Evidence-based Medicine Teaching Research Articles

Case-based EBM instruction for Osteopathic Medical Students: A Case Report

Background: Evidence-based medicine (EBM) is an important part of graduate medical education and a learning outcome necessary for preparing students to become effective residents. However, many medical educators and librarians struggle to offer EBM instruction that is contextualized, relevant, and engaging. Case-based learning (CBL) can establish the relevance of EBM instruction sessions by using clinical scenarios that link theory to practice.   Experience: This case report describes how a college of osteopathic medicine (COM) liaison librarian redesigned a large cohort, lecture-based learning approach to EBM instruction into interactive, relevant, and contextualized CBL labs. CBL labs with smaller student groups were designed to provide an active learning environment and encourage peer-to-peer learning. The CBL format has been previously applied to EBM instruction but not quantifiably evaluated. A modified rubric was created to provide a quantifiable measurement of student performance in future evaluations.   Discussion: First-year osteopathic medical students participated in CBL sessions, integrating EBM into their curriculum. The small groups facilitated personalized guidance, peer-to-peer learning, and critical thinking. Clinical scenarios that were mapped to the students’ curriculum provided relevance to the learning experience.   The CBL format allowed the librarian to support students individually and increased engagement compared to lecture-based learning. Challenges included assessing the students’ prior EBM knowledge and the time commitment for a solo librarian. However, group assignments and a grading rubric helped to minimize the challenge.   Conclusion: The initial pilot testing of this instructional design format and rubric has shown promise in reaching the objectives of providing a relevant and active learning platform with quantifiable results. A future randomized controlled trial is planned to provide quantifiable evidence supporting CBL labs for EBM instruction when compared to lecture-based learning

Librarian-Led Assessment of Medical Students' Evidence-Based Medicine Competency: Facilitators and Barriers.

We must ensure, through rigorous assessment that physicians have the evidence-based medicine (EBM) skills to identify and apply the best available information to their clinical work. However, there is limited guidance on how to assess EBM competency. With a better understanding of their current role in EBM education, Health Sciences Librarians (HSLs), as experts, should be able to contribute to the assessment of medical student EBM competence. The purpose of this study is to explore the HSLs perspective on EBM assessment practices, both current state and potential future activities. We conducted focus groups with librarians from across the United States to explore their perceptions of assessing EBM competence in medical students. Participants had been trained to be raters of EBM competence as part of a novel Objective Structured Clinical Examination (OSCE). This OSCE was just the starting point and the discussion covered topics of current EBM assessment and possibility for expanded responsibilities at their own institutions. We used a reflexive thematic analysis approach to construct themes from our conversations. We constructed eight themes in four broad categories that influence the success of librarians being able to engage in effective assessment of EBM: administrative, curricular, medical student, and librarian. Our results inform medical school leadership by pointing out the modifiable factors that enable librarians to be more engaged in conducting effective assessment. They highlight the need for novel tools, like EBM OSCEs, that can address multiple barriers and create opportunities for deeper integration of librarians into assessment processes.

Implementation of an Evidence-Based Medicine Curriculum for Postgraduate Emergency Medicine Physician Assistant and Nurse Practitioner Fellows.

Within physician assistant (PA) education, the inclusion of evidence-based medicine (EBM) is mandatory. Despite existing literature on EBM training methodologies for PA students and emergency medicine (EM) physician residents, there exists a dearth of published data concerning EBM instruction within postgraduate PA EM programs. A pilot study is described providing an overview of implementation of an EBM curriculum in a single-institution postgraduate physician assistant and nurse practitioner emergency medicine fellowship. Quantitative data using pre-curriculum and post-curriculum surveys were collected. The curriculum included statistical concept screencasts, required attendance at a journal club with assigned topics for discussion, and used a critical appraisal tool designed to help fellows better analyze and understand the articles being reviewed. Upon graduation, fellows participated in structured interviews to collect qualitative data about the curriculum and application of learned concepts to the clinical setting. There was a statistically significant improvement in fellows' reported confidence in discussing the medical literature with practicing providers ( P = .02). However, there was no difference in prescores and postscores on EBM knowledge questions or on fellows' feelings of importance of EBM to clinical practice. Qualitative data revealed several themes, including helpfulness of tools provided in the curriculum, appreciation of curricular changes made secondary to fellow suggestions, and reports of improvement in reviewing medical literature and comfort in participation in local journal clubs upon graduation from the fellowship program. Limitations, including small sample size and validity concerns, are discussed. Positive changes were made to the curriculum based on qualitative data collected. The authors advocate for subsequent investigations into this subject within a multi-institutional and multispecialty context, thereby enhancing the breadth of the findings. Nevertheless, this study furnishes the initial accessible substantiation of the viability of introducing an EBM curriculum within this specific demographic.

Editorial

The World Health Journal, launched in June 2020. It is an academic and scientific publication edited and fully sponsored by Professionals On Line, Peru. This publication is focused on health sciences worldwide, and publishes original articles and papers related to medical sciences, epidemiology, and public health. The thematic focus of the journal favors original and unpublished articles in the area of public health, nutrition, health policies, social security, health statistics, health education, mental health, medical ethics, epidemiological surveillance, epidemiology, administration in health, health promotion, health systems and services, and the various approaches to evidence-based medicine and medical education. The Editorial Committee values in a special way the presentation of cases, and the approach of updating topics. The purpose of the Journal is to promote and disseminate research carried out in the Health sector at an international level.

Interview: Kari Tikkinen

What initially sparked your interest in medicine, and what led you specifically to the field of urology? I was not sure about medicine until I was almost 20. In high school I was thinking, besides medicine, about biology, geography, and sports for university. I ended up with the most “secure” one, and I have not regretted that. Life probably would have been quite different if I had chosen something else. In medical school, I was always interested in both medicine and surgery. I don’t think that is very typical. I think many medicine students are clearly thinking that I definitely want, or I definitely don’t want, to become a surgeon, and the same applies for internal medicine for many of those who become surgeons. But I was genuinely interested in both. I found that urology and cardiology were fields that were in between surgery and medicine, urology being the most conservative field of surgery, and cardiology the most interventional field of medicine. But despite being the most conservative, I found many fascinating surgeries and interventions in urology. I went to medical school at the University of Tampere, Finland. Urologic research was one of the strongest fields there. At the end of medical school, I started to work on my PhD on nocturia and overactive bladder, supervised by urology professor Teuvo Tammela and epidemiology professor Anssi Auvinen. I felt that I somehow understood lower urinary tract symptom research, and felt that I could contribute a little bit. I also met many urologists that were the nicest colleagues possible. So, urology was then a logical choice for me. And again, I have no reason to regret. Urology is indeed a great field. I really enjoy the patient interaction and follow-up of patients that is more common in urology than in general in other surgical fields. How do you balance your work as a Professor and Supervisor at the University of Helsinki alongside your surgical roles? I was appointed as Full Professor of Urology at the University of Helsinki in June 2020. Earlier, I worked for many years as 75% clinician and 25% Academy of Finland clinical researcher. In reality, as is typical for clinician-scientists, that 25% researcher portion took substantially more hours than you would get from 25%. Since being a Professor, I have been less involved in clinical work. But I find it important and interesting to continue in clinical patient work. Currently, I work about 35% in clinical work and 65% in research. Of my clinical work, one-third is operations, mostly endourology, one-third is outpatients, including some smaller operations, and one-third is mostly urodynamics. I only do a small variety of operations to maintain or improve the quality in those. Most of my time as Professor, I do research. But what is it in reality? The type of research we do; large-scale, randomised trials and meta-analyses with pragmatic approaches and patient-important outcomes, is, unfortunately, undervalued, and not so well financially supported in Finland. So, for a big proportion of my time, I apply for grants to keep our projects alive. The rest of the time, I oversee projects, plan new ones, guide postdoc and PhD students, and write; I really like those tasks. I also have positions at the scientific committees of the European Association of Urology (EAU) and International Continence Society (ICS), different guideline groups, Scandinavian Journal of Surgery, and at some Finnish governmental institutes. Different kinds of tasks for these endeavours also take time. I also give some lectures for medical students and other doctors. So, I am not suffering from lack of work. You are the lead of the Clinical Urology and Epidemiology (CLUE) Working Group. Could you discuss the aims of this group, and how it came into being? During my post-doctoral fellowship at McMaster University, Ontario, Canada, hosted by Distinguished Professor Gordon Guyatt, I was exposed to the cutting edge of evidence-based medicine, and learned advanced methods of clinical epidemiology. The fellowship inspired me to recruit Finnish and international collaborators to create a collaborative research network, the CLUE Working Group. We work on a range of projects at the forefront of clinical epidemiology. We aim to deliver improvements in our understanding of disease management across urology and other areas of surgery and medicine. CLUE includes numerous clinicians and methodologists with a shared vision of promoting evidence-based clinical practice through practice-changing research, innovation in research methodology, and the promotion of evidence-based medicine practices and education, as well as knowledge translation. We have conducted numerous large-scale series of systematic reviews and meta-analyses, as well as large, pragmatic, randomised trials. We are just revising ethics and drug regulator applications of the Avoiding Risks of Thrombosis and bleeding in Surgery (ARTS) trial that is going to recruit more than 5,000 patients undergoing urologic, general, or gynaecologic surgery. The ARTS trial will be the first to compare the direct oral anticoagulant apixaban to no anticoagulation in these fields. This study has potential to change practice towards more patient-friendly and effective approach worldwide. You have extensively researched population studies of lower urinary tract symptoms, particularly nocturia and overactive bladder. Your PhD thesis on this topic achieved international recognition. Could you discuss your findings, and the importance of this topic? My PhD thesis was based on the Finnish National Nocturia and Overactive Bladder (FINNO) Study. We invited a random sample of 6,000 Finnish men and women aged 18–79. Approximately two-thirds participated; a big thanks to all of them! In the population-representative FINNO Study, approximately 28% of subjects reported one, 10% two, 2% three, and 1% four or more void(s)/night. Nocturia was more common among young females than young males, but more common among males than females in old age. Most subjects reported small bother from nocturia with two nocturia episodes, and moderate bother only from three nocturia episodes. Two nocturia episodes impaired health-related quality of life compared to those with no nocturia. We found several important risk factors for nocturia, highlighting its multifactorial aetiology. We also studied so-called overactive bladder syndrome. We found that the prevalence of overactive bladder was 6.5% for males and 9.3% for females, i.e., approximately half of that reported in earlier studies. We found that in the earlier literature, many methodological flaws had led to overestimation of prevalence estimates. For me personally, this part of the thesis led to understanding how important the definitions of diseases can be. If we are not careful in using definitions, we can easily overdiagnose and overtreat, or underdiagnose and undertreat, conditions. Many current definitions of diseases are leading to the overuse of scarce resources in healthcare systems. You chaired the European Association of Urology (EAU) Guideline on Thromboprophylaxis in Urological Surgery, published in 2017. This was the first specific surgical thromboprophylaxis guideline, which holds a great deal of potential in clinical practice. How did you come up with this guideline, and why is it so important? I did my 3-year postdoc at McMaster University between 2011–2013. I had also started as guideline member of the EAU guideline of male lower urinary tract symptoms, so I knew some of the EAU guideline leaders. At McMaster we started to do research on thromboprophylaxis of surgical/urologic patients. EAU leaders asked my opinion if we should have an EAU thromboprophylaxis guideline. I thought not necessarily, as other guidelines were so large and so urology-specific, such as prostate cancer, kidney cancer, or male lower urinary tract symptoms, that thromboprophylaxis felt somewhat small compared to them. Despite this comment, about year later, I was asked to chair the guideline. I collected a great group, and we started to work hard. We wanted to do it properly, and that is why it took about 4 years. The first step was to establish procedure-specific risk of thrombosis and bleeding. This had never been done in any field of surgery before. After this massive amount of work, the project that we call ROTBUS (procedure-specific risks of thrombosis and bleeding in urologic surgery), we were able to provide that first ever procedure specific guideline of thromboprophylaxis in any field of surgery. This work has been very rewarding, and important for patients. We just finalised a similar kind of work for more than 100 general abdominal and gynaecologic surgery procedures, and are starting a large pragmatic trial that examines apixaban in urologic, general abdominal, and gynaecologic surgery patients. We welcome centres to join this potentially very practice-changing ARTS trial by contacting me. You are National Principal Investigator of the SOLIDARITY trial on COVID-19 treatments, led by the World Health Organization (WHO). Please let us know the aims of this trial, and any important findings to date. When the COVID-19 pandemic started, I saw that clinicians were increasingly using hydroxychloroquine and other experimental treatments without trustworthy evidence. I felt that I had to do something. I had trial leadership experience from leading the Antibiotic Prophylaxis Before Shock Wave Lithotripsy (APPEAL) trial; we recently completed the recruitment of more than 1,600 patients and are analysing the data. So, I tried to start a COVID-19 trial in Finland, and was finally able to convince some folks to work together. In the end, as part of the global WHO Solidarity trial, we were able to launch a nationwide, randomised trial that included all university hospitals, and many other major hospitals in Finland. We first studied remdesivir, and are currently studying imatinib and infliximab. I expect we will stop recruitment during the upcoming months, as the pandemic is not as prevalent. We have so far found that remdesivir decreased mortality in COVID patients, and the earlier you start, the better. We are still not sure of the effects of imatinib or infliximab. In Finland, we also follow up all these patients for 2 years post-hospitalisation regarding recovery and potential long-COVID symptoms. I am very glad that we were able to launch SOLIDARITY Finland. Besides providing high-quality evidence for future patients, we have learned a lot about how to conduct large, pragmatic global trials. As an educator, what are you working on at the moment? Where will your focus will lie in future? Teaching young colleagues is a privilege. I hope I can continue contributing through teaching and studying how to diagnose and treat urologic patients and beyond. For me, it is important that we conduct more high-quality research so that we know better what to do. We also need to include peoples’ values and preferences in the decision-making process. With all our technical and scientific advancements and increasing commercialisation, there is risk that physicians forget, or don’t have time, to provide kind care for our patients. These issues are very important, and I will keep educating about them. In terms of research, I am constantly struggling to get funding for this kind of patient-centred, evidence-based research in Finland. But I will keep my eyes open for all opportunities.

Student and educator perceptions of an evidence-based medicine research curriculum: recommendations for research curriculum development

Background: Evidence-based medicine (EBM) allows physicians to integrate evidence, clinical experience, and patient values into clinical decision making and thus has been readily incorporated into medical education; however, there is limited research capturing the perceptions of both student and educator in their experiences in engaging with an EBM-based research curriculum. Assessing the perceptions of both these key stakeholders represents an important area of research as it can help to inform EBM curriculum integration and evaluation efforts.
 Methods: This qualitative study utilizes a constructivist framework to assess the thoughts, beliefs, and feelings of students and tutors interacting with a 2-year EBM-based research curriculum. Students completed semi-structured interviews and tutors completed online surveys to explore their perceptions and experiences. Interview transcripts and survey responses were analysed using conventional descriptive content analysis to create a set of recommendations for EBM curriculum development.
 Results: 13 students and 20 tutors participated, and four major themes were identified. Students noted EBM education was most effective when opportunities existed to apply research skills, complete practical research experience, engage actively in learning, and integrate clinical and research concepts. Tutors found the curriculum to be effective but noted it was challenging to accommodate for the diversity of student knowledge and interest in research.
 Conclusion: This study provides a general set of recommendations for the design, implementation, and refinement of EBM-based research curricula to facilitate student learning through focusing on 1) research consumption, 2) emphasizing application, 3) emphasizing interactivity, 4) curriculum integration, and 5) catering towards student heterogeneity.

Editorial

The World Health Journal, launched in June 2020. It is an academic and scientific publication edited and fully sponsored by Professionals On Line, Peru. This publication is focused on health sciences worldwide, and publishes original articles and papers related to medical sciences, epidemiology, and public health. The thematic focus of the journal favors original and unpublished articles in the area of public health, nutrition, health policies, social security, health statistics, health education, mental health, medical ethics, epidemiological surveillance, epidemiology, administration in health, health promotion, health systems and services, and the various approaches to evidence-based medicine and medical education. The Editorial Committee values in a special way the presentation of cases, and the approach of updating topics. The purpose of the Journal is to promote and disseminate research carried out in the Health sector at an international level.

Is Machine Learning Changing Evidence-Based Medicine?

The paradigm of evidence-based medicine has become a fundamental part of health care and health professions education since the 1990s, even as it has drawn criticism. Meanwhile, in the past decade, increased data collection and computational power have brought about advances in machine learning, such as diagnostic algorithms for pattern recognition in medical images. Machine learning has potential to address some of the limitations of evidence-based medicine, but also presents new questions about what counts as evidence in medicine. Critical appraisal of machine learning can become part of the teaching of evidence-based medicine.

The research escape hunt: An escape room-scavenger hunt for resident education.

Research and evidence-based medicine (EBM) education are important elements of emergency medicine (EM) residency training; however, curricular time is limited and integrating novel strategies to engage learners and improve understanding of complex concepts is challenging. We sought to develop a unique research escape hunt educational experience to teach EM residents basic research and EBM skills using an active-learning, team-based strategy. A nine-station escape room-scavenger hunt was designed around educational content including (1) predictive statistics and diagnostic test characteristics, (2) interpretation of data and statistical analysis, (3) study design, (4) informed consent for research, and (5) the ethical principles guiding research. Stations required participants to use a variety of strategies to solve puzzles, with a correct response required to progress through the escape hunt. Teams worked together to solve each station's puzzles, with opportunities to reinforce the content in real time. Subsequent sessions were presented in a virtual format using Zoom breakout rooms over the past 2 years. Postactivity assessments were grounded in Kirkpatrick's model and focused on participants' reactions, learning, and behavior. Participants reported high levels of satisfaction (100% [21/21] "satisfied" or "extremely satisfied") and engagement (95% [20/21] "engaged" or "very engaged") with the activity, as well as increased comfort with the research and EBM concepts covered (91% [19/21] "agree" or "strongly agree" increased comfort), and demonstrated improvements in knowledge across each content area presented (91% [19/21]). This practical, team-based curriculum was found to be a successful way to engage residents with research methodology and EBM content. This curriculum is feasible for both in-person and virtual formats and we will continue to use this as a component of our EM residency program moving forward.

Evidence-based medicine needs patient and public involvement to remain relevant: A proposal for a new curriculum

IntroductionPublic partnerships, a route to sharing expertise, networks and resources anchored in the United Nations Sustainable Development Goals, has been championed by multiple stakeholders. ObjectiveTo propose a new evidence-based medicine (EBM) curriculum for harnessing patient and public expertise to ensure that EBM teaching and learning can become more relevant and impactful. MethodsA curriculum development group comprising of EBM teachers, patient and public involvement representatives, clinicians, clinical epidemiologists, public health experts and educationalists, with experience of delivering and evaluating face-to-face and online EBM courses across many countries and continents, prepared a new EBM course. ResultsA student-centred, problem-based and clinically integrated course for teaching and learning EBM was developed. In the spirit of shared decision-making, practitioners can learn to support patients, articulate their perspectives, recognise the need for their contribution and ensure community involvement when generating and applying evidence. With end users in mind, the application of research findings, delivery of care and EBM effectiveness in the workplace would carry increased priority. ConclusionsEmbracing patients as EBM collaborators can help deliver cognitive diversity and inspire different ways of thinking and working. Adopting the proposed approach in EBM education lays the foundations for a joint practitioner–patient partnership to ask, acquire, appraise and apply EBM in a more holistic context which will strengthen the EBM proposition.

E-Learning Material of Evidence-Based Medicine for Laypersons.

There is a need for evidence-based medicine (EBM) education for laypersons. However, there are few materials or opportunities to learn EBM for Japanese laypersons. The aim of this study was to develop and test the usability of e-learning material on EBM for health-conscious laypersons in Japan. This study was conducted in two steps. First, content elements for the material were identified using purposive evaluation and a prototype of the e-learning material was developed. Following this, usability testing of the material was conducted. A questionnaire survey and qualitative semi-structured focus group interviews were conducted with health-conscious laypersons. Subsequently, the material was refined and finalized. A total of 217 descriptions related to EBM were extracted from 12 materials and were integrated into 56 major elements. Each element was rated from the viewpoint of usefulness for laypersons and reviewed by four expert panelists, and finally 18 elements were confirmed, most of which were critical appraisal skills related to critical health literacy. For the usability testing after constructing the material, 25 laypersons participated, and 19 (76%) felt very/rather much interest in the contents of the material in the questionnaire. The results of five focus group interviews showed that the effectiveness of the e-learning material was influenced by the story and characters, and whether the contents of the material were consistent with interviewees' daily interests. The e-learning material on EBM was found to be of interest to health-conscious laypersons and appeared to be useful in participants' daily lives. This study successfully developed novel e-learning material on the essential components of EBM for laypersons in Japan. [HLRP: Health Literacy Research and Practice. 2022;6(4):e290-e299.] Plain Language Summary: This study developed and tested the usability of e-learning material to encourage health-conscious laypersons in Japan to learn the fundamentals of evidence-based medicine. Most of the contents of the material are related to critical health literacy. The usability testing showed that the material was of interest to non-health professionals and useful for dealing with health information in their daily lives.

Editorial


 The World Health Journal, launched in June 2020. It is an academic and scientific publication edited and fully sponsored by Professionals On Line, Peru. This publication is focused on health sciences worldwide, and publishes original articles and papers related to medical sciences, epidemiology, and public health. The thematic focus of the journal favors original and unpublished articles in the area of public health, nutrition, health policies, social security, health statistics, health education, mental health, medical ethics, epidemiological surveillance, epidemiology, administration in health, health promotion, health systems and services, and the various approaches to evidence-based medicine and medical education. The Editorial Committee values in a special way the presentation of cases, and the approach of updating topics. The purpose of the Journal is to promote and disseminate research carried out in the Health sector at an international level.

Evidence-Based Veterinary Medicine Learning: an open access tutorial for practitioners and students

EBVM Learning, an open access online tutorial, has been developed to support the teaching of evidence-based veterinary medicine (EBVM).  This paper provides the project background and teaching examples.  The authors request JEAHIL readers share this resource with colleagues who support evidence-based practices including veterinary medicine.

Teaching evidence-based medicine in Mexico: a systematic review of medical doctor curriculums at a national level

ObjectivesTo assess the teaching of evidence-based medicine (EBM) in medical curriculums. As a secondary objective, we assessed the representativeness of science courses related to EBM.Design and settingSystematic review. Accredited curriculums...

Crowdsourcing trainees in a living systematic review provided valuable experiential learning opportunities: a mixed-methods study

ObjectivesTo understand trainee experiences of participating in a living systematic review (LSR) for rheumatoid arthritis and the potential benefits in terms of experiential evidence-based medicine (EBM) education. Study Design and SettingWe conducted a mixed-methods study with trainees who participated in the LSR and who were recruited broadly from training programs in two countries. Trainees received task-specific training and completed one or more tasks in the review: assessing article eligibility, data extraction, and quality assessment. Trainees completed a survey followed by a one-on-one interview. Data were triangulated to produce broad themes. ResultsTwenty one trainees, most of whom had a little prior experience with systematic reviews, reported a positive overall experience. Key benefits included learning opportunities, task segmentation (ability to focus on a single task, as opposed to an entire review), working in a supportive environment, international collaboration, and incentives such as authorship or acknowledgment. Trainees reported improvement in their competency as a Scholar, Collaborator, Leader, and Medical Expert. Challenges included communication and technical difficulties and appropriate matching of tasks to trainee skillsets. ConclusionParticipating in an LSR provided benefits to a wide range of trainees and may provide an opportunity for experiential EBM training, while helping LSR sustainability.

OB-Newborn TEACH Cards: A Curricular Tool for Maternal-Child Rotations That Influences Patient Care.

Evidence-based medicine (EBM) teaching is most successful when integrated with patient care, but finding time for teaching on inpatient rotations is difficult. Obstetrics (OB)-Newborn TEACH (Teaching Evidence-based medicine And Clinical topics in the Hospital) Cards is a curricular tool for efficient teaching sessions on maternity care rotations. We evaluated the impact of OB-Newborn TEACH Cards on resident EBM attitudes and skills, exposure to clinical topics, and patient management. OB-Newborn TEACH Cards includes 56 cards on obstetrics and newborn topics with background and foreground discussion questions. Residents on a family medicine maternal-child service completed pre- and postrotation surveys to assess the cards' impact on EBM attitudes and skills. Faculty and residents also completed point-of-care surveys to assess the self-reported influence on management decisions. Of 24 potential resident participants, 58% completed pre- and postrotation surveys, which showed significant increase in perceived EBM skills like applying evidence to a clinical scenario (P=.04), but a decrease in reported attitudes that EBM is realistic (P=.028) and useful (P=.025). Residents agreed the cards exposed them to a variety of topics. Point-of-care surveys (n=58) indicated that 57% of the time respondents used a card to learn about a topic not related to a specific patient. When used to learn about specific patients, the cards influenced self-reported patient care 44% of the time. OB-Newborn TEACH Cards are a promising inpatient teaching tool for improving perceived EBM clinical application, exposing residents to maternal-child topics, and influencing patient care decisions.

Editorial

The World Health Journal, launched in June 2020. It is an academic and scientific publication edited and fully sponsored by Professionals On Line, Peru. This publication is focused on health sciences worldwide, and publishes original articles and papers related to medical sciences, epidemiology, and public health. The thematic focus of the journal favors original and unpublished articles in the area of public health, nutrition, health policies, social security, health statistics, health education, mental health, medical ethics, epidemiological surveillance, epidemiology, administration in health, health promotion, health systems and services, and the various approaches to evidence-based medicine and medical education. The Editorial Committee values in a special way the presentation of cases, and the approach of updating topics. The purpose of the Journal is to promote and disseminate research carried out in the Health sector at an international level.

A study on how using an interactive multimedia e-book improves teachers\u2019 ability to teach evidence-based medicine depending on their seniority

BackgroundTeaching evidence-based medicine (EBM) is not an easy task. The role of the electronic book (e-book) is a useful supplement to traditional methods for improving skills. Our aim is to use an interactive e-book or PowerPoint to evaluate instructors’ teaching effects on EBM.MethodsOur study group was introduced to learning EBM using an interactive e-book available on the Internet, while the control group used a PowerPoint presentation. We adopted the Modified Fresno test to assess EBM skills both before and after their learning. EBM teaching sessions via e-book or PowerPoint were 20–30 min long, followed by students’ feedback. We adopted Student’s t-test to compare teachers’ evaluation of their EBM skills prior to the class and the students’ assessment of the teachers’ instruction. We also adopted repeated measures ANCOVA to compare teachers’ evaluation of their EBM skills using the Fresno test both before and after the class.ResultsWe observed no difference regarding EBM skills between the two groups prior to their experimental learning, which was assessed by the Modified Fresno test. After learning, physicians in the study group ranked higher in choosing a case to explain which kind of research design was used for the study type of the question and explaining their choice (P = 0.024) as assessed by the post-test to pre-test Fresno test. Teaching effect was better in the e-book group than in the control group for the items, “I am satisfied with this lesson,” “The teaching was of high quality,” “This was a good teaching method,” and “It aroused my interest in EBM.” However, no differences were observed between the two groups in physicians who had more than 10 years’ experience.ConclusionsThe use of interactive e-books in clinical teaching can enhance a teacher’s EBM skills, though not in more senior physicians. This may suggest that teaching methodology and activities differ for teachers’ varying years of experience.

Face-to-face versus online clinically integrated EBM teaching in an undergraduate medical school: a pilot study

ObjectivesThe aim of this study was to test the feasibility and effectiveness of two models (face-to-face vs online teaching) of clinically integrating evidence-based medicine (EBM) teaching in an undergraduate medical...

Thirty years of teaching evidence-based medicine: have we been getting it all wrong?

Evidence based medicine (EBM) has been synonymous to delivery of quality care for almost thirty years. Since the movement's inception, the assumption has been that decisions based on high quality evidence would translate to better care for patients. Despite EBM's many attractive features and the substantive attention it has received in the contemporary clinical and medical education literature, how it is defined and operationalized as a component of training is often unclear and problematic. How to practice EBM is not well articulated in the literature; therefore, it becomes difficult to teach and equally challenging to assess. In this paper, we put forward a call for deeper consideration of how EBM is taught, and for clarification on how it is defined and operationalized in medical education. In preparing this paper, we considered questions such as what it means to practice EBM, the role that medical education plays in helping realize EBM, how the teaching of EBM can change to reflect recent developments in clinical practice and education, and whether transformations in the practice of medicine necessitate a change inhow we teach EBM. We end with four avenues that may be pursued to advance the teaching of EBM in medical education: (1) consensus on what we mean by EBM; (2) clear articulation of EBM-associated competencies; (3) empirically and theoretically supported means of promoting EBM competencies; (4) ways to assess both skill acquisition and use of EBM. We discuss implications for educators of EBM.