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Dear all, EBM is a multistep process and not all doctors want or need to learn how to practice all five steps of EBM - (1) asking, (2) acquiring, (3) appraising, (4) applying, (5) assessing (BMJ 2004;329:1029-1032). 'Clinicians can incorporate evidence into their practices in 3 ways. First is the "doing" mode, in which at least the first 4 steps are carried out before an intervention is offered. Second is the "using" mode, in which searches are restricted to evidence sources that have already undergone critical appraisal by others, such as evidence-based guidelines or evidence summaries (thus skipping step 3). Third is the "replicating" mode, in which the decisions of respected opinion leaders are followed (abandoning at least steps 2 and 3). Of course, even clinicians trained to the "doing" level move back and forth between these modes, typically depending on whether they are dealing with clinical problems they encounter frequently or only rarely'.(CMAJ 2000; 163 (7)) My questions are: a) If doctors practice in the "USER" mode - is that sufficient to agree that they practice EBM? b) Are there validated instruments that can be used to evaluate EBM in USER mode? Especially web-based tools? (I am aware of two validated questionnaires - Fresno and Berlin that encompass the five steps.) Thanks in advance Kumara ------------------------------------------------------------------- Dr. Kumara Mendis MBBS, MSc (Medical Informatics), MD (Family Medicine) Senior Lecturer School of Rural Health University of Sydney Tel: +61 02 6885 7996 Mob:+61 0408 975 784 ---------------------------------------------------------------------------- ----------------