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Online Curriculum Overview

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Introduction

Evidence Based Medicine (EBM) is a popular catch phrase these days, but, like any knowledge or skillset in medicine, it can be misinterpreted or misapplied. When practiced correctly, EBM can help you integrate best evidence into patient care and can help you evaluate the medical literature you may encounter whe trying to answer clinical questions. Our goal is to give CHOP Pediatric residents a solid foundation in practicing EBM, including experience with the tools to do so effectively.

As part of the Pediatric Teaching Senior month, you will work in groups to create a Critically Appraised Topic, or CAT file. CAT files are brief, clinically relevant summaries of a clinical question of your choice, and they are an indispensible tool in teaching basic EBM techniques.

The general structure of the curriculum requires that you read through the materials provided, gather relevant information, and complete some brief written exercises prior to meeting with your EBM Preceptor for the month.

At the end of the month, you will present your CAT file during Senior Rounds or Morning Report, and the CAT file will be submitted to our CATS Bank so other users can learn from your evaluation of the literature.

In preparation for creation of your CAT file, please read through the following instructions for how to access the EBM teaching materials. Feel free to
send your comments or questions via email to Bimal Desai at "desai /at/ email [dot] chop {dot} edu".

Thanks to the kindness of the Duke University Medical Center Library and the Health Sciences Library at UNC-Chapel Hill, we have permission to link to their excellent EBM tutorial (click HERE for the link). The site consists of four major sections and a final skills test.

Section 1: What is EBM?

A general overview of EBM, with reference to ideas proposed by EBM proponent Dr. David Sackett from McMaster University.

Section 2: The Well-Built Clinical Question

Asking the right question is just as important as finding the right answer. This section walks the you through the process of asking a clinically relevant, unambiguous, and answerable question. This question will become the basis of your CAT file.

Section 3: The Literature Search

This section shows you how to translate your clinical questions into appropriate PubMed/MEDLINE search strategies that are most likely to yield useful results. You are encouraged to follow along with the examples provided and experiment with the PubMed search interface. At first glance, the PubMed interface can be daunting, but with a little practice it can be a very powerful tool.

Section 4: Evaluating the Evidence

Once you have identified a handful of pertinant articles that address your clinical question, the next step is to evaluate the evidence. Your goal is to examine the quality, validity, and applicability of the evidence you found.

Depending on your clinical question, you may have to look at different subsections of this link. There are different links for evaluating papers on therapy, diagnosis, prognosis, and etiology/harm.

Final Skills Test: Test Your Knowledge

Finally, you've completed the tutorial! The first case in this section allows you to test what you've learned using the case of Henry, a 5 year old boy with a history of fever and sore throat.

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