University of New England Armidale
HLTH101: Information and Evidence in Health and Social Care
Due Date 03/02/2021
This document is specifically for the purpose of developing critical reflection techniques. Through the Health 101 course as part of the Diploma in Community Welfare and Wellbeing, students made six forum posts as part of professional skills building with two posts chosen by students for the final assignment.
I have fount it difficult to move away from critical thinking and analysis into the personal mode of self-reflection, and connecting the two has presented challenges.
Background of Evidence-Based Practice
After evidence-based medicine fundamentally changed clinician approach to medical practice in the 1990s, evidence-based practice (EBP) began adoption in other healthcare contexts (Zimerman, A.L., 2013). I was quite surprised that EBP is such a recent phenomenon, as I expected medicine would always have involved doctors relating discoveries to each other. Although I was aware of journal work, until this course I was not aware of how to connect it to my personal or professional development. The evidence confirms that EBP and critical reflection support learning (Kuennen, J.K., 2015).
Protecting Clients from the Government
Relying on peer-reviewed journals through this course has altered my attitude toward the information I both access and am privy to. I chose the first post from ‘Module 4: How to determine the quality of evidence and information’, where I discovered how public policy can have a very real impact on healthcare staff and clients, and on the provision of healthcare. This reinforces my belief that social work and healthcare must be publicly funded and available to all. I already confirm reliability of sources and promote socialism, yet now I am aware of how opinions can be properly refuted, and how healthcare policy may be reduced in effectiveness.
Facts are the data-driven observations conducted through peer-reviewed research, as indexed at the UNE Library. Opinions are based upon vested interests, a misunderstanding of data, or couched within an emotional frame of reference (Kuhne & Schemer, 2015).
Good note-taking is the practical application of fact vs opinion which ensures good care and avoids malpractice or malfeasance. Yet as Kilty and Orsini (2019) clarify, criminalisation of medical conditions creates ethical conflicts to record-keeping.
Kühne R, Schemer C. The Emotional Effects of News Frames on Information Processing and Opinion Formation. Communication Research. 2015;42(3):387-407. doi:10.1177/0093650213514599
Jennifer M. Kilty & Michael Orsini (2019) “We write as little as we have to”: charting practices and documenting disclosure in response to HIV criminalization in Canada, AIDS Care, 31:8, 1035-1040, DOI: 10.1080/09540121.2019.1587371
Imperfect, Invaluable Information
I chose the second post ‘Module 6: How to find and use ABS (Australian Bureau of Statistics) data’, which introduced me to the functional validity of accurate data and to the limitations of how data may be valid and reliable (Australian Bureau of Statistics, 26 June, 2017). The historical collection of statistical data provides rare insights into temporal epochs, allowing insight into the evolution of societies, and also to the creation of good policy based on observed trends.
Census data allows administration of labour, land, and resources, and this activity dates back several thousand years (Office of National Statistics, UK, 2020) and provides a clear and precise chronology and topography of the people (Ingram, (Ed.), 1823, The Anglo-Saxon Chronicles). There are also valuable insights into global population structures and how they are changing (Ray, M. (Ed.), Brittanica Online, n.d.).
The ABS first began in 1911 and has been conducted every five years, 2016 being the first year it was partially conducted online (Australian Bureau of Statistics, 2020), and accurate and contemporary data allow[s] policy making to become relevant (Killick et al., 2016).
Office of National Statistics, UK, (2016). Census-taking in the ancient world. https://www.ons.gov.uk/census/2011census/howourcensusworks/aboutcensuses/censushistory/censustakingintheancientworld
The Anglo-Saxon Chronicle by J.A. Giles and J. Ingram. (Electronic release date: 1 Sep 1996). http://www.gutenberg.org/cache/epub/657/pg657.html
Britannica Online.(N.d.). Modern Census Procedure. https://www.britannica.com/science/census/Modern-census-procedure
Australian Bureau of Statistics.(N.d.). 2016 Census Overview. https://www.abs.gov.au/websitedbs/D3310114.nsf/Home/Assuring%20Census%20Data%20Quality
Killick, L., Hall, H., Duff, A. S., & Deakin, M. (2016). The census as an information source in public policy-making. Journal of Information Science, 42(3), 386–395. https://doi.org/10.1177/0165551516628471
Social Workers and Evidence
Factual and Reliable
I began this course of study with no awareness of the academic process, and neither that of healthcare staff and their professional requirements. I have struggled through this course to re-program my thinking and attitudes so I can invest in the skills and knowledge presented. Having long-ago lost faith in the reliability of even government-sponsored news sources, I have maintained a habit of triangulating sources to ascertain the ‘reality’ of a given topic. This course has provided an avenue by which to access the latest research and protocols relevant to social work as a profession: The Lancet, The British Medical Journal, the Australian Association for Social Workers, and many more.
For me, though, the clinch was going to the Australian Bureau of Statistics. This opened my mind to the bedrock of irrefutable and mostly reliable function of raw data collection. I am convinced that policy could only be more effective with better data, yet data collection itself is open to question (Rappleye et al., 2020). It is also best done within a framework, implying multidisciplinary and multinational cooperation (Comiskey et al., 2020). As a social worker, my awareness of who collects and how the raw data was collected, in particular the intention for collecting that data, would be of key importance.
Social Work and EBP
This course has repeatedly and consistently pushed me to support any and all opinions with evidence, mostly through the UNE Library with its vast resource of peer-reviewed journals. As a social worker, there is a huge wealth of reliable journals searchable through a wide variety of sources – all peer-reviewed. I learned how to differentiate between peer-reviewed articles, too, as some seem to be relevant, but upon deeper consideration, are not. Prior to this course, I would have followed current practices and attempted to clarify articles, yet now I am able to search current research already completed and to make informed changes to my practice based on current evidence.References
Zimerman, A.L., (2013). Evidence-Based Medicine: A Short History of a Modern Medical Movement. Virtual Mentor. 2013;15i(1):71-76. doi: 10.1001/virtualmentor.2013.15.1.mhst1-1301
Kuennen, J. K. (2015). Critical Reflection: A Transformative Learning Process Integrating Theory and Evidence-Based Practice. Worldviews on Evidence-Based Nursing, 12(5), 306–308. https://doi.org/10.1111/wvn.12095
Australian Bureau of Statistics, (26 June, 2017). Historical Data Quality. https://www.abs.gov.au/websitedbs/censushome.nsf/home/historicalquality?opendocument&navpos=470
Rappleye, J., Komatsu, H., Uchida, Y., Krys, K., & Markus, H., (2020). ‘Better policies for better lives’?: constructive critique of the OECD’s (mis)measure of student well-being. Journal of Education Policy, 35(2), 258–282. https://doi.org/10.1080/02680939.2019.1576923
Comiskey, C., Bretteville-Jensen, A.L., Bergeron, H., Bühringer, G., Dargan, P., Davoli, M., Faggiano, F., Fischer, G., Roíguez de Fonseca, F., Garretsen, H.F.L., Hickman, M., Korf, D.J., Krajewski, K., Paoli, L., & Spanagel, R. (2020). Better data, better policy and better lives: A call for improved drug monitoring and concerted responses. Addiction (Abingdon, England), 115(2), 199–200. https://doi.org/10.1111/add.14763
List of professional EBP resources: