Original Publication
Open Access

An Integrated Practical Evidence-Based Medicine Curriculum, Critical Appraisal: Therapy

Published: April 2, 2014 | 10.15766/mep_2374-8265.9750

Included in this publication:

  • Appendix A Critical Appraisal Therapy.ppt
  • Appendix B Therapy Article Case Scenarios.docx
  • Appendix C Therapy Worksheet.docx
  • Appendix D Therapy Worksheet Answers.docx
  • Appendix E Therapy Resources.References.docx
  • Appendix F Therapy Learner Evaluation Tool.doc
  • Facilitator's Guide for Appraisal of Therapy MedEdPortal.docx

To view all publication components, extract (i.e., unzip) them from the downloaded .zip file.


Editor's Note: This publication predates our implementation of the Educational Summary Report in 2016 and thus displays a different format than newer publications.

Abstract

Introduction: Rather than memorizing facts and creating ingrained habits, medical residents and students in training must learn to be flexible in their clinical approach, integrating best evidence as it becomes available. Typically, in the majority of pediatric training programs, evidence-based medicine (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. This small-group session reintroduces residents to basic EBM principles and gives instruction regarding the appraisal of an article about a new theory. Three additional sessions in this series discuss how to develop an answerable clinical question, how to utilize evidence-based resources and how to appraise an article about a diagnostic test have been described. Methods: Learners are provided with a reintroduction to basic EBM principles, before being introduced to therapy-related articles, validity measures, results analysis, and clinical application. They then review two example cases before a wrap-up debriefing and homework assignment. Results: Evaluation of the first two cohorts of residents participating in our curriculum revealed overall improvement in EBM knowledge. Participants were evaluated using a quiz comprised of true/false, matching, and multiple choice questions both prior to the initiation and at the completion of all small group sessions. For Cohort 1, the participant group scored marginally higher overall than compared to non-participant controls (M = 18.8 ± 2.5 vs. 15.9 ± 2.3, p = .15). Participant scores were significantly higher than control scores on the short-answer questions only (M = 3.8 ± 0.4 vs. 3.2 ± 0.5, p = .03).  Cohort 2 (n = 12) took the same EBM review quiz before the start and after the completion of their first year. Overall average scores showed improvement from precourse 10.4 ± 5.1 to postcourse 13.3 ± 3.4 (p = .01). Discussion: This curriculum was designed for use with pediatric residents. While some of the sample cases and examples are pediatric-focused, the principles and skills are applicable to residents training in any specialty. The classes could easily be adapted for use with medical students with some clinical experience in their last two years of training.


Educational Objectives

By the end of this session, learners will be able to:

  1. Articulate understanding of general evidence-based medicine principles.
  2. Explain validity measures specific to articles about a new therapy.
  3. Demonstrate an ability to critically appraise an article about a new therapy and describe its clinical applicability.

Author Information

  • Maribeth Chitkara, MD: Stony Brook University School of Medicine
  • Rachel Boykan, MD: Stony Brook University School of Medicine

Disclosures
None to report.

Funding/Support
None to report.

Prior Presentations
Boykan R, Chitkara M. A new approach to integrating evidence-based medicine skills in resident clinical education. Presented at: Pediatric Educational Excellence Across the Curriculum Annual Meeting; September 2011.

Boykan R, Chitkara M, Farkas J. An integrated practical evidence-based medicine curriculum for pediatric residents. Presented at: AAMC Northeastern Group on Educational Affairs (NEGEA) Meeting; March 2012.

Boykan R, Chitkara M, Farkas J. An integrated practical evidence-based medicine curriculum for pediatric residents. Presented at: Pediatric Academic Societies Meeting; April, 2012.

Chitkara M, Boykan R, Messina C. Rethink journal club: year two of an EBM curriculum for pediatric residents. Presented at: AAMC Northeastern Group on Educational Affairs (NEGEA) Meeting; April 2013.

Chitkara M, Boykan R, Messina C. Rethink journal club: year two of an EBM curriculum for pediatric residents. Presented at: Association of Pediatric Program Directors and Council on Medical Student Education in Pediatrics Annual Meeting; April 2013. 

Boykan R, Chitkara M, Messina C. Initial evaluation of a longitudinal evidence-based medicine curriculum for pediatric residents. Presented at: AAMC Northeastern Group on Educational Affairs (NEGEA) Meeting; April 2013.

Boykan R, Chitkara M, Messina C. Initial evaluation of a longitudinal evidence-based medicine curriculum for pediatric residents. Presented at: Association of Pediatric Program Directors and Council on Medical Student Education in Pediatrics Annual Meeting; April 2013. 

A practical approach to teaching EBM to pediatric residents-beyond the journal club. Workshop presented at: Pediatric Academic Societies Meeting; April 2012; Boston, MA. 

A practical approach to teaching EBM to pediatric residents. Workshop presented at: Association of Pediatric Program Directors and Council on Medical Student Education in Pediatrics Annual Meeting; April 2013. 

Designing an evidence-based medicine curriculum for pediatric residents – beyond the journal club. Workshop presented at: Pediatric Academic Societies Annual Meeting; May 2013.



Citation

Chitkara M, Boykan R. An integrated practical evidence-based medicine curriculum, critical appraisal: therapy. MedEdPORTAL. 2014;10:9750. https://doi.org/10.15766/mep_2374-8265.9750