Original Publication
Open Access

An Integrated Practical Evidence-Based Medicine Curriculum, Critical Appraisal: Harm/Causation and Prognosis

Published: May 12, 2014 | 10.15766/mep_2374-8265.9788

Included in this publication:

  • Facilitator's Guide for Appraisal of Harm&Causation.docx; Prognosis.docx
  • Appendix A- CAT 3A- Harm.Causation.ppt
  • Appendix B Harm article case scenarios-2.docx
  • Appendix C Harm-Worksheet.docx
  • Appendix D CAT 3B -Prognosis.ppt
  • Appendix E Prognosis Case Scenarios.docx
  • Appendix F Prognosis Worksheet.docx
  • Appendix G Harm Causation Prognosis-Worksheets with answers.docx
  • Appendix H Harm-Causation & Prognosis Learner Evaluation Tool.doc
  • Appendix I Harm-Causation & Prognosis Resources.References.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: 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. 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. In this 1-hour session, residents are reintroduced to basic EBM principles and given instruction regarding the appraisal of articles about harm/causation and prognosis. Methods: Guided practice both during and after the sessions reinforces skills learned. This small-group session is intended for use in a longitudinal EBM curriculum. The first five sessions, how to develop an answerable clinical question/utilize evidence-based resources, how to appraise an article about a diagnostic test, how to appraise a systematic review or meta-analysis article, and how to appraise an article about therapy have been described in separate MedEdPORTAL publications. Results: Participants completing the first year of this longitudinal EBM curriculum were evaluated using a quiz comprised of true/false, matching, and multiple-choice questions prior to the initiation and at the completion of all small-group sessions. Evaluation of the first two cohorts of residents participating in our curriculum revealed overall improvement in EBM knowledge. These data have been presented at regional and national conferences, including the Association of Pediatric Program Directors and Council on Medical Student Education in Pediatrics meeting, April 2013, the Northeastern Group on Educational Affairs meeting, April 2013, and the Pediatric Academic Society Meeting EBM Special Interest Group, May 2013. Discussion: The need to teach EBM goes beyond meeting the requirements of residency. In this session, learners are reintroduced to basic EBM principles and given instruction regarding the appraisal of articles about harm/causation and prognosis. Guided practice both during and after the sessions reinforces skills learned. 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 2 years of medical school.


Educational Objectives

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

  1. Articulate general evidence-based medicine principles.
  2. Demonstrate understanding of validity measures specific to articles about harm/causation and prognosis.
  3. Exhibit an ability to critically appraise an article about harm/causation or prognosis and describe its clinical applicability.

Author Information

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

Boykan R, Chitkara M. An integrated practical evidence-based medicine curriculum, critical appraisal: harm/causation and prognosis. MedEdPORTAL. 2014;10:9788. https://doi.org/10.15766/mep_2374-8265.9788