Licensed Master of Social Workers' Engagement in the Process of Evidence-Based Practice: Barriers and Facilitators

Purpose:This article describes the qualitative responses from licensed masters-level social workers (LMSWs) regarding what they perceive as barriers and facilitators to consistently engaging in the process of evidence-based practice (EBP). Method:Two open-ended questions were posed to determine what helps social workers consistently use the EBP process and what inhibits them from regularly applying EBP to guide clinical decision-making. A total of 113 responses were recorded. Content analysis was used to identify emergent themes. Results:Facilitators to the consistent use of EBP included: the belief that EBP improves outcomes, research that was vetted and disseminated by trusted partners such as the National Association of Social Workers (NASW), and ethical mandates. Barriers included: time, lack of applicable research, client-specific factors, and cost. Factors identified as both facilitating and impeding the EBP process were lack of necessary technology, organizational context, provider beliefs, and research knowledge/training. Discussion and Conclusion: Providers identified a number of barriers and facilitators to engaging in the process of evidence-based practice, which guided the extent to which they consistently engaged in the process, and how difficult they perceived itto be.

Social Work Research and Evidence-Based Practice in Experimental Medicine Exploring Issues in the Xenotransplantation Context

Purpose: The purpose of this paper was to discuss challenges to interdisciplinary evidence-based social work practice (EBP) within a context of xenotransplantation (XTx) using genetically modified animal organs, and the broader context of experimental medicine.Method This paper reviewed EBP terminology and discussed the meaning and function of evidence-based social work practice within an IDT in a XTx setting. Meta-analytic systematic reviews, and psychosocial surveys, were discussed to glean insights into ways in which IDTs can incorporate those research methodologies into EBP within an experimental medical (i.e., XTx) context. Several issues that arise while conducting psychosocial research in preparation for clinical trials were also discussed.Conclusions Social workers can assume leadership roles on IDT's within experimental medicine by using their group facilitation skills and training in EBP. An evidence-based pathway model for interdisciplinary care was proposed and briefly illustrated as a framework for collaboration among IDT members using EBP in XTx practice.

Effectiveness of skin protectors and calendula officinalis for prevention and treatment of radiodermatitis: an integrative review

OBJECTIVE

to analyze the effectiveness of skin protectors and Calendula officinalis for prevention and treatment of radiodermatitis.

METHOD

an integrative review conducted at CINAHL, Cochrane Library, Embase, MEDLINE/PubMed, IBECS, LILACS, and Web of Science. The final sample consisted of five studies, four clinical studies and one preclinical. Critical appreciation and narrative synthesis of the findings were carried out.

RESULTS

the Cavilon™ skin protector was more effective than Sorbolene (cream with 10% glycerin) and less effective than Mometasone Furoate cream. Calendula officinalis was more effective than Trolamine and essential fatty acids and less effective than Ching Wan Hung® for prevention and treatment of radiodermatitis.

CONCLUSION

data confirm the potential of Calendula officinalis for prevention and treatment of radiodermatitis and point to promising results regarding skin protector use; however, there is a need for further testing as to the effectiveness of such products.

Active Collaboration with Clients: An Underemphasized but Vital Part of Evidence-Based Practice

Evidence-based practice (EBP) is a widely recognized concept in contemporary social work practice. However, recent studies have shown that social workers do not understand EBP correctly. Standardized administrative approaches to implementing EBP have led to confusion about its core practice decision-making process. This collaborative process is the heart of EBP in direct social work practice. This article explores the EBP process and addresses a vital but often underemphasized step of EBP: active collaboration with the client in decision making. Active collaboration with the client is shown to be important in that it (a) is consistent with social work's professional values and ethics, (b) is consistent with patient-centered health care in the Patient Protection and Affordable Care Act and contemporary health care approaches, (c) is consistent with culturally competent practice, and (d) has empirical support for its beneficial impact. Correctly and fully understanding EBP in direct practice is important to improving social work practice and improving client outcomes.

Transforming Nursing Education and the Formation of Students

Transforming nursing education is a current focus across the country, the result of recent national reports that have made significant contributions for evaluating and changing curricula and ways students are taught. However, the need to ground these strategies for change within our discipline’s ontological foundation through nursing theory must be addressed. The purpose of this article is to use Parse’s Humanbecoming Paradigm to provide educators with exemplars of discipline-specific theory-based changes across educational levels. The exemplars are situated within the important tensions that educators face today in undergraduate, advanced practice, and doctoral programs. Conclusions are drawn regarding continuing efforts to ensure that nurse educators incorporate discipline-relevant theories when transforming nursing education.

The Diffusion of Evidence-Based Practice: Reviewing the Evidence-Based Practice Networks in the United States and German-Speaking Countries

Evidence-based practice (EBP) has had a major influence on U.S. social work while it has rarely been adapted in German-speaking countries. This study investigates how knowledge about EBP is diffused within and across geographical contexts. Network analysis methods reveals different diffusion patterns and provide reasons for these differences. For example, the U.S. discourse is self-contained and based on a more homogeneous knowledge base, while the German discourse is more heterogeneous and focuses on a notion of reflexive professionalism. The different conceptual influences within the U.S. and German discourses are discussed in light of future directions of disciplinary social work.

Attitudes Toward Adoption of Evidence-Based Practice Among Physical Therapists and Social Workers: A Lesson for Interprofessional Continuing Education

INTRODUCTION

Professionals who embrace evidence-based practice (EBP) continually search for research evidence, appraise, and apply it, while interacting with each client in his/her situation. This dynamic learning process takes a substantial commitment from professionals and requires a positive attitude toward EBP. The main objective of this research was to explore the following: 1) distinct dimensions of attitudes toward adoption of EBP among physical therapists and social workers and 2) the relationship between these dimensions of attitudes and selected background characteristics of the compared professions.

METHODS

Cross-sectional web-based surveys were conducted in 2012 and 2013 on a population-based sample from the Icelandic Physical Therapy Association and the Icelandic Association of Social Workers. The participants were 214 physical therapists (76.3% women) and 163 social workers (92.2% women). The Evidence-Based Practice Attitude Scale (EBPAS) and its four subscales were used to survey dimensions of attitudes toward EBP. Scores on the total EBPAS range from zero to five, with a higher score indicating a more positive attitude toward EBPs. Linear regression was used to explore the relationship between the EBPAS scales and selected background variables.

RESULTS

The overall response rate was 39%. Both professions generally held positive attitudes toward adoption of EBP, with an average EBPAS total score of 3.06 (SD = 0.46). The professionals' background characteristics were independently related to at least one dimension of attitudes toward EBP. More positive attitudes were associated with being a physical therapist, a woman, in a younger age group, having a graduate degree, working with individual clients, and having at least five same-profession coworkers.

DISCUSSION

The results may be useful to design continuing education focusing on EBP. Such inventions should be targeted to professional attitudes, background, and other contextual factors.

Dissemination of trauma-focused cognitive-behavioral therapy with community practitioners: focus on self-efficacy

In this article the authors report on a collaborative effort to disseminate trauma-focused cognitive-behavioral therapy (TF-CBT) with community practitioners (N = 33). They discuss the evolution and planning of this local initiative and the research component to assess practitioners' self-efficacy at the basic and advanced levels of training. Self-efficacy scores increased significantly and were positively associated with practice experience. Independent implementation effort was low due to low referral numbers. Final ratings were high for competence, the value of consultation sessions, and future use of the model. The results offer insight into this approach to dissemination and implementation.

Social work practitioners' integration of clients' religion and spirituality in practice: a literature review

Emerging research on religion, spirituality, health, and mental health has begun to catch the attention of helping professionals. Some clients are expressing a desire for their health and mental health practitioners to initiate discussion of their religious or spiritual beliefs as they relate to their case. Social workers are the most represented group among personnel providing mental health services, so it is important to understand their attitudes, views, and behaviors regarding integrating clients' religion and spirituality (RS) into practice. Few studies have assessed such an integration; those that are available focus primarily on practitioner characteristics and use of specific helping activities to integrate clients' RS in treatment. This article discusses how RS have been integrated into social work practice and education and reviews instruments used to assess such practices. In addition, the findings from previous studies examining social workers' integration of clients' RS are compared with those of other helping professions. Finally, implications for education and practice are discussed.

Methodological pluralism in the age of evidence-informed practice and policy

The use of evidence in practice and policy in public health and social services is a tricky endeavour. While virtually every practitioner, manager, or policy maker would agree that evidence should be used, there is disagreement about the nature of evidence and which evidence should be used, how, when, in what circumstances, and for whom. Within these disagreements, however, can be found some essential truths: (1) scientific knowledge evolves over time; (2) different types of evidence are needed for different purposes; (3) evidence has a range of quality; (4) synthesising multiple forms of evidence is difficult and inevitably includes some level of subjectivity; and (5) effective implementation of evidence is as important as the decision to use evidence in the first place. This paper will discuss the use of evidence in practice in what is arguably the most complex helping environment - social services - detailing the emergence and evolution of evidence-informed practice, dispelling some myths about its structure and application, and linking it to the broader origins and structure of the social and governmental systems in which it operates. Using this expanded view, the paper will then describe some useful approaches for incorporating these larger considerations into the use of evidence in practice.

Using principles of practice-based research to teach evidence-based practice in social work

Social work educators are in a good position to encourage the uptake of evidence-based practice more widely throughout the profession. Despite increasing attention being paid to it within professional literature, it seems to be making inroads to practice only very slowly. This article interprets that slow uptake as a function of confusion about the definition and scope of evidence-based practice, and also as an expression of the distance between the practice and research communities within the profession. Practice-based research is introduced as a framework that responds to both of these concerns. Finally the importance of social work education as a catalyst of evidence-based practice is articulated and the five-step evidence-based practice process is explicated with considerations from practice-based research incorporated along with pedagogical implications.

Teaching evidence-based social work in foundation practice courses: learning from pedagogical choices of allied fields

The field of social work is attuned to the need to incorporate evidence-based practice education into masters-level curriculum. One question remaining is how to integrate evidence-based practice in the foundation practice courses. Integration of evidence-based practice across the foundation-level curriculum coincides with the Council on Social Work Education's mandate that student's engage in research-informed practice and practice-informed research. Through a discussion of definitions, criticisms, and pedagogy across the allied fields of medicine, nursing, and social work the authors address the current status of evidence-based practice curriculum in foundation-level education. The authors incorporate the lessons learned from allied fields and a Masters of Social Work student's analyses of their experience of evidence-based practice learning to propose an adult-learner model to improve evidence-based practice pedagogy in Social Work.

The Current State of Evidence-Based Practice in Social Work: A Review of the Literature and Qualitative Analysis of Expert Interviews

While there is recent movement toward Evidence-Based Practice (EBP) in social work, criticisms subsist regarding the profession's translation of research into viable practices. Evidence describing effective interventions exists, but research that addresses dissemination and implementation is generally lacking. This paper highlights existing literature on dissemination and explores the barriers, themes, and trends in EBP through eight expert interviews. The interviews reflect the issues described in the literature and provide additional insight to the process of implementation and dissemination of EBP. Findings from the literature and interviews are synthesized into research and practice recommendations.While there is a call for Evidence-Based Practice (EBP) in social work and mental health services, there have also been a number of criticisms about the implementation of research findings into viable methods of practice. These barriers range from the egregious lag-time between research development to dissemination of evidence to practice settings to a veritable lack of support and training for community practitioners. There is a growing body of evidence describing effective interventions, but there is not a substantial body of work addressing the dissemination of these programs and other research findings for use in the field. This paper highlights some of the work around dissemination of EBPs in the field of social work with an emphasis on mental health services including an overview of the barriers to the use of evidence in practice and proposed models of conceptualization and implementation of EBP. To further highlight the current barriers, themes, and trends in EBP eight experts in the field of EBP were interviewed. The goal of the interviews was to survey the opinions of expert researchers in the area of EBP to supplement knowledge described in the literature. The experts' responses reflected many of the same issues described in the literature as well as additional information regarding their efforts toward determining the most viable options to address the barriers to implementing and disseminating EBP. Findings from the literature review and interviews are synthesized into recommendations for future research and practice efforts.