Evidence-based Practice or Learning-based Practice Yekoutiel Sabah

Evidence-Based Practice: From Purism to Pragmatism?

Instrumental -rather than epistemological -shift

1/ Instrumental rather than epistemological: Expertise and experience are not truly considered as legitimate sources of knowledge and are ignored EBP movement main effort: Overcoming the obstacles for the use of evidence Meta-analyses and systematic reviews User-friendly EBP websites EBP books and practice guidelines Training SW’ers to use evidence (critically)

2/ Instrumental rather than epistemological : Naturalistic Decision-Making is ignored Evidence-Informed Practice (EIP) asks us to decide “rationally”: think critically about the research; identify what is known and unknown, accurately assess clients and/or systems, honestly and transparently weigh the evidence with respect to client context, and make the best decision possible given the limitations of each of these steps (A.Shlonsky) Too many choices, too many decisions, too little time to decide, too little relevant evidence (based on Schwartz, B. (2004). The Paradox of Choice - Why More Is less)

LBP recognizes: The essential value of practitioners’ expertise and the necessity to structure its formation The Naturalistic character of practitioners’ decision-making Learning-based Practice - LBP

Pattern* matching: Using prior experience to recognize cues, categorize situations and consider actions “Satisficing”: Select the first adequate solution rather than the optimal (EBP) solution. If necessary, reassess situation and seek for more information Expertise: The first option considered is usually satisfactory *(cognitive schemata, interpretive scheme, mental models, frames of reference, …) Naturalistic Decision-Making - NDM

Takes time to acquire Tacit and unverified (outcomes are often not defined and not measured) Apprenticeship in SW training is uncommon Supervision is often inadequate SW’ers work mostly alone Simulation of practice is difficult and unusual The problems with Expertise

LBP: Turning experience into expertise LBP aspires to structure the experience in order to generate expertise Constant individual, intra and inter-organizational learning Learning from practical success Learning is social Expose and share tacit knowledge ICT’s facilitate learning

LBP efforts led by the Ministry Intra-organizational Learning Teams: Combining several sources of knowledge Inter-organizational Virtual Communities of Practice: Utilization and creation of knowledge “Practice Wisdom” training: Externalization of knowledge and practice based expertise “The Outcomes Initiative”: Practice-based research

EBP vs. LBP  Evidence  Optimal  Algorithmic and rational  Choose among given options  Training: weighing and using evidence  Individual decision-making  Evidence and expertise  Adequate  Heuristics and expertise  Generating responses  Training: learning and building expertise  Group decision-making