Teaching evidence based medicine in family medicine

Abstract

The concept of evidence based medicine (EBM) as the integration of clinical expertise, patient values and the best evidence was introduced by David Sackett in the 1980s. Scientific literature in medicine is often marked by expansion, acummulation and quick expiration. Reading all important articles to keep in touch with relevant information is impossible. Finding the best evidence that answers a clinical question in general practice (GP) in a short time is not easy. Five useful steps are described- represented by the acronym 5A+E: assess, ask, acquire, appraise, apply and evaluate.The habit of conducting an evidence search on the spot is proposed. Although students of medicine at University of Split School of Medicine are taught EBM from the first day of their study and in all courses, their experience of evidence-searching and critical appraisal of the evidence, in real time with real patient is inadequate. Teaching the final-year students the practical use of EBM in a GPs office is different and can have an important role in their professional development. It can positively impact on quality of their future work in family practice (or some other medical specialty) by acquiring this habit of constant evidence-checking to ensure that best practice becomes a mechanism for life-long learning. EBM is a foundation stone of every branch of medicine and important part of Family Medicine as scientific and professional discipline. To have an EB answer resulting from GPs everyday work is becoming a part of everyday practice.