Imagine
going to the doctor because you are not feeling well. Before you had a chance to describe your
symptoms, the doctor writes out a prescription and says, “Take two of these
three times a day, and call me next week.”
“But –
I haven’t told you what’s wrong,’ you say. “How do I know this will help me?”
“Why
wouldn’t it?” says the doctor. “It worked for my last two patients.” (Christensen and Raynor, 2003)
In this post, I will argue that the most compelling reason for the use of evidence-based practice is that it helps prevent unnecessary harm being caused to both, pupils and staff, by the non-use of the best available current evidence. As such, evidence-based practice is an ethical endeavour, with the non-use of best available evidence representing unethical practice. This may seem an obvious point, but is often overlooked. So to help make the argument as explicit as possible, I have devised a couple of 2 x 2 tables to summarise the harmful consequences of the non-use of evidence, and the potential benefits resulting from the evidence-based practice.
The harm cause by the
non-use of evidence-based practice.
Drawing upon the work of Gray (2001) and cited by (Gambrill, 2006), Table 1 seeks to illustrates the consequences
of the non-use of evidence-based practice when making leadership and management
decisions. So in Q1, we may have new
practices which are warranted by a comprehensive range of evidence, which are
not introduced due to a lack of awareness of the evidence. In Q2, we have good practices which benefit
pupils and/or staff – which are withdrawn without sufficient consideration
whether the decision is warranted. In Q3 we may have practices introduced, for
which there is little or no evidence, but nevertheless cause harm to pupils and
or staff. Finally, in Q4 we may have
practices which are continued to be used – and not withdrawn – despite causing
harm to pupils and/or staff.
Table 1 The consequences
of the non-use of evidence-based practice
Practices
|
|||
Introduced
|
Withdrawn
|
||
Net impact
|
Good
|
Q1 NO
|
Q2 YES
|
Harm
|
Q3 YES
|
Q4 NO
|
On the other hand, Table 2 illustrates the consequences of
the use of evidence-based practice.
Table 2 The benefits of the using of evidence-based practice
Practices
|
|||
Introduced
|
Withdrawn
|
||
Net impact
|
Good
|
Q1 YES
|
Q2 NO
|
Harm
|
Q3 NO
|
Q4 YES
|
Some final words
As (Gambrill, 2006) states when discussing the status of the
professional code of ethics and states:
Are these merely for window dressing, to impress interested
parties that our intentions are good and therefore our outcomes are good, to
convince others that we are doing the right things. Or are these codes really meaningful? Is it ethical to agree to abide by the
guidelines described in professional codes of ethics, for example, to draw upon
practice-related research and then simply not do so.(p351)
References
CHRISTENSEN, C. M. & RAYNOR, M. E. 2003. Why
hard-nosed executives should care about management theory. Harvard business review, 81,
66-75.
GAMBRILL, E.
2006. Evidence-based practice and policy: Choices ahead. Research on Social Work
Practice, 16, 338-357.