Getting change right

Effective change is a choice

Contributor: Dr Stephen W Hart, November 2017

Its 4:00pm on a Friday. Forty of us are crammed into a meeting room that is designed for 20. Someone has placed a plate of cheese and crackers covered in plastic wrap on the table in the mistaken belief that at some point there will be a celebration. Earlier in the week, an email had gone out to all staff advising of the meeting and foreshadowing a ‘major announcement’.

There was a low mummering in the room as we waited past the scheduled meeting start time for the CEO to arrive. After 15 minutes he arrives with a bustle of self-imposed urgency. He’s followed by the usual entourage and, oh no, it’s worse than we thought – consultants in blue suits and grey pantsuits.

Thirty minutes of PowerPoint slides followed. Graphs showing decline were accompanied with the words ‘crisis’ and ‘urgency’ and the phrases ‘stop the rot’ and ‘we’re all in this together’. The initial doomsday slides were then somehow, through some sleight of hand, magically transformed into graphs that showed lines heading upwards. These slides were accompanied by the words ‘growth’ and ‘turnaround’ and phrases like ‘cost efficiencies’ and ‘realignment of focus’.

At this point the CEO had an urgent matter to deal with and handed over to the consultants to explain the detail. The consultants, who for some reason thought that smiling was the best way to engage with us on a human level, then proceeded to explain – through more PowerPoint slides – how the ‘turnaround’ would be achieved. Apparently, we were told, the solution was astonishingly clever. In addition to our usual work, we would form teams to solve the organisations’ problems. These teams, under the skilled and expert guidance of the consultants, would find ways to reduce costs and improve profits.

The consultants then handed over to the HR Manager, who at this stage was the only executive left in the room.

“Any questions?”, she asked.

It was now 4:55. The first question was: “Will there be any job losses?”. The HR Manager replied that it was still too early to tell but the company would do everything it could to avoid job losses. The second question was: “If we need to reduce costs, and 80% of our costs are labour, how can we possibly avoid job losses?”.  The HR Manager looked at the Consultants who proceeded to hand out a FAQ sheet and said, “It’s still too early to answer all your questions, but information about the improvement teams can be found on these sheets.” It was now after 5pm, bus and train timetables wait for no one and people dispersed. The cheese remained unmoved.

The scenario described above could be taking place in hundreds of workplaces across the world. Despite extensive literature and research into how to make change work, many organisations still choose to manage change poorly. John Kotter wrote his ground-breaking article ‘Leading Change: Why Transformation Efforts Fail’ over 20 years ago and yet we still get it wrong more than we get it right.

Our research of over 400 recent change experiences has shown that only 44% of the change initiatives studied have met or are on track to meet their change objectives. Only 50% of people contributing to our research stated that they continued to feel motivated and that they contributed discretionary effort during the change processes studied.

From the evidence in our data, the biggest contributors to change success comes from these three key factors:

  1. Listen to the concerns of the people who are experiencing the change and respond to those concerns
  2. Give the people who are responsible for leading the change the capability (skills and knowledge) and the capacity (time and resources) they need to get the job done
  3. Ensure the change is well planned and the implementation goes smoothly

Listen and respond to concerns

Our data shows us that most organisations typically ‘oversell’ the change. We recommend spending less time talking and more time listening and responding. Employees know the company better than most executives. Sales folks don’t need to be told that sales are down, they see it in their commissions every month. Listen to employees’ ideas and, most importantly, respond effectively to their concerns. In our research, when we looked at the change initiatives where people didn’t feel their concerns were responded to, only 11% of those change initiatives met the change objectives.

Where people didn’t feel their concerns were responded to, only 11% of those change initiatives met the change objectives

Once people become aware that a change is coming, often one of their next concerns is “How will this affect me and my job?”. It’s the question that we know is coming, that we can anticipate, but organisations continue to choose to not provide effective responses to this most predicable of concerns.

There is plenty of information and sites available that deal with effective communication and listening and responding to concerns, this article is not designed to replicate that information. The message here is to encourage (demand?) that we do a better job with change. The data gives us a compelling argument – listen and respond effectively to people’s concerns during change or risk a failure rate of 89%.

Capability and Capacity

Both capability and capacity are important for effective change that delivers on the change objectives. The people who are leading the change need the skills, knowledge, time and resources to do their job well. Too often managers are expected to add on to their responsibilities a change leadership role to an already overloaded work schedule. Whilst there is no doubt a view that ‘leading change is the job’, the reality of modern workplaces means that managers are being asked to do more with less – something has to give.

Organisations can choose to invest in the capability and capacity of their change leaders, or not. The consequences are that they are also choosing to achieve their change objectives, or not

Only 28% of the change initiatives we studied identified that the people responsible for leading the change had both the capability and capacity to be effective. In the cases where leaders did have effective change capability and capacity, however, 85% of those leaders’ change initiatives met or were on track to meet the change objectives. The skill, knowledge, time and resource investment provided an exceptional return.

Organisations can choose to invest in the capability and capacity of their change leaders, or not. The consequences are that they are also choosing to achieve their change objectives, or not.

Planning and Implementation

Effective planning and implementation of change are also crucial factors. In the over 400 change experiences that we studied, only 26% evidenced effective planning and implementation. Where there was effective planning and implementation, 86% of those change initiatives met, or were on track to meet, their objectives. In many cases it was reported that if there was a plan, it wasn’t transparent to the people involved in the change process.

Again, there is plenty of information and sites available that deal with effective change planning and implementation, this article is not designed to replicate that information. The evidence compels us, however, to choose to plan well and implement well if we want to achieve our change objectives.


I recently asked on a twitter post for people to complete this sentence: “Introducing a new organisational change using the same failed approach as the last change is ………. “. One of the responses was “something we see every day” and another was “the definition of organisational insanity”. Despite over 20 years of strong evidence on how to lead change more effectively, most organisations still choose to do it poorly.

What would happen if organisations listened and responded to their people during change, gave their change leaders the knowledge, skills, time and resources to lead change and those leaders then planned and implemented the change effectively? When all of those factors are present, our data tells us that change objectives are met 93% of the time. Equally importantly, when all of these factors are present, 100% of people involved in those change processes report that they continue to contribute discretionary effort during the change, 96% report that they remain motivated and 100% report that they feel positive about the future.

We know how to lead change effectively, it’s a choice that evidence compels us to make.


Leading change? Trust me, I know what I’m doing

Trust 1

Contributor: Dr Stephen W Hart, May 2017

Trust in our leaders has been shown to have a direct relationship to our job performance, organisational commitment and job satisfaction1. What specifically, however, is the relationship between the trust we have in our leaders and the effectiveness of organisational change? This article uses an evidence-based approach to, firstly, present data that illuminates the relationship between trust and achieving workplace change objectives. We then draw upon expertise to provide interpretative analysis of the findings from the data. Finally, guidance for practitioners is offered by exploring how to maintain and sustain trust throughout the process of workplace change.

A recent article in Forbes2 states that 63% of employees do not trust their CEO. The author of the Forbes’ article declares that ‘trust is toast’. What are the implications for workplace change in an environment where there is a crisis of trust – Is trust a key factor to consider when leading workplace change? Our research says that it is.

Analysis of the responses to our Workplace Change Survey shows strong relationships3 between trust in the people leading change and the indicators of successful change outcomes.

When asked if they trusted the people leading the change process that they were participating in, 48% of our respondents reported that they trusted their leaders whilst 29% did not trust the people leading the change that they were experiencing (please refer to Diagram 1).

diagram 1

Trust and outcomes

So, is it a big deal if people don’t trust the leaders of change? There is a strong relationship in the data between trust and whether people believe a change will meet its objectives. If trust is low, then the achievement of objectives is reported as low, if trust is high, then achievement of objectives is high (for stats geeks, r = 0.65).

Our data also shows a strong relationship between trust in the leaders of change and whether employees are motivated and feel positive about the future.

Trust and process

Diagram 2 below shows all of the factors of change where there is a strong relationship with trust in the leaders of the change (r > 0.6). Our data has also shown a strong relationship between trust in leaders and:

  • the perceived capability of those leaders
  • whether people feel their concerns are responded to
  • that the change is well planned
  • that the change progresses smoothly

diagram 2

Implications for practice

There are several implications of these findings for change practitioners. An effective change process needs to be led by capable leaders. In particular, leaders who have the capabilities required to respond effectively to the concerns of the people whilst also being able to plan and manage the change process well. Whilst this may seem obvious, our data shows that evidence for leaders having this complete combination of factors is only demonstrated in 22% of the 432 change processes studied.

Organisations need to ensure that they are placing the responsibility for leading change in the hands of capable leaders. If organisational change capability is lacking, they need to ensure that the organisation is ‘change ready’ by building the leadership capability required to support the change effort. Capable leaders then have the responsibility to ensure that they demonstrate that capability by responding to the concerns of their employees and planning and managing change effectively.

Building leader capability

‘Despite all the noise and rhetoric about resistors, perhaps the greatest saboteurs of change are organisations themselves, through their lack of investment in building comprehensive change capability.’

Leaders who are trusted are highly capable. They have the skills and knowledge required to lead change effectively. They know what they’re doing. Organisations have a role to play in ensuring that their leaders have the capabilities required to lead change. It has been known since the 1960s that leadership requires both task and relationship capability4 and yet we continue to see change programs that focus on building one of these aspects of change capability – relationship or task – but rarely both. In fact, through the 1990s to this decade, there has been a shift towards relationship factors of change capability building. Our data shows that we are now better at relationship factors of change, such as responding to concerns, than the technical aspects of planning and implementing change (please refer to Diagram 3) – although improvement is clearly required in both areas. A balanced program of change capability building is required in both relational factors and task factors. Despite all the noise and rhetoric about resistors, perhaps the greatest saboteurs of change are organisations themselves, through their lack of investment in building comprehensive change capability.

diagram 3



  1. Dirks, K., Ferrin, D. (2002) Trust in Leadership: Meta-Analytic Findings and Implications for Research and Practice. Journal of Applied Psychology, 2002 August, 87 (4), 611-628
  1. Comaford, C. (2017) 63% Of Employees Don’t Trust Their Leader — Here’s What You Can Do To Change That, Forbes,
  2. Evans, J. (1996). Straightforward statistics for the behavioural sciences. Pacific Grove, CA: Brooks/Cole Publishing
  3. Blake, R. Mouton, J. (1964). The Managerial Grid: The Key to Leadership Excellence. Houston: Gulf Publishing Co


Why aren’t you engaging women in your workplace change?



Is there a change initiative underway in your organisation? Is it gender inclusive? – our research says that it’s probably not.

We’ve studied over 200 change initiatives across more than 30 countries and we’ve found that women, compared to their male colleagues, have less access to information (-7.3%), less influence (-5.2%) and less opportunity to be involved (-4.0%) in workplace change.

If women are less involved and are less able to influence change, then they are excluded from opportunities and future positioning in the post-change organisation.

The fact that there is a gender gap in our approaches to workplace change perhaps shouldn’t be surprising – gender inequality permeates all aspects of our workplaces – what is surprising is that it is not acknowledged more widely. When we thought carefully about this, we came to the conclusion that we’re not aware of any workplace change plan that we’ve seen that includes a specific inclusion strategy.

Workplace change can be a time of uncertainty and anxiety but it can also be a time of opportunity as new roles open up and new directions are forged. If women are less involved and are less able to influence change, then they are excluded from opportunities and future positioning in the post-change organisation.

The chart below shows the responses by gender averaged for each of the questions asked in our workplace change survey. Female respondents have reported lower ratings for all of the questions (except for feeling positive about the future). They report, compared to their male counterparts, that they have significantly less access to information about changes (-7.3%), feel that they are less able to influence change processes (-5.2%) and feel they have less opportunity to be involved in change processes (-4.0%). Female respondents have expressed greater concerns about the capability of those leading the change (-7.5%) and also about whether the change will meet its’ objectives (-3.6%).  The most significant difference between the genders is the perception of whether change milestones are being celebrated (-12.5%). Despite these barriers to involvement, women are still more likely to be positive about the future (+2%), perhaps pointing to greater resilience.

Gender Perspectives

As leaders and influencers of change we need to ensure we take responsibility to engage our entire workforce with our workplace change efforts. To address the identified gender inequality in workplace change we need to:

  1. Ensure our change communication is gender inclusive
  2. Ensure women are equitably represented in our project governance
  3. Act to ensure women are involved and engaged with workplace change

Ensure our change communication is gender inclusive and accessible

There is (hopefully) a lot of communication that flows in times of change, some formal and a lot that’s more informal. How accessible is that communication to women? If there are formal meetings, do women feel empowered to leave their desks or workstations to attend, or are they left behind to answer the phones or ‘man’ the counter to minimise service disruption. If there is formal written communication, has it been checked for gender inclusiveness.

Inclusiveness in informal communication is particularly challenging. Do we ensure that women are included in our informal discussions on change, in corridors, lift wells, coffee shops and bars. So much of our change communication is through informal means and we need to ensure women are included in those conversations.

Ensure women are equitably represented in our project governance

Involving women in our workplace change initiatives means involvement at every level. What is the gender representation at the highest level of change governance for your workplace change initiative? Do women have a genuine voice in decision making and in setting strategic change direction? Ensure women are represented at every level of change governance and that they have an equal voice.

Act to ensure women are involved and engaged with workplace change

Some practical, actionable steps you can implement immediately:

  • Review your change project governance representation and address any inequity
  • Check your change communication for gender bias through the use of gender decoders such as this one from Kat Matfield
  • Run the Workplace Change Survey and analyse for gender differences so you have access to real-time data for your workplace change initiative

The question is not whether there is gender inequity in workplace change, the question is what are we collectively going to do about it now that it has been exposed through research.



Change is a risky business

The language of business is often framed in terms of value contribution and opportunity vs risk. As leaders and practitioners of change we need to ensure that we align with this lexicon when discussing our approach to leading change in organisations. The purpose of most change efforts is often to increase organisational value in some substantial way. There is inevitably, of course, always also risk involved that needs to be managed. What is often overlooked (or papered over) when presenting our change initiatives for endorsement are the risks associated with change initiatives and presenting those risks in a transparent way.

Risk impact is typically assessed through a risk matrix by considering likelihood and consequence.

Risk Matrix

Whilst the actual failure rate of organisational change initiatives is open to conjecture (see David Wilkinson’s ‘Common Myths of Organisational Change’) a good predictor of future success may be found in past performance. How effective have recent change initiatives been in your organisation? If we are honest with ourselves, many of us may assess the risk of the Likelihood of our change effort failing, based on past performance, as being at least ‘Possible’, possibly ‘Likely’ and even perhaps ‘Almost Certain’.

The Consequence of the change failing to meet its objectives will depend on the change initiative being undertaken. For a major organisational change effort, we are most likely to be facing at least a ‘Major’ consequence for the organisation if the change completely or partially fails.

Therefore, when looking at the risk profile of major organisational change, the evidence suggests to us that in many organisations we are facing a risk assessment of ‘High’ to ‘Extreme’ for our change initiatives.

Such an honest assessment is rarely found in initiative proposals. Benefits are often highlighted and risk often underplayed – despite the evidence of our past performance. The consequence of underplaying the risk, however, is often to our detriment and may lead to negative outcomes for our organisations and our people. We often lament that ‘management’ doesn’t provide enough support for the change initiative and/or do not engage, consult or involve our people sufficiently. Perhaps though, as leaders and managers of change, this lack of support and engagement is of our own making as we neglect to talk about the risky business of change.

The opportunity that presents itself when we talk more transparently about the ‘High’ to ‘Extreme’ risk of organisational change is that we can also talk about appropriate Risk Treatment. Risk Treatment specifies the options and actions that we can put in place to mitigate risk.

The good news is that there is evidence that points us to effective treatment that can mitigate the risk associated with organisational change.

Whilst the overall risk assessment may be ‘High’ or ‘Extreme’, we can break down the factors of risk and identify the mitigation strategies. For example:

Risk Mitigation

The mitigation strategies for each specific change will be dependent on the organisation and context. Once identified, however, these strategies can be costed in terms of time and resource. You may find that managing the risk associated with your change effort may come at some significant cost. It is a cost, however, that is necessarily required to mitigate the risk and the Risk Treatment can be justified through evidence.

Is it acceptable to your business, for example, to invest $500,000 to mitigate the ‘High’ to ‘Extreme’ risk associated with an initiative that has the potential to add $5M of value to the business?

By adopting the language of business and positioning our organisational change strategies as legitimate, evidence-based risk treatment, our change practice can add value to both our people and our organisations.

Contribute to the Workplace Change Project by completing the Workplace Change survey The link to the survey and to share with your colleagues is here:

Relationships in change

imageThrough this series of posts we are trying to tell a story of change through a deeper understanding of evidence and the interpretative analysis of data using practitioner expertise. One helpful lens through which to view data is the use of correlations that expose relationships between factors. We’ll place a cautionary note early that correlation does not show causation and suggest that you read this excellent article from the future work centre about the caution required when viewing data.


Relationships in Change


The relationship diagram shown here has been generated through analysis of the data coming from the Workplace Change Survey (results from the survey have already been presented in a previous post). The diagram on the left shows the relationships between the factors in the survey as exposed through correlations.

In the relationship diagram, the thicker yellow lines show a very strong positive relationship, the thinner lines show a strong positive relationship1.



Correlations show if there is a relationship between variables in data. In the example shown on the right, where people reported that they felt that their concerns were being responded to, they were also likely to have reported that they felt that they were being listened to. Conversely, if they felt that their concerns weren’t being responded to, they were also likely to have reported that they weren’t being listened to.


Interpretative Analysis

What follows is our interpretative analysis from the perspective of our experience and expertise. It is quite legitimate that you may have an alternative view and we welcome your insights and perspectives. Your contributions will add richness to our collective wisdom.

People who reported that they thought that the objectives of the change were being met also reported that they received relevant information about the change, that their concerns were listened to, their concerns were responded to, that change planning and implementation was effective and that milestones were celebrated.

Positive feelings were associated with receiving relevant information, concerns being listened to, that change planning was effective, that they were able to influence the change process and that the change was meeting its objectives.

As change practitioners, we frequently advocate for greater, more meaningful communication throughout change processes. The data points towards the significance of listening, responding, and involving people in change processes if we want to achieve our change objectives and maintain the positivity of our people. Effective planning and implementation appears to be equally important and are complimentary to engaging our people in the change effort.

Change practitioners may look at this relationship diagram and shrug their shoulders – ‘of course, we know this’. We may know this through our expertise but there is now additional evidence through the data that supports our wisdom.

We will purposefully restrain from further analysis and interpretation at this point to allow collaborative input and for you to share your insight from your expertise in the comments area.


Stats stuff



n=189; N>20,000; E=6%; c=0.9





1Correlation ‘strength’ is based on Evans’ (1996) suggestions of r: · .00-.19 “very weak” · .20-.39 “weak” · .40-.59 “moderate” · .60-.79 “strong” · .80-1.0 “very strong”.  Evans J. D., 1996, Straightforward statistics for the behavioral sciences. Pacific Grove, CA: Brooks/Cole Publishing


It would be great if you contribute to the data collection. The link to the survey and to share with your colleagues is here:



Change by the numbers

We have been running our Workplace Change survey for some weeks now and, although the survey is still open, we have decided to release some early data based on the responses received to date. The respondent characteristics are detailed below but it is useful to note here that they were from a broad range of organisations across a number of countries. Respondents to the survey were asked to report on a change process that they are currently undergoing or have recently participated in.

Workplace ChangeThe graphs on the left show the distribution of the responses and builds a picture of areas of strength and areas for improvement in our current approach to workplace change. It can be seen that there was strong agreement from the respondents that they were both clear about the reasons for the change and that they also agreed that the change was necessary. This early ‘buy-in’, however, was not capitalised upon by the leaders of the change processes and the respondents reported mixed results with regards to their concerns being listened to and being responded to.

There was a very strong relationship in the data between people’s perception that their concerns were being responded to and their confidence that the change would meet its objectives. That is, where people rated highly that their concerns were being responded to, they also rated highly their confidence that the change would meet its objectives (correspondingly, if the response to concerns was poor, confidence in meeting objectives was also poor).

The respondent’s perception of the planning and implementation associated with the change they were experiencing was mixed and the celebration of milestones was particularly poor and the lowest rated factor.

The view of the respondents that most of the change efforts that they were participating in will not meet the change objectives should be of concern. Despite this factor being common knowledge over many decades now (that most change efforts fail), it appears that we still have a significant path to travel to improve organisational (and individual) outcomes through better change practice.

How to use the data

The data confirms much of what we may have considered to be ‘known’ to us as leaders and practitioners. This practice knowledge can now be verified in the data from the survey and should give leaders and practitioners confidence to advocate for improved approaches to workplace change from an evidence base. The emphasis that is currently being placed on obtaining ‘buy in’ needs to be maintained but we also need to follow through with good change leadership practice to ensure that organisational objectives are met and that people feel engaged and more positive throughout the change process.

You may like to run the survey ‘in-process’ whilst undertaking your own change effort, please let us know. You will be able to compare your organisation’s change effort to this benchmark data and identify areas of strength and areas for improvement that will enable you to adjust your approach if necessary. Please note that the workplace change project does not charge for the use of the survey, however, there are limits to the support we can provide. We do ask that if you use the survey that you share your data (de-identified) with us to enable us to generate a greater data pool for analysis and benchmarking. This enhanced analysis will in turn be shared back with practitioners and leaders. Contact us for more information.

Share the link

The more data we have, the more useful the analysis. Please share the survey link with colleagues and ask them to contribute. If you are reading this article and have not yet completed the Workplace Change survey, please do so:

What’s next

We are currently looking at the correlations between the survey items and the corresponding relationships in the data. Keep an eye on this page as we will release this information in the coming weeks.

Stats stuff

Demographicsn=147; N>20,000; E=6.8%; c=0.9; Population sample characteristics: Gender 43%m/57%f; Location – Australia, New Zealand, UK, USA, Canada, Europe, South America, Middle East, Asia; Respondents were people from across a broad range of organisations in the public, private and not-for-profit sectors who are currently or who have recently experienced a change process.

Evidence Based Practice in Workplace Change

evidenceMy social media feeds are filled with posts that declare the solutions to almost all of my organisational and personal problems in seven or less easy steps. Apparently there are 4 steps to leadership; 7 keys to successful change implementation and a particular favourite – 14 bizarre sleeping habits of super successful peoplea. I think the proposition in the last example is that if I sleep in a sound-proof ‘snoratorium’ that I will be transformed into a super successful person. These posts have one thing in common, they don’t provide any real evidence that support their claims.

In this post, I’ll invite you to consider whether evidenced based practice (EBP) can be adopted as a more helpful approach when developing strategies to guide and inform workplace change efforts.

Evidence based practice (EBP) is best known as an approach to patient care and is used extensively in clinical settings. A frequently quoted definition of evidence based practice in medicine has been provided by Sackett1 who describes EBP as ‘the conscientious, explicit and judicious use of current best evidence in making decisions about the care of the individual patient’. Represented diagrammatically in Figure 1, it can be seen that evidence based practice occurs when clinicians apply their expertise to consider the best approach to patient care taking into account research evidence and the needs and preferences of the patient.


Figure 1: Evidence Based Practice in Healthcare2

The concept of evidence based practice has been extended to other disciplines including management3 and the proposition put forward in this article is that it can also be applied to the practice of workplace change (please refer to Figure 2).


Figure 2: Evidence Based Practice in Workplace Change

Figure 2 shows that Evidence Based Practice in Workplace Change only occurs when an approach to change consists of the application of expertise, using best evidence relating to organisational change, in consideration of organisational context.

Exploring each of these terms a little further:

Change expertise: Just as you would want to have a highly skilled and experienced clinician to manage your healthcare needs, EBP-WC requires highly skilled and experienced change practitioners to apply their expertise to the change process. The ‘change practitioner’ in EBP-WC may be leader/s from within the organisation and/or specialist change practitioners either from within or from outside of the organisation.

Organisational context: The expertise must be applied taking into account the values and preferences of the organisation, that is, the organisational context. Within that organisational context, the values and preferences of the workforce, customers and other stakeholders need to be taken into account.

Evidence: Perhaps the most challenging question that confronts EBP-WC is “What constitutes best evidence in workplace change?”. Identifying high quality evidence relating to workplace change is difficult and, just as in medicine4, much of what is available needs to be carefully analysed for bias and selectivity.

In future articles the concept of EBP-WC will be explored further, both in terms of its construct and also its application.


Contribute to the workplace change project – complete the Workplace Change Survey


1Sackett, D. (2002) Evidence-based Medicine: How to Practise and Teach EBM. London, Churchill Livingstone

2Duke University Medical Centre. (2016) What is Evidence-Based Practice (EBP)? Retrieved from:

3Pfeffer, J. and Sutton, R. (2006) Evidence-Based Management. Harvard Business Review, Jan 2006

4Every-Palmer, S. and Howick, J. (2014) How evidence-based medicine is failing due to biased trails and selective publication. Journal of Evaluation in Clinical Practice 20 (2014)


a  The first two titles are fictitious but represent many such articles that come in to my social media feeds, the third title, perhaps unfortunately, is real