In 1996 I attended a course at McMaster University on Problem-Based
learning. Part of the learning process required participants to find and
appraise information to address the "learning issues" which emerged from
the PBL process. It was a bit early for EBM to be the focus of the
literature searches. But the principles apply. Group members all agreed
that the searching and appraising of information when related to a specific
problem was a more satisfying process than learning these skills in
isolation. The information that was found to address the "learning issues"
varied greatly in quality, as did the processes for searching and
appraising it by each group member. Being a librarian I was able to comment
and advise on the sources of information, searching techniques, quality
indicators etc. All of the group members agreed that the "integration of
information skills" into the learning process be recommended, with
supportive "lectures" dealing with gaps in knowledge and more complex
issues.
I believe this model could be applied to the acquiring of EBM skills.
NOTE: The group members came from a variety of countries, and included
doctors, nurses and other health professionals.
Sheelagh Noonan BA Dip Lib
Medical Knowledge Architect
AusDoctors.net
Phone: 02 9966 9797
Fax: 02 9906 3821
email: [log in to unmask]
http://www.ausdoctors.net
David Birnbaum
<[log in to unmask]> To: [log in to unmask]
Sent by: "Evidence based cc:
health (EBH) is the Subject: Re: REGARD FROM PERÚ!
integration of individual
knowledge"
<EVIDENCE-BASED-HEALTH@JISCM
AIL.AC.UK>
05/09/01 11:53 PM
Please respond to David
Birnbaum
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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