Evidence-Based Practice and Social Work: An Illustration of the Steps Involved (Practice FORUM‪)‬

The current focus of the health care system involves a commitment to the process of considering evidence when making decisions (Donald, 2002). The principles of an emerging paradigm referred to as evidence-based practice (EBP) are ideally suited to fulfill this commitment. "Evidence-based practice is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of clients" (Gibbs & Gambrill, 2002, p. 452). Theoretically, EBP works by converting information from thousands of studies into risk estimates and thereby provides a framework for addressing questions asking "what is the chance that" certain things harm or benefit people, according to a fair and scientifically rigorous process (Donald). EBP offers social work practitioners and administrators a philosophy of practice that is compatible with obligations described in the profession's code of ethics and educational accreditation policies and standards (for example, informed consent, to draw on practice--and policy-related research findings) (Gambrill, 2003). Unfortunately, however, Gambrill noted that the philosophy and technology of EBP described in health care are typically not described in the social work literature. "If social workers do not take the time to comprehend the systemic, client-oriented vision of EBP, then we risk losing critical opportunities to decrease gaps between professional, ethical obligations and accreditation standards and what is done in everyday practice" (Gambrill, p. 18). Thus, in an era in which social workers must defend their domain from encroaching disciplines, adding the role of evidence-based practitioner to the plethora of other social work roles is fundamental. Using the vaccine safety dilemma as an example, we present the five steps involved in EBP and demonstrate their utility to social work practice.