In 1996, in an editorial published by the British Medical Journal, David Sackett, M.D., offered a simple definition of “evidence-based medicine” and urged his colleagues to adopt its tenets. Put simply, evidence-based medicine is the deliberate use of evi
by Site Staff
August 30, 2004
Isn’t that what doctors have always done? There are all those clinical trials, medical journals and scholarly conferences that review the latest results from different treatments. They’re swimming with evidence.
It turns out that much of the practice of medicine is based on expert opinion and individual case studies. In fact, the core of physician training is the apprenticeship model, where they shadow senior doctors during patient rounds and sit in on “grand round” lectures.
One analysis showing the need for an evidence-based approach to medicine examined the treatment of patients with myocardial infarction (heart attack) from 1960 to 1990. It turns out there was plenty of solid research and data being published in the journals that showed the efficacy of thrombolytic therapy (the use of drugs to dissolve blood clots) in the 1970s. By the mid-1980s, the research appeared irrefutable. Still, medical textbooks and expert opinion lagged the data by almost 10 years, according to Victor Montori (“Respiratory Care,” 2001).
In our own field of professional learning and development, we are much worse off than the field of medicine. We’ve learned our craft from experts, case studies and decades-old research in very controlled environments. How much do we really know about instructional systems design, constructivism or learning styles as they apply to adult learners in today’s work environment?
Most of the applied learning research that is done today is “lab” research (typically using college students as subjects), and the good research rarely reaches the desks of instructional designers, training managers or CLOs.
What’s worse, we seem to have a profession where fictitious information and sloppy research are tolerated. You know that statement and graph we’ve all seen that states, “People only remember 10 percent of what they read, and 30 percent of what they hear”? It’s bogus. Made up. Embarrassingly contrived and disseminated. (See www.work-learning.com/chigraph.htm. for more details.)
Or how about this one: “Only 10 percent of training results in behavior change on the job.” You’ve heard that, right? It turns out that a training manager named David Georgenson used a rhetorical opening in a 1982 article about the transfer of training. His made-up literary effect has been picked up ever since and referenced as “findings,” “research,” “a report” and “a comprehensive survey.” (See The Industrial-Organizational Psychologist, Vol. 39, No. 2, October 2001).
I suggest that our own field of professional learning and development could benefit from a healthy dose of “evidence-based training,” defined as the conscientious and explicit use of the best current evidence in the design and development of workplace learning programs. Evidence-based training does not discriminate against experience or situation; it simply integrates the instructional designer’s expertise and the learners’ preferences with the best and most context-relevant external data.
Signs of increased interest in rigorous analysis can be seen in the Learning Economics Group (www.learningeconomics.org), which was formed to look at the economic impact of learning on organizations. We can also look to the work of Will Thalheimer, Ph.D., who is digging out evidence-based design strategies from academic research and making them accessible to corporate trainers. These are small signs that we are moving in the right direction, but there is much more that needs to be done.
Sackett’s call to arms, a simple definition of evidence-based medicine 10 years ago, has led to a small but growing global movement in health care. It has spawned an entire series of articles, Web sites, conferences and journals that support his original idea. It is my hope that 10 years from now we will see that the same progress has occurred in our own field. Hopefully we’ll come to the day where we actually fund, understand and value applied learning research and obtain dramatically better performance results.
Kevin Kruse is a president of AXIOM Professional Health Learning and facilitator of www.e-LearningGuru.com. For more information, e-mail Kevin at kkruse@clomedia.com.