Evidence-based practice, the magic words that I have been hearing buzzing around for the last 10 years.\u00a0 \u201cIs your work evidence-based?\u201d\u00a0\u00a0 \u201cWe have to work evidence-based, otherwise……\u201d<\/p>\n
I heard it from physical therapists, doctors and sport scientists.
\nAs a coach my reply to the first question was:\u00a0 \u201cno, definitely not\u201d, and to the second one: \u201cI don\u2019t have to do that, and I am grateful for that……\u201d
\nAnd no, I am not hiding behind the often heard statement of coaches that \u201ctheir evidence is in their medals or victories of their athletes and teams\u201d.<\/p>\n
A long time ago I used to have a colleague who was very good coach. He decided to go and study exercise physiology. A few years later he came to the track and questioned the idea that I was trying to increase the ATP and CP levels and the activity of the related enzymes in the muscles of my sprinters. Not a lot of research has been done in that area. And I answered him: \u201cLook, my athletes need to be trained now.\u00a0 I just can\u2019t wait until everything is proven by science, but if you want to do the research and tell in 5 years\u2019 time\u00a0 that I was right, please go ahead…..\u201d.<\/p>\n
Most coaches aren\u2019t directly interested in the mechanisms behind the improvement of their athletes. They know, they assume, they have learned from reality that it works, at least for some of their athletes. Most of the time they find out by accident, by copying other coaches\u2019 programs or by trial-and-error.
\nCoaches are always under time pressure, there is always a short-term goal to accomplish, a tournament, a championship within the next weeks or months. They are not interested in generalized research that hardly applies to their specific athletes, research derived from basic science, from test tubes, rats or sport students.
\nIn many cases coaches see little value to be derived from science with its myopia, its models, its simplifications of the real world and its singular variables.
\nAnd in the short term they are right: science and coaching have different agendas, different goals, and different time frames. But in the long-term, coaches should be interested in science in order to improve their knowledge and understanding of their field, otherwise they can be blamed for myopia, and relying on simple models and singular variables like medal counts.<\/p>\n
Ok, let\u2019s talk about evidence, but what is the value of evidence
\nNowadays it is hard to find consensus on a specific subject or an intervention, especially when there are so many limitations to research: e.g.\u00a0 the effects of an intervention in the short-term e.g. a few weeks of intervention in research,\u00a0 but not in the long-term e.g. the career of an athlete.
\nOr the value of research coming from the average athlete or sport student, applied to the elite athlete, the genetic freak that you happen to coach.<\/p>\n
But anxiety, uncertainty, insecurity and the fear to take responsibility seem to have become the markers of modern society.\u00a0 We love evidence-based, protocols, prescriptions, simple and clear-cut solutions for complex problems. So if it fails we can say:\u00a0 \u201cwe followed this protocol, so …..\u201d. In other words, you learn not to think and be critical, not to have your brain work out a creative solution yourself. Yes, there is safety in numbers.<\/p>\n
Evidence-based is also leading to lack of creativity, and to slowing down of innovative thinking. Innovative solutions don\u2019t carry much evidence, otherwise it wouldn\u2019t be innovative. Evidence based practice creates marginally effective interventions or training, and is based on population averages instead of individual needs.<\/p>\n
Evidence-based practice, while it started off with good intentions,\u00a0 is in crisis. It is an illusion to think that all of our decisions and actions can be based on rational evidence only, especially in medicine, where anything that was not based on randomized, double-blind, placebo controlled trials would be viewed with suspicion.
\nSmith and Pell in their article gave a good example of the fact that there has never been a thorough research done on the effectiveness of the use of a parachute, while jumping out of a plane, compared to not using a parachute.<\/p>\n
Literature:
\nSmith, G.S.C;\u00a0 Pell, J.P: Parachute used to prevent death and major trauma related to gravitational challenge: systematic review of randomised controlled trails; Br.Med.J. Vol.327, pg.1459-1461.<\/p>\n
Williams, D.D.R; Garner, J: The case against \u201cthe evidence\u201d a different perspective on evidence-based-medicine; Br.J.Psychiatry; Vol.180, 2002, pg.8-12.<\/p>\n
Greenhalgh, T; Howick, J; Maskrey, N: Evidence based medicine: a movement in crisis? Br.Med.J. Vol.348, g3725, 2014, pg.1-7.<\/p>\n","protected":false},"excerpt":{"rendered":"
Evidence-based practice, the magic words that I have been hearing buzzing around for the last 10 years.\u00a0 \u201cIs your work evidence-based?\u201d\u00a0\u00a0 \u201cWe have to work evidence-based, otherwise……\u201d I heard it from physical therapists, doctors and …<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-858","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/helpingthebesttogetbetter.com\/index.php?rest_route=\/wp\/v2\/posts\/858","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/helpingthebesttogetbetter.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/helpingthebesttogetbetter.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/helpingthebesttogetbetter.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/helpingthebesttogetbetter.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=858"}],"version-history":[{"count":2,"href":"https:\/\/helpingthebesttogetbetter.com\/index.php?rest_route=\/wp\/v2\/posts\/858\/revisions"}],"predecessor-version":[{"id":860,"href":"https:\/\/helpingthebesttogetbetter.com\/index.php?rest_route=\/wp\/v2\/posts\/858\/revisions\/860"}],"wp:attachment":[{"href":"https:\/\/helpingthebesttogetbetter.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=858"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/helpingthebesttogetbetter.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=858"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/helpingthebesttogetbetter.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=858"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}