The simple fact is that the secondary literature, although large, still scarsely covers the range of clinical questions.
I run 2 Q&A services for primary care (www.attract.wales.nhs.uk and www.clinicalanswers.nhs.uk) and we've examined what resources were used in our answer. In two separate evaluations (on the different services and 18 months apart) the number of questions that could be answer solely by secondary material was 21%.
Cheers
jon
Dear All,
I agree with the comment about EBM teaching moving forward.
I have developed an EBM teaching programme for a graduate entry course. They are training to be users of EBM (at the moment) so it made sense to start with how to find relevant material. Hence we decided to start with consideration of evidence-based guidelines and other ready appraised sources, eg Clinical Evidence. There is now a wealth of ready appraised sources so why expect clinicians to search primary literature? Would they change their practice based on a single study found after a search in Medline?
We have very limited teaching time for EBM so confine this to teaching a few points about interpreting NNTs and sensitivity/specificity for example, which are clinically useful (rather than say, the finer points of type 1 errors). Critical appraisal is extremely important for researchers and specialists and those who are developing policies, but I wonder how necessary this is in order to access ready appraised literature that can be applied immediately? (or is that a sacrilegious comment?)
Incidently we also include our medical librarian in our teaching sessions and she offers appropriate IT training if required. I'd be interested to know if others use this strategy.
Elaine Bentley
-----------------------------------------
Email provided by http://www.ntlhome.com/
|