evidence-based practice a new approach of teaching the practice of management eric barends, cebma...
TRANSCRIPT
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Evidence-Based Practice
A New Approach of Teaching The Practice of Management
Eric Barends, CEBMa – Denise Rousseau, CMUMay 6th, 2014
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Mission Today• Teaching Evidence-based practice (in 1 hour)
• Disappointment
• Inspiration
Who are we and what is our mission (today)?
Eric Barends• manager
• teacher
• director
• CEBMa
Denise Rousseau• researcher
• teacher
• professor
• CMU / Heinz / Tepper
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Postgraduate Course
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Postgraduate Course
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Postgraduate Course
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Postgraduate Course
Current developments
Education
Access to research databases
Rapid Evidence Assessments
Building a community
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Postgraduate Course
CEBMa Database of Evidence Summaries
Online learning modules
Accreditational bodies
Future developments: practice
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1. Some background
2. Teaching: learning principles
3. Teaching: curriculum
4. Teaching: examples
5. Your questions
Today
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Evidence based management:
What is it?
1. Some background
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Evidence-based practice
Central Premise:
Decisions should be based on a
combination of critical thinking
and the ‘best available evidence‘.
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Evidence?
findings from scientific research,
organizational facts & figures,
benchmarking, best practices,
professional experience
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All managers base their
decisions on ‘evidence’
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But…many managers pay
little or no attention to the
quality of the evidence they
base their decisions on
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Trust me, 20 years of management experience
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SO ...
20
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Teach managers how to
critically evaluate the
trustworthiness of evidence
from multiple sources
and help them find ‘the best available’ evidence
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An example
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An example
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An example
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Maslow, A.H. "A Theory of Human Motivation”
An example
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An example
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Professional experience and
judgment
Organizational data, facts and figures
Stakeholders’ values and concerns
Scientific research findings
AskAcquire
AppraiseAggregate
ApplyAssess
An example
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Professional experience and judgment
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Maslow, A.H. (1943). "A Theory of Human Motivation," Psychological Review 50(4)
Wahba, M. A., & Bridwell, L. G. (1976). Maslow reconsidered: A review of research on the need hierarchy theory. Organizational Behavior and Human Performance, 15(2)
Scientific research findings
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How evidence-based are we (managers)?
“I’ve never thought I need more
evidence before making a
decision;
I know what needs to be done,
we get on with it and we get
results.”
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1. Incompetent people benefit more from feedback than
highly competent people.
2. Task conflict improves work group performance while
relational conflict harms it.
3. Encouraging employees to participate in decision
making is more effective for improving organizational
performance than setting performance goals.
True (likely) or false (not likely)?
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How evidence-based are we?
959 (US) + 626 (Dutch) HR professionals
35 statements, based on an extensive body of
evidence
true / false / uncertain
HR Professionals' beliefs about effective human resource practices: correspondence between research and practice, (Rynes et al, 2002, Sanders et al 2008)
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Outcome: not better than random chance
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EBP:
Teach managers how to
critically evaluate the
trustworthiness of evidence
from multiple sources
and help them find ‘the best available’ evidence
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2. Teaching EBP:
Learning principles
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Discuss with your neighbours:
When it comes to teaching,
what are important learning principles?
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Learning principles
1. The brain needs time to get used to new things. Longer periods in between practice sessions lead to a longer overall retention.
2. Training program should include opportunities for practice, linked to real world situations .
3. The human brain seeks comfort in what it knows and is familiar with; addressing / confronting prior knowledge increases understanding (start from where the students are)
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Learning principles
4. Higher order thinking only happens when people work on questions / problems / issues themselves.
5. Learning from failure is important for learning. Speculating and predicting before finding the correct answers helps people become adaptive learners / experts.
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Teaching EBP =
Small groups
Problem based
Real life cases
EBP starts with a practical question, not with an academic answer
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3. Teaching EBP:
Curriculum
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Limitations of human judgment & common forms of cognitive bias
Retrieving & critically assessing experiential evidence
Retrieving & critically assessing organizational evidence (qualitative & quantitative)
Searching in research databases
Efficiently reading research articles
Critically appraising evidence from research
Weighing and aggregating evidence from multiple sources
Incorporating evidence into the decision making process
Different types of decisions and decision-making processes
Assessing the outcome of decisions made
EBP: Curriculum
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Professional experience and
judgment
Organizational data, facts and figures
Stakeholders’ values and concerns
Scientific research findings
AskAcquire
AppraiseAggregate
ApplyAssess
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A critical and reflective attitude
Skills to distinguish trustworthy from less trustworthy evidence.
Thinking in terms of probabilities
EBP: outcome
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CAT: Critically Appraised Topic
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CAT: Critically Appraised Topic
A critically appraised topic (CAT) is a
structured, short (2 – 5 pages max) summary
of evidence on a topic of interest, focused
around a practical problem or question..
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CAT: structure
1) Background / context
2) Question (PICOC)
3) Search strategy
4) Results / evidence summary
5) Findings
6) Limitations
7) Recommendation
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CAT: 3 hits
1. Small group (2-3), scientific evidence, list of topics
2. Individual, scientific evidence & theory, own topic
3. Individual, evidence from multiple sources, real life question / issue
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CAT: examples
Is there a valid and reliable way to measure the productivity of knowledge workers?
To what extent will leadership training improve the effectiveness of leaders (e.g. managers, executives), what are the characteristics of effective leadership training programs?
What research evaluating the effects of 360-degree has been published in peer-reviewed scholarly journals in the past 10 years? Which of the variables that are expected to have an impact on the effectiveness of 360-degree feedback are most widely studied and what is known of their effect?
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CAT-walk
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4. Teaching EBP:
Examples
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Critical attitude
ASK
Critically appraisal: research findings
Organizational evidence
4. Teaching EBP: examples
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Critical attitude
ASK
Critically appraisal: research findings
Organizational evidence
4. Teaching EBP: examples
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Discuss with your neighbours:
What are the most common cognitive biases in management?
(give an example)
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We are predisposed to selectively
search for or interpret information in
ways that confirms our existing beliefs,
expectations and assumptions, and
ignore information to the contrary.
In other words, we “see what we want to see”
Confirmation bias
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The amount of information increases faster than our ability to process it.
Increase of information
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McKinsey (1997 / 2001)
Case study / best practice
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War on Talent
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1. Pattern recognition
2. Confirmation-bias
3. Small numbers fallacy
4. Outcome bias
5. Halo effect
6. Authority-bias
7. Groupthink
8. Availability bias
Biases
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Assignment
One of your best friends is trader on the stock exchange. He enthusiastically tells you he has analyzed a large number of financial and economic data and that he has discovered an interesting phenomenon: "The position of the Dow Jones index multiplied by the price of oil is two days ahead of the gold price!" In other words, if both the Dow Jones and the oil price go up, the price of gold will rise within a day.
Bias? Critical questions?
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We are predisposed to see order, pattern and causal relations in the world.
Patternicity: The tendency to find meaningful patterns in both meaningful and meaningless noise.
Bias: pattern recognition
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Assignment
Most people will prefer doctor B
Why? Bias? Critical questions?
doctor A doctor B
Last operation: patient died on the
operating table
Last operation: patient recovered
faster than expected
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Outcome bias
We are inclined to evaluate the quality of a decision (intervention, method) on the basis of its outcome.
Bias: Outcome bias
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The Asch Experiment
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Nasa, Challenger
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Groupthink:
Groupthink is a psychological phenomenon that occurs within a group of people, in which the desire for harmony or conformity in the group results in an incorrect or irrational decision
Bias: Groupthink
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Bounded rationality
System 1
Fast Intuitive, associative heuristics & biases
System 2
Slow (lazy) Deliberate, ‘reasoning’ Rational
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Bounded rationality
limbic system and brainstem(system 1)
neo cortex(system 2)
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Critical attitude
ASK
Critically appraisal: research findings
Organizational evidence
Teaching EBP: examples
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Postgraduate Course
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Postgraduate Course
1. Problem identification
2. Surfacing assumptions
3. Logic model
4. Formulating a searchable question
5. Formulate sub-questions
5 steps
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Postgraduate Course
For which problem is ….. the solution?
For who(m)
Why
How big ?
How do we know (what is the evidence?)
Step 1: What is the problem?
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Postgraduate Course
“Door to needle time”, 48 UK hospitals in Westmidland
Our hospital
The problem
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Postgraduate Course
Discuss with your neighbours possible causes for these
differences that could not be solved by the implementation of
Lean / Six Sigma
60595857565453525150494847464544434241403938373635343332313029282726252423222120191817161514131211109876543210
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Postgraduate Course
1. Problem identification
2. Surfacing assumptions
3. Logic model
4. Formulating a searchable question
5. Formulate sub-questions
5 steps
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Postgraduate Course
Logic model
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Postgraduate Course
A logic model spells out the process by which a
problem or intervention is expected to produce
certain outcomes.
In making expectations (its logic) explicit, a logic
model helps identify the kind of evidence
needed.
Logic model
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Critical attitude
ASK
Critically appraisal: research findings
Organizational evidence
4. Teaching EBP: examples
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Critical appraisal
Always start with a practical question:- does it work?- how many employees …?- how do employees feel about …?
How could we find out?
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87
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Critical appraisal
Amanda Burls:
“I never tell them anything about randomization or blinding, I just ask: “How are you going to know? How would you test this if I would give you a half million dollars to test it?” And when they come up with a suggestion I say, “Alright, can you think of any reason you got the results showing it works, while in fact it doesn’t.” And they say, “Well, it could be this, it could be that” And then I say, “Ok, then redesign your study so it can’t be this,” and what they come up with are precisely those things: randomization and blinding.”
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How trustworthy is this study?
Two studies, different designs
Studies with methodological flaws
Best available evidence (so what now?)
Online course!
Critical appraisal
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Critical attitude
ASK
Critically appraisal: research findings
Organizational evidence
4. Teaching EBP: examples
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91
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Organizational facts and figures
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Organizational facts and figures
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Organizational facts and figures
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95
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Organizational facts and figures
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Organizational facts and figures
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Examples
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1. Added value
2. Types of organizational evidence
3. Starting point: logic model
4. Statistical aspects to consider
5. Barriers to overcome
Organizational evidence
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5. Barriers to overcome
1. Small numbers problem
2. Measurement errors
3. Context
4. Tainted data
5. Politics
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