Diana Rodriguez posted:
>Dear Members List:
>Thanks for your previous answers.
>Now, I would like to know your opinion about the importance to teach E.B.M
to students of >the schools of Medicine.
>Is it important as a subject in the curriculum at the Pre-grade level?.
>Should the Professors teach the courses using the instruments that E.B.M
preconize ?
>I would like to know what is happening in your countries about it.
>Thanks in advance
Papers like "Effectiveness of instruction in critical appraisal
(evidence-based medicine) skills: a critical appraisal" (Norman GR, Shannon
SI, CAN MED ASSOC J 1998;158:177-81) suggest that the largest gains in
knowledge occur when teaching is at the undergraduate rather than residency
level, but that evidence showing impact on application in practice is
sketchy. Another paper worth looking at is the critical review by Hyde,
Parkes, Deeks & Milne at http://www.bham.ac.uk/arif/SysRevs/TeachCritApp.pdf
. I believe in teaching these skills and habits to all health care
professionals as early as possible (my courses have involved student nurses,
dietitians, and administrators among others), and through self-directed
learning exercises rather than just lecture or prefabricated examples, but
also recognize that we're guided more by belief than evidence of real
effectiveness at this point. Perhaps that's all that can be expected in the
early stages of building a culture, and not unreasonable so long as we seek
direction through external evidence as well as self-evaluation along the
way.
David Birnbaum, PhD, MPH
Clinical Assistant Professor
Dept. of Health Care & Epidemiology
University of British Columbia, Canada
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