For your EBM project we’ll be following the four steps of EBM. More information can be found at theEBMproject website.
- ASK a clinical question
- ACQUIRE the evidence
- APPRAISE the paper
- APPLY it to your patient
For the assignment we’ll go through all four components.
1. ASK a question
In the first week of the rotation, each student finds a case in which you have a question. You should incorporate all the pertinent patient data. We will review each student’s questions in the first week. If you can find the answer to that question in a textbook, it’s considered background information. If the answer is still under discovery and you need to go to the literature, this is a foreground question.
The next step is to form the foreground question into one that for which we can search for an answer. The most commonly used approach is the PICO question. In this framework, there are 4 components to every clinical question, the Patient population, Intervention, Comparison and Outcome (PICO).
2. ACQUIRE the evidence
Each student will find a different article that addresses the same PICO question. Communicate to be sure each student has a different article. If two students pick the same article, neither gets credit. Use PubMed, Google Scholar, Scopus or any search strategy that finds you credible sources. Wikipedia and Medscape do not count.
3. APPRAISE the literature
Use the Sackett and Guyatt rubrics to evaluate the article you found. Every student will present their article to the group. No slides. Less than 5 minutes each. Then as a group come to a consensus opinion based on all your articles, regarding the recommendation to follow.
Here are the rubrics to evaluate articles based on question-type.
- Appraising articles on therapy
- Appraising articles on diagnosis
- Appraising articles on harm
- Appraising articles on prognosis
- Appraising systematic reviews
You should have access to VIEW these rubrics, but not to edit them. In order to edit them, you’ll need to use it on Google Docs or as a Word document.
If you would like to use this as a Google Document. Go to the File menu and pick “Make a Copy…” This will save a copy within your own Google Drive which you can edit.
If you prefer using Microsoft Word, you can download a copy as a .docx file. To do this, go to the File menu at the top and pick “Download As…” From the next menu, pick Microsoft Word. Then you should be able to open it in Word.
4. APPLY the results to your patient
Return to the initial patient presentation and apply your consensus recommendation. How would you have managed the patient differently?