Disseminators vs revisionists: attitudes to the ‘implementation gap’ in evidence‐based practice
| Date | 29 January 2010 |
| Published date | 29 January 2010 |
| Pages | 28-38 |
| DOI | https://doi.org/10.5042/jcs.2010.0019 |
| Author | Nick Midgley |
| Subject Matter | Education,Health & social care,Sociology |
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10.5042/jcs.2010.0019
Abstract
Ambiguities in the term ‘evidence-based practice’ (EBP) are often used to hide some of the
tensions within the idea itself. This article seeks to clarify what EBP means and how evidence
and knowledge can contribute to the development of children’s services. It acknowledges the
‘implementation gap’ between evidence-based practice and evidence-based practitioners,
and discusses two contrasting perspectives on the problem and its solution. For
‘disseminators’ the primary issue is better translation of findings into practice, illustrated here
by the work of the National Institute of Health and Clinical Excellence (NICE). ‘Revisionists’
look beyond obstacles and drivers to implementation and instead advocate looking again at
the relationship between research and practice and propose a number of radical proposals for
how this relationship can be re-envisioned.
Key words
evidence-based practice; implementation; research utilisation; disseminators and revisionists;
Type 2 translation
early 1940s may have had a very direct influence
on the development of children’s services in the
UK today.
In his autobiography, Cochrane describes
how, as a young medical officer, he found himself
caring for a motley group of prisoners of various
nationalities, many of whom were suffering
from tuberculosis. Cochrane and his colleagues
attended to the men as best as they could,
herded together behind a wire fence. However,
Introduction: the rise of
evidence-based practice
Archie Cochrane was a Professor of Tuberculosis
and Chest Diseases and an epidemiologist, but he
is probably best remembered today as one of the
founding figures of the evidence-based medicine
movement. His professional life had very little
direct connection to the social care of young
children, so it may be surprising to discover that an
experience he had in a prisoner of war camp in the
Disseminators vs
revisionists: attitudes to
the ‘implementation gap’ in
evidence-based practice*
Nick Midgley
Anna Freud Centre, London, UK
*An earlier version of this article appeared as an editorial in Clinical Child Psychology and Psychiatry 14 (3) (2009). With thanks to the editors of that
Journal for permission to use that editorial as the basis for this article.
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