Morten Sager Ph D and senior lecturer in theory of science ...eng.uvm.dk/-/media/filer/enguvm/enguvm/nordic-lighthouse-project/... · Lighting always create shadows. ... the Sahlgrenska

www.gu.se

Morten Sager

Ph D and senior lecturer in theory of science

Department of philosophy, linguistics and theory of science

Master's in evidence-basing

www.gu.se

The Many Faces of Evidence

– A Close Look at Evidence-

Based Practice

Ingemar Bohlin och Morten Sager (Eds)

Arkiv Förlag, 2011

www.gu.se

In the shadow of the evidence

Lighting always create shadows. What is out there?

How do we search where

there no light

(yet)?

Pupils

Practitioners

”Tacit knowledge”

MASTER'S IN EVIDENCE-BASING

www.gu.se

The approach

• My vantage point:

– Theory of science, i.e. philosophy, sociology and history of science

– Lack of competence (and infrastructure…)

• Practical skills

• and critical perspectives

• Orthodox ”Evidence”

• and pluralist views on evidence

– Why do they have to be combined?

REAL vs. RUBBISH EBM

Not enough with ”complexity”

– How can practical skills and critical analysis all be combined in one

master's programme?

Developing the programme

• My faculty: the Humanities, Liberal arts.

• Reference group at University of

Gothenburg

– Eleven departments and centres including

the Sahlgrenska Academy (Medicine,

Public Health etc), the Business school, the

departments of psychology, social work,

public administration, education.

External reference group

Recently: Close collaboration with The Swedish Institute for Educational Research (Skolforskningsinstitutet)

• Practical assessment of the usefulness and the consequences

of systematic reviews in education

• Training of nine teachers in one course at the master’s

programme (15 ECTS)

• Now: implementation of some of the findings of systematic

reviews


Who enrolled?

• Students

– 20 students, mostly part-time studies

– Many professionals from the various welfare sectors: teachers, physicians, social workers, psychologists, nurses, physiotherapists, teachers

– Wide age span: from management to ”fresh-baked students”. Born 1957-1987.

Can the two types of skills be combined?

•Methods AND perspectives. Tools AND reflections.

•Learning in relation to ordinary work-place and work task.

•Multi-disciplinary meetings. Many perspectives on the

same thing.

–Health care, social care and education

KLINIKER – VERKSAMHETER


LEDNING LEDNING



LEDNING LEDNING



LEDNING LEDNING


LEDNING

www.gu.se


Evidence-basing

• Broad definition

– Intention in the wellfare sector on various levels:

”EBM” according to the Swedish National Encyclopedia:

term that expresses the principle that every intervention

shall be based on the best (most reliable) knowledge

available at the moment of decision.

• What’s new?

• Nothing…

www.gu.se

Well… yes!

• The proliferation of methods, tools, or…

Increased

• Transparence and systematics

• Reproducibility

• Simplified communication of

strength of evidence

• National and international

collaborations

…different kinds of formalizations

PICO-searches

Databases

MeSH-terms

Appraisal templates

Metaanalysis

GRADE

Priority setting

Guidelines

CONSORT

DECIDE

…different kinds of formalizations

PICO-searches

Databases

MeSH-terms

Appraisal templates

Metaanalysis

GRADE

Priority setting

Guidelines

CONSORT

DECIDE


www.gu.se

Internal validity

Hierarchy


www.gu.se

GUIDELINES/ MANUALS

DO THIS

And this

And this

Then this

och så här

och så här

Och sedan så här

och så här

och så här

och så här

GUIDELINES/ MANUALS

DO THIS

And this

And this

Then this

och så här

och så här

Och sedan så här

och så här

och så här

och så här


A chain:

From

patients/clients/pupils to

patients/clients/pupils Master's in evidence-basing

Classic

evidence chain Master's in evidence-basing

www.gu.se

JUDGMENTS

FORMALIZATIONS

The strive to increase

objectivity and improve

practice

www.gu.se

(Sager & Bohlin 2011)

Formalizations and judgments interacting

Formalizations

PICO-sökningar

Databaser

MeSH-termer

Metaanalys

Granskningsmallar

GRADE

Formalizations

PICO-sökningar

Databaser

MeSH-termer

Metaanalys

Granskningsmallar

GRADE

Informalities

Judgments

Tacit knowledge

Decisions to include

Competence

Informalities

Judgments

Tacit knowledge

Decisions to include

Competence ? (In-)formalities

www.gu.se

JUDGMENTS

FORMALIZATIONS

The strive to increase

objectivity and improve

practice

What you need

to learn to use

evidence

TACIT KNOWLEDGE JUDGMENT EXPERTISE

etc


etc


etc


etc


etc


etc


etc


etc

One – or more

chains?

Methodological

pluralism

KLINIKER

VERKSAMHETER

LEDNING


ORGANIZATION

RCTs

and other

studies

SYSTEMATIC

REVIEWS

GUIDELINES

GOVERNMENT

and OTHER

AGENCIES

META-

SYNTHESIS

META-

ANALYSIS

GOVERNMENT

and OTHER

AGENCIES

MANAGE-

MENT

PROGRAM

THEORY

Complicating things even more

”Evidence-basing = How are organizations affected

by new knowledge?

AUDITS, INDICATORS and

SYSTEMATIC FOLLOW-UP

PUBLIC

COMPARISONS

IMP

LEM

ENTA

TIO

N

IMP

LEM

ENTA

TIO

N SU

PP

OR

T SU

PP

OR

T

ORGANIZATIONS

RCTs

and other

studies

SYSTEMATIC

REVIEWS

GUIDELINES

GOVERNMENT

and OTHER

AGENCIES

META-

SYNTHESIS

META-

ANALYSIS

GOVERNMENT

and OTHER

AGENCIES

PROGRAM

THEORY

Knowing the tools and knowing when to use them –

and their limitations.



IMP

LEM

ENTA

TIO

N

IMP

LEM

ENTA

TIO

N SU

PP

OR

T SU

PP

OR

T

PUBLIC

COMPARISONS

MANAGE-

MENT

KLINIKER

VERKSAMHETER

RCTer,

andra

studier

SYSTEMA-

TISKA

ÖVERSIKTER

RIKTLINJER

MYNDIGHETER eller

CENTRALA

ORGANISATIONER

META-

SYNTES

META-

ANALYS

LEDNING

KLINIKER

VERKSAMHETER

KLINIKER

VERKSAMHETER

LEDNING

Evidence for what organization?


ORGANIZATIONS

RCTs

and other

studies

SYSTEMATIC

REVIEWS

GUIDELINES

GOVERNMENT

and OTHER

AGENCIES

META-

SYNTHESIS

META-

ANALYSIS

GOVERNMENT

and OTHER

AGENCIES

PROGRAM

THEORY

Knowing the tools and knowing when to use them –

and their limitations.



IMP

LEM

ENTA

TIO

N

IMP

LEM

ENTA

TIO

N SU

PP

OR

T SU

PP

OR

T

PUBLIC

COMPARISONS

MANAGE-

MENT

1st semester 1st semester

2nd semester

2nd semester

KLINIKER

VERKSAMHETER

RCTer,

andra

studier

SYSTEMA-

TISKA

ÖVERSIKTER

RIKTLINJER

MYNDIGHETER eller

CENTRALA

ORGANISATIONER

META-

SYNTES

META-

ANALYS

MYNDIGHETER eller

CENTRALA

ORGANISATIONER

KVALITETSREGISTER

AUDITS, INDIKATORER och

SYSTEMATISK UPPFÖLJNING

ÖPPNA

JÄMFÖRELSER

STÖ

D F

ÖR

ST

ÖD

FÖ

R FÖ

RÄ

ND

RIN

G

FÖR

ÄN

DR

ING

EVIDENSBASERING 2.0:

Hur påverkas organisationer av ny kunskap?

TA TA

masterprogrammet i evidensbasering

Kommunikation av lärandemål

Kommunikation av lärandemål

EARLY WARNING

SYSTEM

EARLY WARNING

SYSTEM

STUDIERO 6,2

STUDIERO 6,2

Pedagogical model

•Methods AND perspectives. Tools AND reflections.

•Learning in relation to ordinary work-place and work task.

•Multi-disciplinary meetings. Many perspectives on the

same thing.

–Health care, social care and education



LEDNING LEDNING



LEDNING LEDNING



LEDNING LEDNING


LEDNING

Thanks!


Documents

Morten Sager Ph D and senior lecturer in theory of science ...eng.uvm.dk/-/media/filer/enguvm/enguvm/nordic-lighthouse-project/... · Lighting always create shadows. ... the Sahlgrenska