Dear members,
I have been following with interest the recent discussion on live EBM
teaching on the question posed by Ati Yates and the members' responses.
I would like to share our experience with you on live EBM teaching to
female medical students which took place in early November. Final year
medical students in their senior clerkship spend 5 weeks in our
department as a part of their rotational training. We wanted to try out
EBM teaching with our senior clerks. On 10th November I presented a
seminar on Introduction to EBM (as a pilot) for which I used slides
and material from the CEBM web pages. Due acknowledgement was of course
given to the centre in the booklet I prepared which accompanied the
lecture.
A few hands-on exercises were included which simulated scenarios
students would encounter in their day-to-day practice. One of these is a
live search for evidence concerning a focused clinical question. As the
time was limited, the clinical question was not an offshoot from our
discussion but a pre-prepared one. The seminar went like this:
Initially I presented a lecture with slides on the definition of EBM, on
the evidence concerning the usefulness of EBM (Prof. Sackett kindly sent
me three recent examples of outcome research when clinical care is (and
isn't) evidence-based), and on levels of evidence and grades of
recommendation and key EBM terms.
I used the example given in the McMaster.ebm WWW page on finding
evidence for this exercise
(http://hiru.mcmaster.ca/ebm/overview.htm)
and modified it for local use. I have reproduced the exercise below:
You are the junior medical resident working in Jimi hospital. You admit
a 43 year-old, previously well man who experienced a witnessed grand mal
seizure. He had never had a seizure before and had not had any recent
head trauma. He drank alcohol once or twice a week but had not had
alcohol on the day of the seizure. Physical examination was negative.
The patient is given a loading dose of phenytoin intravenously and the
drug is continued orally. A computed tomographic head scan is completely
normal and an electroencephalogram shows only non specific changes. The
patient is very concerned about the risk of his seizure recurring.
The task was to provide the patient an evidence based reply on his
prognosis.
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Our medical faculty is equipped with a computer lab for female students
with over 20 computers of which 5 are connected to the WWW through a
dedicated line purely for students' use. Similar facilities exist for
male students. The female computer lab was booked for the seminar and
the students performed an on-line search using PUBMED and coming out
with relevant articles. Prior to this exercise I reinforced their skills
in Medline search using the projection facility (with a special OHP, the
computer screen could be projected on the wall - this is not an LCD).
The students seemed to have enjoyed the seminar because they continue to
practice on line searching so that we overshot the allotted time by an
hour. We are hoping to incorporate this exercise in all our future
clerkships.
I hope I have not bored you with our experiment and I shall be grateful
for any feedback.
Thanking you all in anticipation,
Bye for now,
Badri
Dr.P.Badrinath M.D.,M.Phil.,(Epid) PhD(Cantab)
Assistant Professor and Epidemiologist,
Department of Community Medicine,
UAE University, PO Box 17666, Al Ain,
United Arab Emirates.
Tel: 00 971 3 5039 652
Fax: 00 971 3 672022.
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