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Understanding and accepting what EBM is all about i.e. the focus on patient's role in clinical decision making. also...the CEBM web site Oxford is a good place for intro... What is EBM? Evidence-based medicine is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients. Read the full article by clicking on the link below. Evidence based medicine: what it is and what it isn't Good doctors and health professionals use both individual clinical expertise and the best available external evidence, and neither alone is enough. Without clinical expertise, practice risks becoming tyrannised by evidence, for even excellent external evidence may be inapplicable to or inappropriate for an individual patient. Without current best evidence, practice risks becoming rapidly out of date, to the detriment of patients. Evidence-based medicine is not restricted to randomised trials and meta-analyses. It involves tracking down the best external evidence with which to answer our clinical questions. The Five Steps of EBP 1. Asking Focused Questions: translation of uncertainty to an answerable question 2. Finding the Evidence: systematic retrieval of best evidence available 3. Critical Appraisal: testing evidence for validity, clinical relevance, and applicability Critical appraisal is the process of assessing and interpreting evidence by systematically considering its validity, results and relevance to an individual's work. Within the last decade critical appraisal has been added as a topic to many medical school and UK Royal College curricula, and several continuing professional development ventures have been funded to provide further training. Teaching critical appraisal skills in health care settings. 4. Making a Decision: application of results in practice 5. Evaluating Performance: auditing evidence-based decisions What evidence is there that teaching EBM achieves its aims? A five year old Cochrane review found sparse evidence—one randomised controlled trial showing that about six hours of journal club time devoted to critical appraisal increased knowledge of this. Two subsequent randomised controlled trials with broader teaching showed a sustained educational benefit across several of (Evidence based medicine has come a long way read more). Incorporating EBM into practice The likelihood that a clinician will incorporate EBM into their practice cannot be predicted by any demographics or practice related factors. Even those physicians who are enthusiastic about EBM rely more on traditional information sources than EBM related sources. The most important barriers to increased use of EBM by practicing physicians appears to be a lack of knowledge and familiarity with the basic skills, rather than skepticism about the concept. Read more http://www.cebm.net/?o=1014 other intro sites... http://www.hsl.unc.edu/services/tutorials/ebm/ http://www.cebm.net/index.aspx?o=1025 Best, Paul E. Alexander ----- Original Message ---- From: Dr Ebtisam <[log in to unmask]> To: [log in to unmask] Sent: Thu, February 3, 2011 5:19:31 PM Subject: EBM where to start.. Hello all I am happy to be a member in this site, as i would love to learn and enhance my knowledge and skills as well about the EBM as many going on lately about it. I consider my self a beginner and would love to know how to start and where kindly. Thanks and have a nice day Dr Ebtisam