Research, quality improvement and evidence-based practice: Ethical implications

Recently I've begun to ask myself the question as to whether within the 'school-research/evidence community'  there is a shared understanding of the similarities and differences between - research, quality improvement and evidence-based practice, and the ethical implications of these similarities and difference.  This is a critical issue because if schools and school leaders are not fully aware of the ethical issues, there is a real-risk that pupils will be disadvantaged by well meaning, but ultimately flawed attempts at randomised control trials masquerading as quality improvement or evidence-informed practice.  Unfortunately, this cannot be put down to ignorance - as the knowledge exists in the health-care sector of how to conduct ethically sound quality improvement interventions.

So to help school leaders begin to explore the ethical implications of seeking to develop the research/evidence based school, this post will:
  • define research, quality improvement and evidence-based practice; 
  • provide school-based examples for each term; 
  • explore the overlaps between each terms, with particular reference to ethics;
  • outline BERA's guidance on the ethical conduct of research;
  • highlight future posts which will seek to provide schools with guidance on the ethical conduct of quality improvement activities.
What do we mean by research, quality improvement and evidence-based practice?

Without wishing to get into the scientific paradigm wars, I would like to offer the following definitions to allow us get some purchase on what is meant by each of the following.

Research can be defined as the process of creating new generalisable knowledge, and which could include both the generation and testing of hypotheses.

Quality Improvement  can be defined as systematic, data-guided activities designed to bring about immediate improvements in local settings.  (Lynn et al., 2007)

Evidence-based practice can be defined as the making of decisions through the conscientious, explicit and judicious use of the best available evidence from multiple sources in order to increase the likelihood of a favourable outcome. (Amended from Barends et al., 2014)

Hicks (2016) writing about health care, usefully summarises the differences as follows : Quality improvement seeks to improve care, research seeks to generate new knowledge, and EBP allows clinicians to have the best available evidence at the point of care.    So how does this translate into  an educational context.  One possible way to rewrite Hicks summary of differences between quality improvement, research, and evidence-based practice is to say:  Quality improvement seeks to improve the individual school or multi-academy trust, research seeks to generate new knowledge, and EBP allows educators to have and use the best available evidence when making a decision.

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