Evidence-Based Medicine (EBM) is the use of best evidence to allow health care teams to make decisions about the care of patients. The practice of EBM utilizes efficient electronic resource-tools to gather high quality primary and secondary literature resources to identify and solve problems, as well as form best practices. Medical knowledge is constantly changing and expanding. Clinicians must have the EBM training and resources to incorporate these changes into their practice in an efficient and accurate manner.
EBM resources and tools can be used in a variety of ways. Some tools are used to identify quickly and efficiently the management strategies of individual patients. Others are used to identify and develop best practices for various patient populations. Resources can also be used to identify unique medical phenomena and form strategies for contributing to medical knowledge. In addition to the EBM tools used for direct patient care, EBM content also includes instruction on study design, quality of evidence and biostatistics.
The practice and use of EBM should develop throughout medical school and continue through the lifelong practice of medicine. Here are some of the objectives of our EBM curriculum:
- Students should be able to form clinical questions using an evidence-based approach to advance patient care.
- Students should be able to insert themselves into the clinical team and be responsive to the clinical team using all identified EBM tools, especially PubMed, secondary summary search tools and guideline search tools.
- Students should be able to identify the function of all relevant EBM tools. Students should be able to use all relevant EBM tools longitudinally across various clinical situations.
- Students should be able to accurately and concisely present the rationale, methodology, results and conclusions of a primary study. Students should be able to identify primary studies relevant to a patient issue.
- Students should be able to:
- Determine when to use various biostatistical tools.
- Evaluate the biostatistical approach of primary studies to determine if study conclusions are impactful and relevant to clinical practice.
EBM resources and practices are interwoven into all aspects of the medical student curriculum. Early in the curriculum students learn about the use of primary literature to support Case-Based Instruction and problem solving. Other EBM tools evolve longitudinally across the curriculum to support scholarly research projects, knowledge of biostatistics, biomedical informatics and population medicine. As clinical clerkships begin, EBM training activities provide students with the skills to engage and respond to clinical situations during required and elective clerkship activities. Later, patient entrustability assessments, chart review exercises, and simulation allow students to refine their EBM skills with respect to patient evaluations and presentations.