- Evidence-Based Medicine
- ACGME
- Articles
- Lectures (Slides)
| Why evidence based medicine? | ||
| Evidence-based medicine (EBM), also known as evidence-based practice (EBP), is used to apply the best available evidence to determine the risks and benefits of treatments and diagnostic tests. EBM can be used on those parts of medical practice subject to scientific methods and to apply those methods to ensure the best prediction of outcomes in medical treatment. | ||
| Using PICO to construct clinical questions: | ||
| P: Patient, poplutation or problem | ||
| What are the characteristics of your population or patient? | ||
| What is the disease or condition you are interested in? | ||
| I: Intervention or exposure | ||
| What are you going to do with this patient/population? | ||
| (treat, diagnose, observe, etc) | ||
| C: Comparison | ||
| What are the alternatives to the intervention? | ||
| (placebo, different treatments) | ||
| O: Outcome | ||
| What are the relevant outcomes? | ||
| (morbidity, mortality, complications, etc) | ||
| Start with the patient/population as clinical questions arise from patient care. Translate your clinical question into a searchable one using the PICO format. What is the best type of study to answer the question? Perform a literature search in the appropriate sources. | ||
| Sensitivity, Specificity and Likelihood Ratios | ||
| In order to examine this topic, we will use the article, Can Urine Clarity Exclude the Diagnosis of Urinary Tract Infection? Pediatrics, 2000. | ||
| Read about sensitivity, specificity and likelihood ratios here. | ||
| How to Choose the Appropriate Statistical Test | ||
| Here is a nice table from graphpad.com on how to select a statistical test. | ||
| EBM Tools | ||
| (from the Center for Evidence-Based Medicine - CEBM.NET) | ||
| Levels of evidence | ||
| Pre-test probability | ||
| Likelihood ratios | ||
| Number needed to treat | ||
| All-purpose 2X2 table analyzer | ||
| EBM Resources | ||
| The User's Guide to the Medical Literature (login required) | ||
| Center for Health Evidence (aka Canadian User's Guide to the Medical Literature) |
| The ACGME Outcome Project | ||
| Goal 1: To ensure that all residents develop competence as physicians in order to complete training and practice as independent physicians. | ||
Goal 2: To improve patient care via resident education. |
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| The ACGME Core Competencies | ||
| Medical Knowledge | ||
| Residents (fellows) must demonstrate knowledge about established and evolving biomedical, clinical, and cognate sciences and the application of this knowledge to medical care. | ||
| Patient Care | ||
| Residents (fellows) must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health. | ||
| Practice Based Learning and Improvement | ||
| Residents (fellows) must be able to investigate and evaluate their patient care practices, appraise and assimilate scientific evidence and improve their patient care practices. | ||
| System Based Practice | ||
| Residents (fellows) must demonstrate an awareness of and responsiveness to the larger context and system of health care and the ability to effectively call on system resources to provide care that is of optimal value. | ||
| Professionalism | ||
| Residents (fellows) must demonstrate a commitment to carrying out professional responsibilities, adherence to ethical principles and sensitivity to a diverse patient population. | ||
| Interpersonal and Communication Skills | ||
| Residents must be able to demonstrate interpersonal and communication skills that result in effective information exchange and teaming with patients, their patients' families and professional associates. | ||
| Three Steps of Setting Goals for Teaching: | ||
| 1. Define the goals (knowledge, skills and attitude) | ||
| What do you want them to learn? | ||
| How will they learn it? | ||
| 2. Tell your learners the goals. | ||
| "My goals for you are..." | ||
| Be specific, clear and concrete. | ||
| Tell them the relevance of the goals. | ||
| 3. Ask the learners for their goals. | ||
| ACGME Duty Hours Standards | ||
The ACGME Approved Standards Website |
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| Assessment in Graduate Medical Education: A Primer for Pediatrc Program Directors (from the ABP) | ||
| Download the guide here. | ||
| Guidebood for Teaching and Assessing Professionalism (from the ABP) | ||
| Download the guide here. |
| Eh? | ||
