I recently completed the Practice EBM course in the company of a diverse group of professionals including physicians, dentists, physiotherapists, and researchers with varying levels of experience in evaluating and conducting research. Having previously completed an intense Masters in Health Services Research, I came to the group as a new DPhil student confident in my solid training foundation and reasonably good critical appraisal skills. I participated in the course to refresh my knowledge and to prepare to teach components of a similar course in the future.
I got more than I bargained for. I learned 3 principles of EBM: use it or lose it, practice makes perfect, and be more critical.
1. Use it or lose it.
It is challenging for graduate students (and working professionals) to stay current and retain a solid knowledge base given the wide range of essential information needed to interpret and evaluate different types of studies. Continuing to develop and reassess foundational knowledge is vital for maintaining a high level of achievement and productivity. Staying at the top of your game requires ongoing training and practice.
The EBM course covers all the fundamentals and the instructors teach clearly and carefully. Although I experienced a few moments of panic, briefly forgetting the exact definitions of sensitivity and positive predictive values that I worked so hard to learn in my Masters was one such example, I walked away greatly relieved as the course helped me re-establish the core concepts of randomized controlled trials, diagnostics accuracy studies, and systematic reviews and meta-analysis.
2. Practice makes perfect.
Critical appraisal is rooted in the basics, but also requires running through examples with the experts. A strong analytic perspective is necessary to think through the implications of different issues on the validity of study results and the quality of the evidence. One benefit of the EBM course is the efficient teaching of the basics with clarity and enthusiasm, but a distinct advantage is the opportunity to develop an analytic perspective through practice with the analytical experts. This is a key to critical appraisal and it cannot be gleaned from the pages of a book.
3. Be more critical.
After six and a half years, 78 months, 2340 days of research-focused University education I’m analytical, but not critical enough. Although the entire 3-day course encourages critical thinking, the tipping point, for me, occurred when a course instructor reviewed several news articles that had misinterpreted research findings. The high-profile articles would certainly have impacted upon public perception and behavior, but the instructors contacted the news agencies to point out their shortcomings by clearly explaining the findings of the original research studies. What happened next was refreshing and significant: the news stories were promptly changed. While this is not an appraisal of evidence, it’s an example of how practitioners and advocates of EBM are capable of using the skills they’ve practiced to understand research and convey the best available information.
Now I’m eager to do the same. I’m ready to question research evidence and make sure it is not misrepresented or misinterpreted and, after refreshing my knowledge and practicing my skills, I might be better prepared than I think.