EBM for clinical years:

Evidence-Based Medicine for clinical years: Sep 13th 2016

Professor Carl Heneghan

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imagesThis talk is a 45 minute introduction to EBM for medical students, setting out why EBM is important and vital to becoming an effective clinician. The talk sets out different evidence and its importance to  decision making: from expert opinion  through to systematic reviews, using key examples for each of these scenarios. Highlighting “a 21st century clinician who cannot critically read a study is as unprepared as one who cannot take a blood pressure or examine the cardiovascular system.”  (BMJ 2008:337:704-705).

Building on the importance of EBM, and how to embed this as early as possible in the learning of the student, it further emphasizes the significance of EBM by pointing out the requirements in the GMC’s “Tomorrow’s Doctors” guidance relating to evidence-based practice. These are:

  • Be aware that treatment options should be based on clinical need and the effectiveness of treatment options, and that decisions should be arrived at through assessment and discussion with the patient
  • Must be aware of their responsibility to maintain their knowledge and skills throughout their careers.
  • Students are expected to keep up to date and to apply knowledge necessary for good clinical care.

The talk then discusses the steps of EBM:

  1. Ask a focused question.
  2. Track down some evidence
  3. Critically appraise evidence for its validity and effect
  4. Apply the evidence in practice

And then how to ask a general and a specific question about patient care; introducing PICO for the first time:

  • Specific Questions ask questions about actual  patient care decisions and actions
  • General Questions ask question about  a condition. These types of questions typically ask who, what, where, when,

Finally, the Heart Attack example points out some of the major changes that have occurred in the evidence-base in this area since I qualified. Further emphasizing the need for keeping up to date. The Rosiglitazone example shows how years previous to its withdrawal, by keeping up to date and through simple appraisal skills, some clinicians were aware of the benefits and the harms and therefore not routinely recommending it whilst others were. Finally, the talk links to the COMPAre tracking switched outcomes project, which is an example of how medical students can get involved in some of the CEBM’s research projects.

If you have any examples of how to enthuse and kick of a session better – the hook – then please leave a comment and I’ll get back to you.

Download the pdf of the talk


One comment on “EBM for clinical years:

  1. Pingback: Níveis de Evidência Científica | Ineodoc

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