Yes, I agree as none of my medic friends understood that this happens and what the trickle down effect can be. Some of them even have grave misunderstandings about the Belmont report and have no real knowledge of Helsinki at all. Maybe post trial funding clarity could be made mandatory where funding is applied for?
Best
Amy

From: Ash Paul <[log in to unmask]>
Reply-To: Ash Paul <[log in to unmask]>
Date: Thu, 26 Apr 2012 10:14:34 -0700
To: <[log in to unmask]>
Subject: Re: EBHC curriculum undergradaute posgraduate

Dear Anke,
This is an excellent piece of work.
I seem to remember that Terry Shaneyfelt from our Group mentioned some time back that he had also received a large grant to set up a similar teaching programme in his medical school.
From a practical healthcare commissioners point, though this is not directly related to critical appraisal of literature, what I find missing is a section where the medical students will be taught the ethics of clinical trials. It's vitally important that doctors are aware of important stuff like the 'Helsinki Statement'. We have had instances in the past in the NHS where patients have been put into very expensive trials without sorting out the thorny question of post-trial funding, and at the end of the trial, the pharmaceutical company has withdrawn financial support for the hugely expensive drugs used in the trial, leaving the NHS to pick up the tab with the tax-payers monies.
Regards,
 
Ash
Dr Ash Paul
Medical Director, East of England SCG
Midlands and East Specialised Commissioning Group (East of England Office)
Endeavour House, Coopers End Road
Stansted CM24 1SJ
(: 01279666300
È: 01279210740
 
 
 

From: Michael Power <[log in to unmask]>
To: [log in to unmask]
Sent: Thursday, 26 April 2012, 14:42
Subject: Re: EBHC curriculum undergradaute posgraduate

Hi Anke

Congratulations on a nice piece of work

I would suggest that under the APPRAISE heading (both under- and
post-graduate) you specify type of question (rather than type of
study).

See
    http://www.cebm.net/index.aspx?o=5653

and click on "Preview"


I would also suggest that you include the dimensions on which quality
of evidence is appraised

  Effect size
      Relative and absolute effect sizes
      Statistically significance
      Clinical importance
  Precision (confidence interval)
  Accuracy (risk of bias)
  Heterogeneity or inconsistency of results between studies
  Directness of applicability of evidence to individual patient or
general recommendation
      Populations similar?
      Interventions similar
      Comparison with alternative options similar
      Outcomes proxies or patient-important?
      Times (of intervention and follow up) long enough?

Best wishes

Michael



On 4/26/12, Rohwer, AC, Miss <[log in to unmask]> <[log in to unmask]> wrote:
> Dear Carlos,
>
> The Centre for Evidence-based Health Care
> (www.sun.ac.za/cebhc<http://www.sun.ac.za/cebhc>) at Stellenbosch
> University, South Africa, has been working towards integrating EBHC
> competencies into the under- and postgraduate graduate curricula. This
> process is still in progress, but is worth sharing at this stage.
>
> The Faculty of Health Sciences (FHS) at Stellenbosch University (SU) is
> currently in the process of reviewing the graduate attributes of a newly
> qualified health care professional and has adopted the CanMEDS framework
> (http://rcpsc.medical.org/canmeds/CanMEDS2005/CanMEDS2005_e.pdf) . This
> framework was developed in Canada, first implemented in 1997 and has since
> been used in medical education internationally. It serves as a guide to the
> essential abilities of a medical doctor to optimise patient outcomes and
> defines the attributes of the graduate according to seven interdependent
> roles: Medical expert, Scholar, Professional, Communicator, Collaborator,
> Manager and Health Advocate. These attributes are all individually defined
> and described according to key competencies and enabling competencies.
>
> The SU FHS has assembled working teams consisting of lecturers, module
> chairs and other relevant academic staff for each of these roles. Dr Taryn
> Young and I are part of the team working on the “scholar” role, of which
> evidence-based health care (EBHC) competencies form a big part. Last year,
> we developed key and enabling EBHC competencies according to the five steps
> of EBHC (asking, accessing, appraising, applying, auditing) and included
> these as formal graduate competencies under the “scholar” role. The
> undergraduate EBHC competencies are:
>
> Key Competencies (undergraduate)
>
> 1.      ASK
>
> a.      Identify knowledge gaps
>
> b.      Formulate focused answerable questions using the PICO format when
> faced with an uncertain situation
>
> c.      Identify the various types of questions
>
>
> 2.      ACCESS
>
> a.      Identify and understand the best sources of evidence for each type
> of question
>
> b.      Design a search strategy relevant to the question
>
> c.      Identify appropriate databases
>
> d.      Search effectively and efficiently for evidence-based resources;
>
>
> 3.      APPRAISE
>
> a.      Appraise different types of research for their validity,
> reliability, and applicability
>
>                                                                  i.
> systematic reviews
>
>                                                                ii.
> randomized controlled trials
>
>                                                              iii.
> cohort studies
>
>                                                              iv.
> case-control studies
>
>                                                                v.      cross
> sectional studies
>
>                                                              vi.
> diagnostic studies
>
> b.      Interpret the research findings
>
> c.      Translate outcomes into meaningful summary statistics
>
>
> 4.      APPLY
>
> a.      Know the approach to assess applicability and generalizability of
> research findings in clinical practice
>
> Enabling competencies
>
>
> -          Biostatistics – hypothesis testing, estimation and confidence
> intervals, sample size calculation
>
> -          Epidemiology - study design, measures of occurrence, measures of
> effect and association, screening (sensitivity, specificity, likelihood
> ratios, predictive values), bias and error, confounding, causation
>
> -          Searching electronic databases – principles
>
> o  Identify appropriate search terms
>
> o  Use Medical Subject Headings (MeSH) terms in search
>
> o  Explode MeSH terms to expand retrieval of studies
>
> o  Use appropriate limits (e.g. age, gender, publication type)
>
> o  Use Boolean operators correctly
>
> o  Combine search concepts in final search strategy
>
>
>
> -          Philosophy of critical enquiry
>
> The proposed competencies for each role have now been approved at University
> level, and recently also at the Health Professions Council of South Africa,
> through the Sub-committee for Undergraduate Education and Training (UET) of
> the Medical and Dental Professions Board. This means that these competencies
> should become part of the medical curriculum at SU and that other medical
> curricula in South Africa in future. This is the first and very exciting
> step to formally integrating EBHC teaching to health care professionals in
> South Africa at undergraduate level.
>
> We are busy completing a curriculum assessment evaluating what is currently
> being covered in the medical curriculum. The next steps will be to implement
> and evaluate an integrated curriculum.
>
> For postgraduate EBHC training, we are busy completing a formal evaluation
> of an online EBM module that is offered to Family Medicine specialists in
> training. The aim of this evaluation is to inform development of a more
> generic online module, which can be offered to all medical specialists in
> training. The postgraduate competencies we developed are similar to the
> undergraduate competencies, but comprise the whole process of EBHC:
> Key Competencies (postgraduate)
>
>
> 1.      ASK
>
> a.      Identify knowledge gaps
>
> b.      Formulate focused answerable questions using the PICO format when
> faced with an uncertain situation
>
> c.      Identify the various types of questions
>
>
> 2.      ACCESS
>
> a.      Identify and understand the best sources of evidence for each type
> of question
>
> b.      Design a search strategy relevant to the question
>
> c.      Identify appropriate databases
>
> d.      Search effectively and efficiently for evidence-based resources;
>
>
> 3.      APPRAISE
>
> a.      Appraise different types of research for their validity,
> reliability, and applicability
>
>                                                    i.      systematic
> reviews
>
>                                                  ii.      randomized
> controlled trials
>
>                                                iii.      cohort studies
>
>                                                iv.      case-control
> studies
>
>                                                  v.      cross sectional
> studies
>
>                                                vi.      Diagnostic studies
>
> b.      Interpret the research findings
>
> c.      Translate outcomes into meaningful summary statistics
>
>
> 4.      APPLY
>
> a.      Assess applicability and generalizability of research findings in
> clinical practice
>
> b.      Integrate the results of the research into decision making for their
> individual patient
>
>
>
> 5.      ASSESS
>
> a.      Monitor and evaluate the application in practice
>
>
> Enabling competencies
>
>
> -          Biostatistics – hypothesis testing, estimation and confidence
> intervals, sample size calculation
>
> -          Epidemiology - study design, measures of occurrence, measures of
> effect and association, screening (sensitivity, specificity, likelihood
> ratios, predictive values), bias and error, confounding, causation
>
> -          Searching electronic databases – principles
>
> o  Identify appropriate search terms
>
> o  Use Medical Subject Headings (MeSH) terms in search
>
> o  Explode MeSH terms to expand retrieval of studies
>
> o  Use appropriate limits (e.g. age, gender, publication type)
>
> o  Use Boolean operators correctly
>
> o  Combine search concepts in final search strategy
>
>
>
> -          Monitoring and evaluation – principles
>
> -          Philosophy of critical enquiry
>
> -          Reflection
>
> We welcome any feedback.
>
> Regards,
> Anke Rohwer and Taryn Young
>
> Anke Rohwer
> Researcher
> Centre for Evidence-based Health Care
> Faculty of Health Sciences
> Stellenbosch University
> +27-21-938 9886
> [log in to unmask]<mailto:[log in to unmask]>
>
>
> From: Evidence based health (EBH)
> [mailto:[log in to unmask]] On Behalf Of Dr. Carlos
> Cuello
> Sent: 20 April 2012 05:58 PM
> To: [log in to unmask]
> Subject: EBHC curriculum undergradaute posgraduate
>
> Anyone know of any news about the development and inclusion of an EBHC
> curriculum in U.G and P.G. health professionals?
>
> I did a quick search in Pubmed with no new results beyond the Sicily
> statement (2005).
>
> Thanks in advance
>
> --
> Carlos A. Cuello-García, MD
>
> Tecnologico de Monterrey School of Medicine & Health Sciences
> CITES piso 3. Morones Prieto 3000 pte. Col. Doctores 64710
> Monterrey, NL. Mexico.
> ☎ +52.81.8888.2223<tel:%2B52.81.8888.2223> & 2154. Fax:
> +52.81.8888.2052<tel:%2B52.81.8888.2052> Skype: dr.carlos.cuello
> www.cmbe.net<http://www.cmbe.net> ⚫ Twitter<http://twitter.com/CharlieNeck>
> ⚫ Linkedin<http://mx.linkedin.com/in/drcuello>
>
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