Hello,
I agree that we need another step before "step 1: Translation of uncertainty to an answerable question".
In Norway, we teach our students that step 1 is to identify your information need; asking them to reflect on "What do you need more information about?", What information do you already have about this clinical issue?", "What is usual practice (today) concerning this issue?". I guess this is equivalent to "step 0" that you already mention in the Sicily Statement:
"Indeed, the most difficult step (sometimes dubbed
"step 0") is to get students and colleagues to recognise and
admit uncertainties."
Perhaps this step should be step 1?
Best wishes
Nina Rydland Olsen
PhD student
Centre of Evidence-Based Practice
Bergen University College, Norway
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Fra: Evidence based health (EBH) [mailto:[log in to unmask]] På vegne av Piersante Sestini
Sendt: 22. oktober 2009 12:30
Til: [log in to unmask]
Emne: Re: The EBM curriculum - revising the Sicily statement
Paul Glasziou wrote:
> Do you have suggestions about the curriculum for EBM? The forthcoming
> Sicily EBHC conference (28-31 Nov) will include afternoon discussions of
> the EBM curriculum. The Sicily Statement on the Curriculum for
> evidence-based practice arose out of the first Sicily meetings.
I have two suggestions, both relative to the starting steps:
1) Add a step on "setting a goal" at the beginning. Without a goal is
impossible to ask a question (in particular, to select an outcome)
Note that this would require to move the exploration of patient's values
at this stage, since obviously the patient should participate in the
choice of the goal (and hence in framing the question).
2)Integrate the proposal of Franz Portzolt of explicitly consider
current knowledge and expertise (and look for more expertise if needed
using background questions) while framing the problem.
Porzsolt F, Ohletz A, Thim A, Gardner D, Ruatti H, Meier H,
Schlotz-Gorton N, Schrott L. Evidence-based decision making--the 6-step
approach. ACP J Club. 2003 Nov-Dec;139(3):A11-2
regards,
Piersante Sestini
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