A Report on Evidence-Based Medicine Clinical Training Programs
Project Description
The Agency for Healthcare Research and Quality (AHRQ) has initiated a project whose purpose is to examine innovative clinical teaching programs that explicitly incorporate principles of evidence-based medicine (EBM) into training curricula for health professionals. While AHRQ does not fund educational research, this effort supports that part of the Agency*s mission related to translating medical evidence into practice.
One of the primary goals of EBM is to teach students to become lifelong learners, identify knowledge gaps, and take steps to fill them. EBM has been described by Sackett as a *process of life-long, self-directed learning in which caring for our own patients creates the need for clinically important information about diagnosis, prognosis, therapy, and other clinical and health care issues.* EBM has evolved into an integral part of the curriculum at institutions across the world. Some institutions have developed programs that are explicitly EBM-focused, while others have curricula that incorporate critical elements of EBM teaching yet do not refer to it as such. The current project aims to focus on both instances, and will include programs based in the U.S. and Canada.
The project will document case studies of clinical education programs that have incorporated EBM training into their curricula. The case studies will include a representative sample of different disciplines (medical, dental, and nursing) and levels of training (undergraduate and postgraduate). A final report will describe program design, curriculum, evolution, and areas of innovation.
The AHRQ officer overseeing the project is David Atkins, M.D., with the Center for Practice and Technology Assessment. Health Systems Research, Inc. is providing research support
Criteria for Case Study Program Selection
Even though there is general consensus on key elements of an EBM curriculum, there is wide variation across programs in how these are taught and how much time and emphasis is given to different steps in the EBM critical appraisal process. The current study will employ a set of core characteristics to identify programs. Emphasis will be given to programs that have had several years of experience with their EBM training curricula, programs that have integrated EBM training into multiple components of the educational experience, and/or programs where EBM training is structured longitudinally (beyond a single semester or course). The project will include programs that incorporate into clinical training those elements considered central to EBM:
Defining the problem for a specific patient in the form of an answerable clinical question.
Conducting a search for the best evidence, including an efficient literature search.
Applying the rules of evidence to determine the validity and relevance of the evidence (critical appraisal).
Extracting the clinical message.
Applying the message to the patient.
Next Steps
HSR is interested in talking with individuals in your organization who could provide us with insight into its EBM curriculum. If interested, please contact Rania Awwad by phone (202-828-5100) or e-mail ([log in to unmask]).
Rania Awwad
Health Systems Research, Inc.
1200 18th Street, NW, Suite 700
Washington, D.C. 20036
Tel: (202) 828-5100, x105
Fax:(202) 728-9469
Internet: www.hsrnet.com
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