Current issues of ACP Journal Club are published in Annals of Internal Medicine


Letter

Evaluating Evidence-Based Practice Performance

PDF

ACP J Club. 2006 Nov-Dec;145:A10. doi:10.7326/ACPJC-2006-145-3-A10



To the Editor

Dr. Green provided a useful 1-page form that can be used by trainees to document their efforts in applying evidence-based principles to answering specific clinical questions (1).

We would like to share 2 additional forms designed for use by medical students and residents. These forms ask for the following rating of the quality of the evidence:

Information based on a systematic comprehensive search for the best available evidence

Information based on scientific studies but unclear if the best studies are cited

Information based on case reports or case series

Information based on a consensus of representative experts

Information based on opinions of 1 or a few authors

Unclear what information is based on.

This assessment of the quality of the evidence to support a specific answer was selected for 2 reasons: 1) The form is designed to be used in multiple institutions, and it is unknown if and when an individual curriculum would teach a specific level-of-evidence rating system; and 2) when searching for an answer to a question it is important to consider the totality of the evidence and not just the quality of an individual study.

One of the forms is for medical students and is derived from a study conducted at the University of Missouri-Columbia (2). This study found that providing third-year medical students with an experiential curriculum with clinically integrated teaching of Internet use to answer clinical questions resulted in improvements in the quality of answers found and reductions in the time and number of sites used for searching. The form was subsequently revised to better facilitate communication between students and preceptors by adding 3 yes/no questions for preceptors to complete.

The second form is for residents and has been modified for use in documenting Practice-Based Learning and Improvement competencies as required by the Accreditation Council for Graduate Medical Education.

These forms are freely available at www.dynamicmedical.com/medicalschools.php.

Brian S. Alper, MD, MSPH
Editor-in-Chief, DynaMedMedical Director of Clinical Reference Products, EBSCO Publishing
Columbia, Missouri, USA

Daniel C. Vinson, MD, MSPH
Assistant Professor, Department of Family and Community MedicineUniversity of Missouri-Columbia
Columbia, Missouri, USA


References

1. Green ML. Evaluating evidence-based practice performance. ACP J Club. 2006 Sep-Oct;145(2): A8-10. [PubMed ID: 16944848]

2. Alper BS, Vinson DC. Experiential curriculum improves medical students' ability to answer clinical questions using the internet. Fam Med. 2005;37:565-9. [PubMed ID: 16145634]