An Integrated Practical Evidence-Based Medicine Curriculum: Two Small Group Sessions to Teach PICO Question Formation and Searching Strategies

Publication ID Published Volume
9446 June 17, 2013 9


The need to teach evidence-based medicine (EBM) goes beyond meeting the requirements of residency. For residents and all practicing physicians there must be a process to ensure that doctors know the latest and best information to apply to the care of their patients. Typically, in the majority of pediatric training programs, EBM is taught in the context of a journal club, which may not develop the skills needed to integrate EBM into one’s own clinical practice.

These two small group sessions comprise the beginning of a three-year longitudinal EBM curriculum and focus on the basics of EBM: asking the question and searching for the answer. In two 1.5-hour sessions, learners are introduced to basic EBM principles such as how to pose an answerable question in PICO (Patient/Population/Problem, Intervention/Indicator, Comparison, Outcome) format, and how to efficiently utilize evidence-based resources. Each session begins with a brief (10 minute) introduction. Utilizing the principles of active learning, the group works through one example together then breaks into smaller groups for further practice. The completion and review of homework given after each session helps learners to apply and reinforce basic principles and skills learned during the group sessions. While the curriculum was designed for and has been studied on pediatric residents, it could easily be adapted for use by a broader audience including residents of any specialty, and medical students in their last two years of medical school.

In an initial pilot evaluation of these two sessions, four interns revealed improved knowledge and efficiency in using EBM. Subsequent evaluations of 9 – 10 interns/year completing the entire longitudinal curriculum have reinforced the findings of the pilot. These data have been presented at many regional and national conferences, including the Association of Pediatric Program Directors (APPD) meeting, April, 2011, the Pediatric Educational Excellence Across the Continuum (PEEAC) conference, September, 2011, the Northeastern Group On Educational Affairs (NEGEA) meeting, March 2012, at the Pediatric Academic Society Meeting, April, 2012, and at Women in Medicine Day, Stony Brook University Medical Center, April 25, 2012.


Boykan R, Chitkara M, Kenefick C, Messina C. An integrated practical evidence-based medicine curriculum: two small group sessions to teach PICO question formation and searching strategies. MedEdPORTAL Publications. 2013;9:9446.

Educational Objectives

  1. To formulate three clinical questions using the PICO format, according to the criteria for good question building (worksheet) and according to the checklist.
  2. To conduct three literature searches using appropriate search strategies and resources, according to criteria given for searching and according to the checklist.
  3. To conduct three searches based on PICO questions derived from their own patients over the course of three weeks, using appropriate search strategies and source material to answer the question successfully.


  • Evidence-Based Medicine, Resident Education, Medical Student Education, Problem-Based Learning, Small-Group, PICO

Material Access

Please sign in to access this material.

Please register for an AAMC account if you do not have one.


  • Contact Us

Subscribe to Our Quarterly Newsletter

Receive featured content & announcements!

ISSN 2374-8265