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Comparative evidence-based practice



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Comparative evidence-based practice


Carol Perryman


If more researchers were to take a disciplinary perspective fully into account, one could see the scope for better cross-fertilisation and a better sense of unity between them” (Becher, 1994).

Abstract


Objective: This study examines the adoption of evidence-based practice (EBP) concepts into LIS and three other disciplines (medicine, nursing, social work) by comparing documentation from each. Initial questions are as follows:

  • What elements distinguish differences in the adoption of evidence-based concepts into different disciplines?

  • How are these elements evidenced in the professional publications, association standards, and models for evidence-based practice?

Methods: First, the top ten journals from library science (LIS), medicine, nursing, and social work were identified. Next, primary bibliographic databases for each discipline (LISA, Medline, Cinahl, and Social Services Abstracts) were searched for terminology related to evidence-based practice and research methodologies for the period from 1995-2005, in order to track diffusion of EBP concepts to each field through its top literature. Professional association statements, EBP models, barriers to practice, controversies, and other aspects were considered, then compared between the disciplines.

Results: Disciplines traditionally based on an empirical body of evidence may be more ready to adapt evidence based models for practice than those whose foundations rest at least partially in the social sciences (social work, LIS), and this is evidenced by the patterns of use of EBP-related research methods as reflected in the disciplines’ top resources.

Conclusions: By comparing across disciplines we can better understand how EBP has been adapted to suit the different disciplinary contexts, and consider how this might best occur in LIS. This comparison contributes to the emerging discourse on evidence-based library and information practice (EBLIP) as we work toward a practicable model


Introduction


By some accounts, knowledge of evidence-based library and information practice (EBLIP) appears to be increasing rapidly, especially in the area of health sciences librarianship, and even ready to move beyond that specialty, to more general library communities (Gorman, 2005). Within the past year, proof of this could be found in the publication of an introductory article on EBLIP in a law library journal (Lerdal, 2006) and a professional development module entitled “Can you find the evidence-based practice in your school library?” was offered for the second consecutive year to school library media specialists, sponsored by the Ohio Educational Library Media Association (OELMA) (OELMA, 2006). Awareness of the terminology, at least, can also be assumed by the frequency with which a quick-and-dirty series of Google searches retrieves the phrase ‘evidence-based library practice’ (not in double quotations) in connection with three major library associations:

sla evidence-based library practice - 26,500

ala evidence-based library practice - 60,700

mla evidence-based library practice – 150,000


Our curiosity led us to ask, however, whether awareness (or ubiquity) of the terminology is analogous to acceptance of the concepts or practices of evidence-based practice. Specifically, we wondered how the field of library science differs from other disciplines with regard to the uptake of EBP, and how the different characteristics of disciplines might affect that uptake. Elements for consideration across the disciplines were derived from diffusion theory, wherein specific characteristics of the individuals, organizations, research contexts, and communications channels are known to affect the speed and depth of adoption (Rogers, 1995). Another question concerned ways in which the diffusion of EBP could be mapped through the literature. Understanding elements affecting the diffusion of EBP concepts and practices in other disciplines may inform our own perspective, offering options we may not have considered.

Background



As sociological researchers have found, acceptance of ideas is not accomplished merely by the presentation of new information. Diffusion of innovation (DOI) is a widely accepted theory concerned with processes involved in the dissemination of new ideas, practices, or objects. In his pioneering work, Everett M. Rogers has defined diffusion as the process by which an innovation is communicated through certain channels over time among members of a social system (2003, 11). Acceptance of new practices and concepts is affected by a number of different elements, including perception of relative advantage, compatibility with existing values, experiences, and needs for the individual and the social system. In addition, rates of acceptance (or acceptability) are dictated by perceptions of complexity (level of difficulty of comprehension and application); trialability (ability to experiment with new ideas, practices, or objects); and observability (visibility of results to others). It is this last attribute we are considering in our study, by examining publication trends among four disciplinary areas.


Four major elements in DOI are 1) the innovation itself; 2) the channels of communication; 3) the time of diffusion; and 4) the social system in which it is occurring. According to Rogers (12), innovations are considered ‘new’ if the ideas, practices, or objects are being newly considered, not just if they are actually newly created. Among a population, adoption of innovations is known to follow an s-shaped curve, where awareness escalates after reaching a critical mass based on the percentage of adopters. Innovations often represent a solution to uncertainty, and are evaluated by adopters in relationship to perceived or real costs and benefits. Communication channels are comprised of the ways in which information about the innovation is disseminated, and may be formal (such as the professional literature of a discipline, or continuing education) or informal (peer-to-peer, by methods such as discussion on listservs or among work groups). Communication research has found individuals prefer to learn about innovations informally from others like themselves. Time of diffusion, in innovation research, refers not only to the length of time it takes for an individual or population to adopt or reject the innovation, but also to the stages of awareness, trial, and adaptation. Finally, the social system supplies boundaries to a population in which the innovation is being considered and applied or rejected. External and internal political pressures, norms, the presence, perception, and roles of opinion and change leaders, social structures, and other cultural attributes (including the presence of professional standards of conduct and practice, within a discipline), all lend themselves to the rate and levels of change.

One assumption we are making is that saturation levels of the idea (if not the practice) of evidence-based concepts in the literature are related to awareness within the social systems defined as professions. Support for this assumption is derived from research describing absorptive capacity (ACAP), a theory developed to explain organizational phenomena in the process of change, especially regarding the acquisition, assimilation, transformation, and exploitation of new knowledge (Zahr & George, 2002). Research has shown a direct positive correlation between an organization’s ACAP and its ability to retain a competitive advantage, which is further defined as the ability to continue responding to its business environment by developing new products and services.


We began our study intending to measure the dissemination of new knowledge (EBP) into four distinct disciplines: we cannot, unfortunately, make the further assumption that the literature is actually read by practitioners. This has been proven not to be the case in social work, for instance, where studies have found that less than 2% of respondents to a survey of practitioners mentioned the use of a research base in making intervention decisions (Rosen, 1992, 1993); in nursing, 67% of respondents to a recent survey of research utilization by RNs in the United States report seeking information from colleagues, rather than from published research, and 58% report never using research to support practice at all (Pravikoff, Tanner, & Pierce, 2005); in LIS, although Biggs has made the claim that since the field has no unique knowledge base, it can claim neither professionalism nor disciplinary status (1991), a more recent study found that 50% of respondents to a survey report applying LIS research to practice (Powell, Baker & Mika, 2002). However, as we explain above, in many professions including LIS, peer-to-peer communication channels are preferred to more formal methods, and often form the basis for decision making. Studies of information and decision making behavior among the disciplines will be considered along with the evidence provided by published literature.





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