In an effort to foster the application of the skills you learned in
your EBM course you should practice applying them real-time to patient
care. Questions arise all the time on the wards about the
efficacy of certain tests and therapies and as medical students, you
frequently may wonder why we do things the way we do. Now is
your chance to apply the literature to these questions and practice
evidence rather than "expert based" medicine. This is not meant
to be an involved project. One reason clinicians fail to
practice EBM is because of the misconception that is necessarily takes
a long time or that they have to be an expert in statistics.
Once you learn how to ask a focused question, this takes no time.
If you perform literature searches frequently, that too becomes easy.
Analyzing articles is the area about which even experienced clinicians
can feel intimidated. But there are certain "big picture"
questions you can ask about study design that will help you know
whether to read and apply the articles you find. It is much more
common for students and clinicians to make the mistake of applying
data from an article that does not really answer their clinical
question than missing an inappropriate statistical analysis (journal
editors are quite good at picking up those problems).
A very helpful resource if you are having trouble knowing how to
approach the analysis of a particular study design is the Users'
Guide to the Medical Literature published by JAMA and available in
an interactive format at the following site:
http://pubs.ama-assn.org/misc/usersguides.dtl
(UF owns the rights to this so you must access it through a UF
computer or website.) The "tips" they offer are particularly
useful.
There are many ways you can meet the requirement of the EBM project
and they are described below. The critical point is that is
should be directly related to patient care and you should not spend a
lot of time on it because you need to practice applying EBM
efficiently. All of the possible EBM entries will be evaluated
on the question, whether an appropriate article was found, analysis of
the article, and application to patient care.
- EBM Report
- Journal Club
- EBM talk to team
- Lead evidence-based physical findings rounds
