This informal seminar will be given by Nick Axford and is open to University staff and students.
In fields such as aviation, learning from failure to achieve desired outcomes is an embedded process intended to optimise performance. In health and social care, by contrast, there can be a tendency to cover up or explain away such events.
We see evidence of this behaviour in prevention science when trial results are null or negative. Examples include not publicising findings, conducting spurious sub-group analyses or attributing the outcome to real or perceived weaknesses in trial design or execution. This is unhelpful for several reasons, not least that it contributes to research ‘waste’, undermines respect for science and potentially stifles risk-taking innovation.
This discussion paper describes, with examples, common responses to finding that an intervention does not work or causes harm, such as dismissing the results, decommissioning the intervention, continuing as usual in the absence of a better option, viewing the results in the context of findings from other trials (of the same or similar interventions), and adapting the intervention and testing those adaptations. It argues that the nature of each stakeholder’s response is affected by considerations such as the nature of the ‘failure’, how much they have invested in the intervention (financially, psychologically, politically and organisationally), the extent to which they accept the trial findings (and the need for the evaluation in the first instance) and whether they buy into the evidence-based practice paradigm.
The paper puts forward a series of strategies to promote a more open and honest approach towards trials of interventions that show either no or harmful effects. These strategies are categorised as ‘pre-empting’, ‘preparing for’, ‘acknowledging’ and ‘responding to’ such findings. The paper concludes by arguing that the real failure in prevention science is a failure to learn from and address disappointing results.
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