postgraduate Course  People in many other fields (medicine, social work, criminology, politicians) say it’s a problem in their fields  Not everyone in management but some of people think it’s a problem  Some academics and researchers  Some managers and organizations  Some professional associations  Some commentators and journalists

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10 Origins of EBMgt Postgraduate Course Management not the only field where there are these concerns. What field is this? “a research-user gap” “a research-user gap” “practitioners do not read academic journals” “practitioners do not read academic journals” “the findings of research into what is an effective intervention are not being translated into actual practice” “the findings of research into what is an effective intervention are not being translated into actual practice” “academics not practitioners are driving the research agenda” “academics not practitioners are driving the research agenda” “the relevance, quality and applicability of research is questionable” “the relevance, quality and applicability of research is questionable” “practice is being driven more by fads and fashions than research” “practice is being driven more by fads and fashions than research” “many practices are doing more harm than good” “many practices are doing more harm than good” “the collective wisdom from research is being lost” “the collective wisdom from research is being lost”

11 Evidence-Based Practice Postgraduate Course 1991Medicine 1998Education 1998Probation service 1999Housing policy 1999Social care 2000Nursing 2000Criminal justice ????Management?

12 Academic interest in EBMgt Postgraduate Course Similar ideas around for a long time 2003 – Systematic reviews of evidence 2006 – Rousseau EBMgt Presidential Address and Pfeffer & Sutton book 2007-2009 – Rousseau EBMgt Collaborative 2008-2011 – Several conferences 2011 – Center for Evidence-Based Management (CEBMa) in Amsterdam 2011 – EBMgt Handbook But many researchers not interested at all in EBMgt

13 Manager & practitioner interest in EBMgt  Some HRM and professional bodies express interest (SHRM, SIOP, VOV Learning Network)  Some Universities running courses for practitioners (e.g., Amsterdam, Ghent)  Some publications for practitioners  But managers are:  Used to working in a different way  Under pressure to adopt fads and fashions  Have high expectations of evidence

14 Managers used to working in a different way:  Need to act quickly: Speed more important than accuracy  Organizational politics  Formal authority and hierarchies  Over-emphasize experience  Rewarded for getting things done not doing what works

15 Sometimes we are evidence-based  Try to gather data and information  Invest time and effort in trying to understand and apply it  Question our and others’ assumptions and logic  Are sceptical about what appear to be fads  Resist the temptation to act quickly

16 Sometimes we are not so evidence-based  Act on gut feeling (though intuition can be important for some decisions)  Copy other people who appear successful (benchmarking)  Think there is one ideal way (best practice)  Let the ‘solution’ frame and define our ‘problem’ and create need (kitchen gadgets)  Want to fit in and be as cool as everyone else (fashion)

17 2. Evidence based management: Where does it come from? Postgraduate Course

18 McMaster University Medical School, Canada Medicine: Founding fathers David Sackett Gordon Guyatt Postgraduate Course

19 Problem I: too much information  More than 1 million articles in 40.000 medical journals per year (= 1995; now probably more than 2 million). For a specialist to keep up this means reading 25 articles every day (for a GP more than 100!)  Most of the new insights and treatment methods don’t reach the target group Postgraduate Course

20 Problem II: persistent convictions if you’re hyperventilating breathe into a bag Postgraduate Course

21 Problem III: jumping to conclusions people who have an irregular heartbeat are much more likely to die of coronary disease give them a drug that reduces the number of irregular beats Postgraduate Course

22 Examples of mechanistic reasoning gone wrong:  Oestrogen replacement therapy to reduce cardiac events and stroke in post-menopausal women.  Treatment of measles with antibiotics.  Rest for recovery.  Placing babies on their fronts to prevent Sudden Infant Death Syndrome (SIDS).  Debriefing after psychological trauma Postgraduate Course

23 Problem IV David Sackett Half of what you learn in medical school will be shown to be either dead wrong or out-of-date within 5 years of your graduation; the trouble is that nobody can tell you which half. The most important thing to learn is how to learn on your own. (Remember that your teachers are as full of bullshit as your parents) Postgraduate Course

24 David Sackett “Good doctors use both individual clinical expertise and the best available external evidence, and neither alone is enough. Without clinical expertise, practice risks becoming tyrannized by evidence, for even excellent external evidence may be inapplicable to or inappropriate for an individual patient. Without current best evidence, practice risks becoming rapidly out of date, to the detriment of patients.” Evidence based decision Postgraduate Course

25 Management: Founding Mother Postgraduate Course

26 Jeffrey Pfeffer Robert Sutton Management: Founding Fathers Postgraduate Course

27 2. Evidence-based management: Why do we need it? Postgraduate Course

28 EBMgt: some basic assumptions Postgraduate Course  Research produced by management scholars could be useful to organizations  Drawing on available evidence (including research produced by academics) is likely to improve decisions  Organizations do not appear to be strongly aware of nor use research findings  EBMgt is a potentially useful way of thinking about how we can incorporate research evidence into decision-making

29 Reason 1: Errors and Biases of Human Judgment Postgraduate Course

30  Seeing order in randomness  Mental corner cutting  Misinterpretation of incomplete data  Halo effect  False consensus effect  Reinterpreting evidence  Group think  Self serving bias  Sunk cost fallacy  Cognitive dissonance reduction Postgraduate Course Errors and Biases of Human Judgment  Confirmation bias  Authority bias  In-group bias  Recall bias  Anchoring bias  Inaccurate covariation detection  Distortions due to plausibility

31  Seeing order in randomness  Mental corner cutting  Misinterpretation of incomplete data  Halo effect  False consensus effect  Reinterpreting evidence  Group think  Self serving bias  Sunk cost fallacy  Cognitive dissonance reduction Postgraduate Course Errors and Biases of Human Judgment  Confirmation bias  Authority bias  In-group bias  Recall bias  Anchoring bias  Inaccurate covariation detection  Distortions due to plausibility

32 We are predisposed to see order, pattern and causal relations in the world. Patternicity: The tendency to find meaningful patterns in both meaningful and meaningless noise. Postgraduate Course Seeing order in randomness

33 We are pattern seeking primates: association learning Postgraduate Course Seeing order in randomness

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43 Postgraduate Course Points of impact of V-1 bombs in London

44 Postgraduate Course Points of impact of V-1 bombs in London

45  A Type I error or a false positive, is believing a pattern is real when it is not (finding a non existent pattern)  A Type II error or a false negative, is not believing a pattern is real when it is (not recognizing a real pattern) Postgraduate Course Errors and Biases of Human Judgment Dr. Michael Shermer (Director of the Skeptics Society)

46  A Type I error or a false positive: believe that the rustle in the grass is a dangerous predator when it is just the wind (low cost) Postgraduate Course Errors and Biases of Human Judgment

47  A Type II error or a false negative: believe that the rustle in the grass is just the wind when it is a dangerous predator (high cost) Postgraduate Course Errors and Biases of Human Judgment

48 Pattern detection problem Assessing the difference between a Type I and Type II error is highly problematic (especially in split second ‘life and death’ situations), so the default position is to assume all patterns are real. Postgraduate Course Errors and Biases of Human Judgment

49 Postgraduate Course Errors and Biases of Human Judgment Jennifer Whitson, University of Texas Austin, corporate environments

50 Postgraduate Course Errors and Biases of Human Judgment Erroneous beliefs plaque both experienced professionals and less informed laypeople alike. stress peptic ulcer

51 Peptic ulcer – an infectious disease! This year's Nobel Prize in Physiology or Medicine goes to Barry Marshall and Robin Warren, who with tenacity and a prepared mind challenged prevailing dogmas. By using technologies generally available (fibre endoscopy, silver staining of histological sections and culture techniques for microaerophilic bacteria), they made an irrefutable case that the bacterium Helicobacter pylori is causing disease. By culturing the bacteria they made them amenable to scientific study. In 1982, when this bacterium was discovered by Marshall and Warren, stress and lifestyle were considered the major causes of peptic ulcer disease. It is now firmly established that Helicobacter pylori causes more then 90% of duodenal ulcers. The link between Helicobacter pylori infection and peptic ulcer disease has been established through studies of human volunteers, antibiotic treatment studies and epidemiological studies. Oct 2005

52 Postgraduate Course Errors and Biases of Human Judgment Doctors, teachers, lawyers and managers hold many erroneous beliefs, not because they are ignorant or stupid, but because they seem to be the most sensible conclusion consistent with the available evidence. They hold such beliefs because they seem to be the irresistible products of their own professional experience. They are the products, not of irrationality, but of flawed rationality They are the products, not of irrationality, but of flawed rationality

53  Managers seem to be extremely good at generating ideas, theories, and explanations that have the ring of plausibility. They may be relatively deficient, however, in evaluating and testing those ideas once they are formed.  This requires that we think critically about experience, question our assumptions, and challenge what we think we know  (Show me the evidence!) Postgraduate Course Errors and Biases of Human Judgment

54 3. Evidence-based management: What is stopping us? Postgraduate Course

55 Quick fixes (1) What is the quick fix? A ‘solution’ which Focuses on style and presentation not content Focuses on style and presentation not content Is not evaluated Is not evaluated Is always slower than we hoped Is always slower than we hoped Usually doesn’t work Usually doesn’t work Is followed by another quick fix Is followed by another quick fix Everybody forgets and becomes subject to organizational amnesia Everybody forgets and becomes subject to organizational amnesia

56 Postgraduate Course Quick fixes (2) So why do we do quick fixes? Can be career-enhancing for managers (e.g., issue selling, kick-ass CEOs) Can be career-enhancing for managers (e.g., issue selling, kick-ass CEOs) Speed is often valued over accuracy Speed is often valued over accuracy Heavily sold and marketed Heavily sold and marketed Are we all looking for quick and easy solutions? Are we all looking for quick and easy solutions? So who needs or wants academic research?

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65 Postgraduate Course Management Fads (1) The nearly-forgotten fads Scientific Management/Taylorism Scientific Management/Taylorism Business Process Reengineering Business Process Reengineering Management by results Management by results Excellence Excellence Total Quality Management Total Quality Management Learning Organizations Learning Organizations Knowledge Management Knowledge Management

66 Postgraduate Course Management Fads (2) The fads that haven’t been forgotten (yet) Talent management Talent management Management development Management development Executive coaching Executive coaching Emotional intelligence Emotional intelligence Employee engagement Employee engagement Myers Briggs Type Indicator Myers Briggs Type Indicator Belbin Team Roles Belbin Team Roles General concern about the destructive impact of fads from both practitioners and researchers

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77 FADS * SEEM TO BE ATTRACTIVE, COMPELLING AND IRRESISTIBLE  Promise to deliver a lot and fast  Appear simple  New and shiny  Will make everything alright and help contain anxieties around intractable problems  Help user feel effective and cutting edge  Bits of some fads may work in some contexts So who needs or wants academic research? *Evidence-based management not a fad!

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82  Seeing order in randomness  Mental corner cutting  Misinterpretation of incomplete data  Halo effect  False consensus effect  Reinterpreting evidence  Group think Postgraduate Course Errors and Biases of Human Judgment  Confirmation bias  Authority bias  In-group bias  Recall bias  Anchoring bias  Inaccurate covariation detection  Distortions due to plausibility

83 Postgraduate Course Under pressure to adopt fads “And there we see the power of any big managerial idea (or fad). It may be smart, like quality, or stupid, like conglomeration. Either way, if everybody's doing it, the pressure to do it too is immense. If it turns out to be smart, great. If it turns out to be stupid, well, you were in good company and most likely ended up no worse off than your competitors. Your company's board consists mostly of CEOs who were probably doing it at their companies. How mad can they get?

84 Postgraduate Course The true value of conventional management wisdom is not that it's wise or dumb, but that it's conventional. It makes one of the hardest jobs in the world, managing an organization, a little easier. By following it, managers everywhere see a way to drag their sorry behinds through another quarter without getting fired. And isn't that, really, what it's all about?” (Colvin, 2004, Fortune) Under pressure to adopt fads

85 4. Evidence based management: How does it look like in practice? Postgraduate Course

86 Four sources

87 Postgraduate Course JAMA, 1992

88 Postgraduate Course Push vs Pull Push: teaching (management) principles based upon a convergent body of research and telling students what to do. Pull: teaching (managers) how to find, appraise and apply the outcome of research (evidence) by themselves

89 Postgraduate Course The 5 steps of ‘pull’ EBP 1.Formulate an answerable question 2.Search for the best available evidence 3. Critically appraise the evidence 4.Integrate the evidence with your managerial expertise and organisational concerns and apply 5. Monitor the outcome

90 Postgraduate Course The 5 steps of ‘pull’ EBP 1. Formulate an answerable question 2. Search for the best available evidence 3. Critically appraise the evidence 4.Integrate the evidence with your managerial expertise and organisational concerns and apply 5. Monitor the outcome

91 Answerable question Postgraduate Course I am a consultant, my client a large health-care organization. The board of directors has plans for a merger with a smaller healthcare organization. However, it’s been said that the organizational culture differs widely between the two organizations. The board want’s to know if this can impede a successful outcome.

92 Postgraduate Course P =Population or problem I = Intervention or successfactor C = Comparison O = Outcome C = Context Answerable question: PICO(C)

93 Answerable question: PICOC Postgraduate Course P: What kind of Population are we talking about? Middle managers, back-office employees, medical staff, clerical staff? O: What kind of Outcome are we aiming for? Employee productivity, return on investment, profit margin, competitive position, innovation power, market share, customer satisfaction? P/C: And how is the assumed cultural difference assessed? Is it the personal view of some managers or is it measured by a validated instrument?

94 Postgraduate Course The 5 steps of ‘pull’ EBP 1.Formulate an answerable question 2. Search for the best available evidence 3. Critically appraise the evidence 4.Integrate the evidence with your managerial expertise and organisational concerns and apply 5. Monitor the outcome

95 Where do we search? Postgraduate Course

96 Postgraduate SchoolPostgraduate School Where do we search?

97 Postgraduate Course The 5 steps of ‘pull’ EBP 1.Formulate an answerable question 2.Search for the best available evidence 3. Critically appraise the evidence 4. Integrate the evidence with your managerial expertise and organisational concerns and apply 5. Monitor the outcome

98 Critical appraisal How to read a research article? Postgraduate Course

99 Critical appraisal Postgraduate Course 1.Study designs 2.Levels of evidence 3.Bias / confounding 4.Effect sizes 5.External validity

100 Postgraduate Course Which study for which question? Research designs The “best” evidence depends on the question type !

101 Postgraduate Course Levels of evidence

102 Postgraduate Course The 5 steps of ‘pull’ EBP 1.Formulate an answerable question 2.Search for the best available evidence 3. Critically appraise the evidence 4. Integrate the evidence with your managerial expertise and organisational concerns and apply 5. Monitor the outcome

103 Postgraduate Course 1. Is your organization / division / population so different from those in the study that its results cannot apply? 2. How relevant is the study to what you are seeking to understand or decide? 3.What are your organization’s potential benefits and harms from the intervention? 4. Is the intervention feasible in your setting? Organization concerns Always ask yourself to what extent the evidence is applicable in your situation:

104 Postgraduate Course The 5 steps of ‘pull’ EBP 1.Formulate an answerable question 2.Search for the best available evidence 3. Critically appraise the evidence 4.Integrate the evidence with your managerial expertise and organisational concerns and apply 5. Monitor the outcome

105 Postgraduate Course Monitor the outcome  posttest?  pretest?  control group?

106 Postgraduate Course Do a trial!

107 (*). Why should academics be interested in EBMgt? Postgraduate Course

108 (5). Evidence based management: What can you do as a PhD student? Postgraduate Course

109 Barriers

110 Postgraduate Course Best available evidence = systematic reviews Barriers

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114 Better than a single study: a replication study Better than a replication study: a systematic review / meta analysis If there were 100 RCT’s, 99 of which gave a ‘negative’ result (where, say, the new intervention appeared to be harmful), while one had a ‘positive’ result (were the intervention appeared helpful), it would obviously be a mistake to consider only the single positive RCT. Postgraduate Course

115 115 TYPES OF LITERATURE REVIEW Explicit systematic: Explicit use of rigorous method - can vary as least as much as the range of methods in primary research Implicit systematic: rigorous method but not stated False systematic: described as systematic but with little evidence of explicit rigorous method Argument/thematic: a review that aims to explore and usually support a particular argument or theme with no pretension to use an explicit rigorous method (though thematic reviews can be systematic) Expert or ad hoc review: informed by the skill and experience of the reviewer but no clear method so open to hidden bias. Rapid evidence assessment: a rapid review that may or may not be rigorous and systematic. If it is systematic then in order to be rapid it is likely to be limited in some explicit aspect of scope. (Gough 2007)

116 116 LITERATURE REVIEWS IN MANAGEMENT How many here have had training in reviewing literature? Are we really “standing on the shoulders of giants”? Do you recognize these sort of unqualified statements? “Previous studies have shown that…” “It has been demonstrated that…” But how many studies? Demonstrated how? Did other studies find something else? Very few systematic reviews in management

117 WHAT QUALITIES SHOULD LITERATURE REVIEWS HAVE?

118 118 WHAT QUALITIES SHOULD LITERATURE REVIEWS HAVE? Comprehensive? Reader-friendly? Informative? Balanced? Insightful? Critical? Rigorous? Accessible? User led? Up-to-date? Focused? Exploratory? Inclusive? (of different types of evidence) Transparent? Accurately referenced? Objective? Replicable? Interesting? Standardized?

119 119 WHAT IS A SYSTEMATIC REVIEW? It’s research on existing research With a clear, explicit and replicable methodology Clear review question Search strategy Quality criteria Allows us to draw reliable conclusions about what we know and do not know about a given question or problem

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121 Systematic review Systematic review The intention behind a systematic review is to identify as fully as possible all the scientific studies of relevance to a particular subject and to assess the validity and authority of the evidence of each study separately. As the name indicates, a systematic review takes a systematic approach to identifying studies and has the methodological quality critically appraised by multiple researchers independently of each other, as a consequence of which the review is transparent and reproducible and can be monitored. The use of statistical analysis techniques in a systematic review to pool the results of the individual studies numerically in order to achieve a more accurate estimate of the effect is termed a “meta-analysis”. Postgraduate Course

122 122 THE QUESTIONS SRs ANSWER For any given specific problem: What do we know? What do we not know? What are we not sure about? How do we know we know or don’t know or are not sure that…? What is the basis for our claims? (e.g., How much evidence? What quality?)

123 Stages of a SR Existing research studies SYSTEMATIC REVIEW 1.problem formulation; 2.locating studies; 3.study selection and evaluation; 4.analysis and synthesis; 5.reporting of the results What do we know? What we do not know? Informs practice Informs future research questions Practice- relevant question

124 Stages of a systematic review Stages of a systematic review Postgraduate Course 1.Formulate a focussed review question 2. Search for the best available evidence 3. Select relevant studies 4. Critically appraise the evidence 5. Synthesise the findings 6. Report what is known

125 125 WHAT SORT OF QUESTIONS CAN BE ADDRESSED IN A SR? Each would require much more specificity Does team-building work? Can you improve emotional intelligence? Do increases in EI lead to performance improvements? Does management development improve the performance of managers? Does employee engagement predict organizational performance? Is 360 degree feedback effective? Can potentially great leaders be identified? Is coaching effective?

126 Does team-building work? How would you make this question more specific

127 Postgraduate Course P =Population I = Intervention or factor C = Comparison O = Outcome C = Context PICOC & CIMO C =Context I = Intervention or factor M = Mechanism O = Outcome

128 128 WHAT SORT OF QUESTIONS CAN BE ADDRESSED IN A SR? Does team-building work? What is meant by ‘team’? And what is not included as a ‘team’? What kind of teams? In which particular contexts or settings? What is ‘team building’? And what is not ‘team building’? What does ‘work’ mean? ‘Work’ compared to any other team intervention? No intervention? What outcomes are relevant? What are the mechanisms, processes and theory which might account for possible effects of team building on outcomes? What time periods are relevant for observing any possible effects? What about possible negative effects or harm? What types of data from what sorts of designs would in principle provide good quality, medium quality and poor quality evidence?

129 Postgraduate School Which study for which question? Research question Qualitative studies Surveys Observational studies Controlled studies Effectiveness: does it work?, does A work better than B? +++ Process: how does it work, why does it work? +++ Context: in what circumstances does it work, for whom? ++++ Safety: will it do more good than harm? ++++ Acceptability: will the target group accept the intervention / new method of working? ++++ Cost effectiveness: does it reduce costs? is A cheaper than B? ++ Appropriateness: is this the right intervention / method for this target group? ++++ Satisfaction: is the target group satisfied with the new method of working? +++++

130 Stages of a systematic review Stages of a systematic review Postgraduate Course 1.Formulate a focussed review question 2. Search for the best available evidence 3. Select relevant studies 4. Critically appraise the evidence 5. Synthesise the findings 6. Report what is known

131 131 MAKING DECISIONS ABOUT SEARCH STRATEGY What sources of evidence? What sources will you include or exclude and why? How iterative can you be? Test the question doing some simple searches Does the question work? Does the search strategy work?

132 Postgraduate School Two types of search strategies Search strategy Building blocks method Snowball method

133 Postgraduate School Snowball method Starting from one book or article, you search for other literature on the same topic. Snowballing to older publications by finding out which publications were used by the author (see bibliography of book or article). Snowballing to more recent publications by finding out how often that book or article has been cited by other authors (see Web of Knowledge).

134 Postgraduate School Snowball method ISI Web of Knowledge

135 Postgraduate School Synonyms or related terms …. Synonyms or related terms …. Synonyms or related terms …. Building blocks method Synonyms or related terms …. Keyword 1Keyword 2Keyword 3Keyword 4 ANDANDAND OROROR

136 Postgraduate School

137 Building blocks method

138 Postgraduate School Building blocks method

139 Stages of a systematic review Stages of a systematic review Postgraduate Course 1.Formulate a focussed review question 2. Search for the best available evidence 3. Select relevant studies 4. Critically appraise the evidence 5. Synthesise the findings 6. Report what is known

140 Stages of a systematic review Stages of a systematic review Postgraduate Course 1.Formulate a focussed review question 2. Search for the best available evidence 3. Select relevant studies 4. Critically appraise the evidence 5. Synthesise the findings 6. Report what is known

141 Postgraduate SchoolPostgraduate School Standard appraisal questions 1. Did the study adress a clearly focused issue? 2. Is the sample size justified? 3. Is the design appropriate to the stated aims? 4. Are te measurements likely to be valid and reliable? 5. Are the statistical methods described? 6. Did untoward events occur during the study? 7. Were the basic data adequately described? 8. Do the numbers add up? 9. Was the statistical significance assessed? 10. What do the findings mean? 11. Are important effects overlooked? 12. What implications does the study have for your practice?

142 Stages of a systematic review Stages of a systematic review Postgraduate Course 1.Formulate a focussed review question 2. Search for the best available evidence 3. Select relevant studies 4. Critically appraise the evidence 5. Synthesise the findings 6. Report what is known

143 Once a body of evidence has been collated…. How relevant is this to what we are seeking to understand or decide? How representative is this of the population that concerns us? How reliable, how well-founded theoretically, empirically is it? ‘These are tough but necessary tests for evidence based policy and practice’ Solesbury 2004

144 Stages of a systematic review Stages of a systematic review Postgraduate Course 1.Formulate a focussed review question 2. Search for the best available evidence 3. Select relevant studies 4. Critically appraise the evidence 5. Synthesise the findings 6. Report what is known

145 What does synthesis mean in MOS? Analysis, “…is the job of systematically breaking down something into its constituent parts and describing how they relate to each other – it is not random dissection but a methodological examination” Is the aim is to extract key data, ideas, theories, concepts [arguments] and methodological assumptions from the literature? Synthesis, “…is the act of making connections between the parts identified in analysis. It is about recasting the information into a new or different arrangement. That arrangement should show connections and patterns that have not been produced previously” (Hart, 1998: p.110)

146 146 Summarizing evidence What does the evidence say? Consistency of evidence? Quality of evidence Quantity of evidence (avoiding double counting)

147 The example of management and leadership development Does leadership development work? What do we know? What is the ‘best’ research evidence available? How can this evidence be ‘put together’? What are the strengths and weaknesses of different approaches to synthesis?

148 What methods of synthesis are available? (1/2) Aggregated synthesis Analytic induction Bayesian meta analysis Case Survey Comparative case study Constant targeted comparison Content analysis Critical interpretive synthesis Cross design synthesis Framework analysis Grounded theory Hermeneutical analysis Logical analysis Meta analysis Meta ethnography Meta narrative mapping Meta needs assessment Meta synthesis Metaphorical analysis Mixed method synthesis Narrative synthesis Quasi statistics Realist synthesis Reciprocal analysis Taxonomic analysis Thematic synthesis Theory driven synthesis

149 What methods of synthesis are available? (2/2) Synthesis by aggregation extract and combine data from separate studies to increase the effective sample size. Synthesis by integration collect and compare evidence from primary studies employing two or more data collection methods. Synthesis by interpretation translate key interpretations / meanings from one study to another. Synthesis by explanation identify causal mechanisms and how they operate. (Rousseau, Manning, Denyer, 2008)

150 Van Buren & Erskine, 2002 (building on Kirkpatrick) Organizations reported collecting data on: 78% reaction ( how participants have reacted to the programme) 32% learning ( what participants have learnt from the programme) 9% behaviour ( whether what was learnt is being applied on the job) 7% results ( whether that application is achieving results)

151 Stages of a systematic review Stages of a systematic review Postgraduate Course 1.Formulate a focussed review question 2. Search for the best available evidence 3. Select relevant studies 4. Critically appraise the evidence 5. Synthesise the findings 6. Report what is known

152 Postgraduate School What do you do with this?

153 Does management and leadership development work Overall, the results suggest a medium to large effect size for learning and behaviour (largely based on self report) Absence of evidence of impact of business impact

154 Do the results of synthesis create clarity - or confusion, conflict and controversy? “A wide variety of program outcomes are reported in the literature – some that are effective, but others that are failing. In some respects the lessons for practice can be found in the wide variance reported in these studies. The range of effect sizes clearly shows that it is possible to have very large positive outcomes, or no outcomes at all” (p. 240/241) (Collins and Holton, 1996: 240/241)

155 Do the results of synthesis create clarity - or confusion, conflict and controversy? “Organizations should feel comfortable that their managerial leadership development programmes will produce substantial results, especially if they offer the right development programs for the right people at the right time. For example, it is important to know whether a six-week training session is enough or the right approach to develop new competencies that change managerial behaviours, or it is individual feedback from a supervisor on a weekly basis regarding job performance that is most effective?” (Collins and Holton, 1996: 240/241)

156 systematic review Postgraduate Course Example

157 157 Flexible working conditions and their effects on employee health and wellbeing (Joyce et al, 2010) Background: Flexible working conditions are increasingly popular in developed countries but the effects on employee health and wellbeing are largely unknown. Objectives: To evaluate the effects (benefits and harms) of flexible working interventions on the physical, mental and general health and wellbeing of employees and their families. Search strategy: Our searches (July 2009) covered 12 databases including the Cochrane Public Health Group Specialized Register, CENTRAL; MEDLINE; EMBASE; CINAHL; PsycINFO; Social Science Citation Index; ASSIA; IBSS; Sociological Abstracts; and ABI/Inform. We also searched relevant websites, hand searched key journals, searched bibliographies and contacted study authors and key experts.

158 158 Flexible working conditions and their effects on employee health and wellbeing (Joyce et al, 2010) Selection criteria: Randomized controlled trials (RCT), interrupted time series and controlled before and after studies (CBA), which examined the effects of flexible working interventions on employee health and wellbeing. We excluded studies assessing outcomes for less than six months and extracted outcomes relating to physical, mental and general health/ill health measured using a validated instrument. We also extracted secondary outcomes (including sickness absence, health service usage, behavioral changes, accidents, work-life balance, quality of life, health and wellbeing of children, family members and co-workers) if reported alongside at least one primary outcome. Data collection and analysis: Two experienced review authors conducted data extraction and quality appraisal. We undertook a narrative synthesis as there was substantial heterogeneity between studies.

159 159 Flexible working conditions and their effects on employee health and wellbeing (Joyce et al, 2010) Main results: Ten studies fulfilled the inclusion criteria. Six CBA studies reported on interventions relating to temporal flexibility: self-scheduling of shift work (n = 4), flexitime (n = 1) and overtime (n = 1). The remaining four CBA studies evaluated a form of contractual flexibility: partial/gradual retirement (n = 2), involuntary part-time work (n = 1) and fixed-term contract (n = 1). The studies retrieved had a number of methodological limitations including short follow-up periods, risk of selection bias and reliance on largely self-reported outcome data. Four CBA studies on self- scheduling of shifts and one CBA study on gradual/partial retirement reported statistically significant improvements in either primary outcomes (including systolic blood pressure and heart rate; tiredness; mental health, sleep duration, sleep quality and alertness; self-rated health status) or secondary health outcomes (co-workers social support and sense of community) and no ill health effects were reported. Flexitime was shown not to have significant effects on self-reported physiological and psychological health outcomes. Similarly, when comparing individuals working overtime with those who did not the odds of ill health effects were not significantly higher in the intervention group at follow up. The effects of contractual flexibility on self-reported health (with the exception of gradual/partial retirement, which when controlled by employees improved health outcomes) were either equivocal or negative. No studies differentiated results by socio-economic status, although one study did compare findings by gender but found no differential effect on self- reported health outcomes.

160 160 Flexible working conditions and their effects on employee health and wellbeing (Joyce et al, 2010) Authors’ conclusions: The findings of this review tentatively suggest that flexible working interventions that increase worker control and choice (such as self scheduling or gradual/partial retirement) are likely to have a positive effect on health outcomes. In contrast, interventions that were motivated or dictated by organizational interests, such as fixed-term contract and involuntary part-time employment, found equivocal or negative health effects. Given the partial and methodologically limited evidence base these findings should be interpreted with caution. Moreover, well- designed intervention studies are needed to delineate the impact of flexible working conditions on health, wellbeing and health inequalities.


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