One barrier to educating clinicians about EBP comes from the lack of universal agreement on what it means. Allen Rubin, et al., writing in the Fall 2007 issue of the "Journal of Social Work Education," define evidence-based practice in terms of steps, such as formulating a question regarding needs; finding the best evidence to answer the question; critically examining the validity and utility of the evidence found; integrating that examination with your own clinical experience and the client's values and circumstances before applying it to decisions; and evaluating the outcome achieved. Some sources, however, cite other steps or no steps at all, Spring notes.
Successful implementation of EBP requires students to begin applying it to their fields of expertise, which in turn requires change both immediate and ongoing. In fields steeped deeply in tradition, such as nursing, change is difficult, explain Elizabeth Tweed, et al., in the October 2007 issue of the "Journal of the Medical Library Association. A similar trend exists among social workers, in that experienced practitioners may remain committed to current approaches and lack confidence in their ability to analyze new evidence.
Historically, time constraints have been a chief obstacle in implementing EBP, but ways exist to address these valid concerns. Instructors can and should encourage practitioners to rely more on sources that specifically indicate evidence-based interventions, while remaining careful not to conclude that exclusive use of evidence-supported treatment is all that's needed.
If the most experienced practitioners in mental and physical health fields prove reluctant regarding evidence-based practice, the agencies that employ them likely will not support it either. Rubin and his co-researchers note that social workers typically work in organizations in which policies value quantity over quality. In this case, the policies themselves create an atmosphere that makes EBP difficult.