Social Work Library Orientation Tutorial: Evidence-based Practice in Children and Youths

Evidence-based Social Work: Overview of Key Concepts

From Evidence-based Medicine to Evidence-Based Social Work

The evidence-based movement in the health sciences is over a decade old, and its beginnings
are tied to evidence-based practice in medicine. The first appearance of the term evidence-based
medicine occurred in the fall of 1990 in a document describing the residency program at Canada’s
McMaster University:

Residents are taught to develop an attitude of “enlightened skepticism” toward the application
of diagnostic, therapeutic, and prognostic technologies in their day-to-day management of patients.
This approach, which has been called “evidence-based medicine,” is based on principles outlined
in the text Clinical Epidemiology.

The goal is to be aware of the evidence on which one’s practice is based, the soundness of the
evidence, and the strength of inference the evidence permits. The strategy employed requires a
clear delineation of the relevant question(s); a thorough search of the literature relating to the
questions; a critical appraisal of the evidence, and its applicability to the clinical situation; and
a balanced application of the conclusions to the clinical problem.

[Source: Guyatt, G. and Drummond Rennie. 2002. User’s Guides to the Medical Literature: A
Manual for Evidence-Based Practice. Chicago: American Medical Association, p. xiv.]

Some of the key concepts in this description are evidence and critical appraisal. Evidence can be
defined as that “which furnishes proof,” and critical appraisal can be defined as an evaluation
process “which determines the significance or worth of something by careful appraisal and study.”
These concepts became a fundamental principle for a new approach to patient care, using evidence-
based principles and a philosophy that evidence from the medical literature should support clinical
decisions. As a body of literature began to emerge, it was soon recognized that evidence-based
medicine approaches could be applied to other fields, including social work. Within this field,
some of the principal user groups are practitioners, policy makers, researchers, the general public,
and information professionals.

There are differences between the two disciplines of medicine and social work.

	Social Work	Medicine
Primary Focus	Individuals, Families, Communities	Individuals
Emphasis	Diagnosis	Diagnosis
	Treatment	Treatment
	Individuals, Families, Communities	Whole Patient
Paradigm	Interventions aimed at Environment, Human Behavior and Lifestyle, and Medical Care	Medical Care
[Adapted from : Fineberg, Harvey, MD, PhD, Dean, Harvard University School of Public Health, 1990. Distinctions Between Public Health and Medicine. On the web site of the University of Texas School of Public Health at Houston: Community-Based Public Health Program.

As shown on the chart above, social work research and practice, similar to public health, is aimed
at the broader community. Evidence-based approaches within this context require an understanding
of the complexities of organizational structures, interactions, and myriad other dynamics that shape
and influence decision making at the local, state, regional, and national levels within which social
work operates and within which policies and programs are established.

Role of Librarians and Information Professionals in Evidence-Based Social Work

Librarians and information professionals are trained in the skills and procedures needed for applying
evidence-based principles, including information retrieval and evaluation of search strategies and
results. Librarians and information professionals provide training and instruction on evidence-based
social work concepts, develop web-based resources and guides to evidence-based sources, consult on
search strategies and techniques for identifying the evidence-based literature, and apply criteria
for assessing and evaluating the reliability and validity of search results.