Healthcare and Medicine Reference
can make independent assessments of evidence, and thus evaluate the
credibility of opinions being offered by experts. The decreased emphasis on
authority does not imply a rejection of what one can learn from colleagues
and teachers whose years of experience have provided them with insight.
A final assumption of the new paradigm is that practice based on an under-
standing of the underlying evidence will provide superior practice.
American Medical Association Evidence-Based Practice
Working Group (1992, p. 2421)
An example of searching for best evidence is the problem we often
have in supervising workers with high degrees of education and a belief
that what they do is generally well done. These workers often feel that
they need considerable autonomy and that management is intrusive. How
do we supervise workers who are sometimes antagonistic to the entire
idea of supervision? And won't management lead to conflict with the
supervisor and disenchantment with the organization? After all, turnover
in the human services is no small problem.
Davenport (2005) studied more than 100 companies and 600 individual
highly educated and competent workers. Davenport concluded that the
old dictum of hiring smart people and leaving them alone wasn't the best
way to get the most out of workers. Rather, he concluded that, while knowl-
edge workers can't be managed in the traditional sense of the word, managers
can intervene, but not in a heavy-handed or hierarchical way. Davenport's
conclusion is that knowledge workers need to be handled with a light touch,
but that they also need work-related rules and policies as well as behavioral
expectations and measurements to evaluate performance. Not all knowledge
workers are the same, and the assumption that they are, Davenport says, leads
to under-management, which may result in reduced performance.
2. Use of Management Research and Best Evidence
Competency-based management emphasizes the critical role of best evi-
dence in making supervisory decisions. Best evidence is generated by
high-quality research data, but when practice wisdom exists and it has
been shown to be effective over time, best evidence may also include
practice wisdom. Timmermans
competency-based practice has five important features, as follows.
It is composed of both research evidence and practical experience.
There is skill involved in reading the literature that requires an ability
to synthesize the information and make judgments about the quality
of the evidence available.
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