Graduate medical education training in clinical epidemiology, critical appraisal, and evidence-based medicine

Abstract Background The aims of Evidence-Based medicine (EBM) are to promote critical thinking and produces better patients’ outcome (Profetto-McGrath J, J Prof Nurs Off J Am Assoc Coll Nurs 21:364-371, 2005). Accreditation Council for Graduate Medical Education (ACGME) competencies require trainees to locate, appraise and apply clinical evidence to patients’ care. Despite the emphasis that ACGME place on EBM, few organizations provide adequate training in EBM. This is even more critical in regions where medical trainees matriculate from diverse backgrounds of undergraduate medical education, where EBM may not be emphasized nor taught at all. EBM practice has a history of research in the West, however, EBM has not been widely studied in the Middle East. Methods Clinicians and trainees at Hamad Medical Corporation (HMC) matriculate from many countries in the Middle East and North Africa (MENA) and Asia. Because trainees in Graduate Medical Education (GME) come to HMC from a variety of geographic backgrounds, it is assumed that they also have a variety of experiences and aptitudes in EBM. To assess trainees EBM attitudes and knowledge in the internal medicine department at HMC in Doha, Qatar, the authors surveyed residents and fellows using a two-part survey. The first part was adapted from the evidence-based practice inventory by Kaper to assess trainees’ attitudes and perceptions of EBM. Trainees were also asked to complete the Assessing Competency in Evidence Based Medicine (ACE) tool to evaluate their aptitude in different elements of EBM. The results from the two parts were analyzed. Results The average score on the ACE tool among the participants was 8.9 (±1.6). Most participants rated themselves as beginners or intermediate in their EBM capabilities. Higher ACE scores were observed from participants with educational background from South Asia, and among those with more favorable attitudes towards EBM. There was no clear pattern that early incorporation of EBM into practice will result in better ACE score. Participants also reported reasonable abilities in EBM tasks and a favorable work atmosphere for EBM implementation. Lack of knowledge, resources, and time were the most reported barriers to utilizing EBM. Conclusions While it is clear that participants are enthusiastic about EBM and see it as a useful method for clinical decision making, their aptitude in EBM is not optimal and there are gaps and barriers for them to practice.

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Case Reports, Case Series – From Clinical Practice to Evidence-Based Medicine in Graduate Medical Education

Cureus ◽

10.7759/cureus.1546 ◽

2017 ◽

Cited By ~ 3

Author(s):

Jerry W Sayre ◽

Hale Z Toklu ◽

Fan Ye ◽

Joseph Mazza ◽

Steven Yale

Keyword(s):

Medical Education ◽

Clinical Practice ◽

Graduate Medical Education ◽

Evidence Based Medicine ◽

Case Reports ◽

Case Series ◽

Evidence Based ◽

Graduate Medical ◽

Based Medicine

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Examining aptitude and barriers to Evidence Based Medicine among trainees at an ACGME-I accredited program

10.21203/rs.3.rs-35398/v2 ◽

2020 ◽

Author(s):

Mai Mahmoud ◽

Saad Laws ◽

Antoun Kamal ◽

Dabia Al Mohanadi ◽

Ahmed Al Mohammed ◽

...

Keyword(s):

Medical Education ◽

Middle East ◽

Graduate Medical Education ◽

Evidence Based Medicine ◽

Educational Background ◽

Average Score ◽

Evidence Based ◽

Knowledge Resources ◽

Graduate Medical ◽

Based Medicine

Abstract Background The aims of Evidence-Based medicine (EBM) are to promote critical thinking and produces better patients’ outcome1. Accreditation Council for Graduate Medical Education (ACGME) competencies require trainees to locate, appraise and apply clinical evidence to patients’ care. Despite the emphasis that ACGME place on EBM, few organizations provide adequate training in EBM. This is even more critical in regions where medical trainees matriculate from diverse backgrounds of undergraduate medical education, where EBM may not be emphasized nor taught at all. EBM practice has a history of research in the West, however, EBM has not been widely studied in the Middle East. Methods Clinicians and trainees at Hamad Medical Corporation (HMC) matriculate from many countries in the Middle East and North Africa (MENA) and Asia. Because trainees in Graduate Medical Education (GME) come to HMC from a variety of geographic backgrounds, it is assumed that they also have a variety of experiences and aptitudes in EBM. To assess trainees EBM attitudes and knowledge in the internal medicine department at HMC in Doha, Qatar, the authors surveyed residents and fellows using a two-part survey. The first part was adapted from the evidence-based practice inventory by Kaper to assess trainees’ attitudes and perceptions of EBM. Trainees were also asked to complete the Assessing Competency in Evidence Based Medicine (ACE) tool to evaluate their aptitude in different elements of EBM. The results from the two parts were analyzed.Results The average score on the ACE tool among the participants was 8.9 (±1.6). Most participants rated themselves as beginners or intermediate in their EBM capabilities. Higher ACE scores were observed from participants with educational background from South Asia, and among those with more favorable attitudes towards EBM. Participants also reported reasonable abilities in EBM tasks and a favorable work atmosphere for EBM implementation. Lack of knowledge, resources, and time were the most reported barriers to utilizing EBM. Conclusions Earlier adoption of EBM education and practices leads to increased competence and it should be taught and evaluated in the undergraduate and GME programs. It is hoped that increased emphasis and attention to EBM at earlier stages will have an effect on overall clinician confidence and competence in utilizing EBM in the clinical setting. In a setting where matriculating clinicians arrive from heterogeneous educational backgrounds and EBM experiences, it is important to assess and continuously implement EBM training both cognitively and affectively.

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Examining aptitude and barriers to Evidence Based Medicine among trainees at an ACGME-I accredited program

10.21203/rs.3.rs-35398/v4 ◽

2020 ◽

Author(s):

Mai Mahmoud ◽

Saad Laws ◽

Antoun Kamal ◽

Dabia Al Mohanadi ◽

Ahmed Al Mohammed ◽

...

Keyword(s):

Medical Education ◽

Middle East ◽

Graduate Medical Education ◽

Evidence Based Medicine ◽

Clinical Decision Making ◽

Educational Background ◽

Average Score ◽

Evidence Based ◽

Graduate Medical ◽

Based Medicine

Abstract BackgroundThe aims of Evidence-Based medicine (EBM) are to promote critical thinking and produces better patients’ outcome1. Accreditation Council for Graduate Medical Education (ACGME) competencies require trainees to locate, appraise and apply clinical evidence to patients’ care. Despite the emphasis that ACGME place on EBM, few organizations provide adequate training in EBM. This is even more critical in regions where medical trainees matriculate from diverse backgrounds of undergraduate medical education, where EBM may not be emphasized nor taught at all. EBM practice has a history of research in the West, however, EBM has not been widely studied in the Middle East. MethodsClinicians and trainees at Hamad Medical Corporation (HMC) matriculate from many countries in the Middle East and North Africa (MENA) and Asia. Because trainees in Graduate Medical Education (GME) come to HMC from a variety of geographic backgrounds, it is assumed that they also have a variety of experiences and aptitudes in EBM. To assess trainees EBM attitudes and knowledge in the internal medicine department at HMC in Doha, Qatar, the authors surveyed residents and fellows using a two-part survey. The first part was adapted from the evidence-based practice inventory by Kaper to assess trainees’ attitudes and perceptions of EBM. Trainees were also asked to complete the Assessing Competency in Evidence Based Medicine (ACE) tool to evaluate their aptitude in different elements of EBM. The results from the two parts were analyzed.Results The average score on the ACE tool among the participants was 8.9 (±1.6). Most participants rated themselves as beginners or intermediate in their EBM capabilities. Higher ACE scores were observed from participants with educational background from South Asia, and among those with more favorable attitudes towards EBM. There was no clear pattern that early incorporation of EBM into practice will result in better ACE score. Participants also reported reasonable abilities in EBM tasks and a favorable work atmosphere for EBM implementation. Lack of knowledge, resources, and time were the most reported barriers to utilizing EBM. ConclusionsWhile it is clear that participants are enthusiastic about EBM and see it as a useful method for clinical decision making, their aptitude in EBM is not optimal and there are gaps and barriers for them to practice.

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1449Rapid Evidence for Practice modules: using team-based learning to teach evidence-based medicine

International Journal of Epidemiology ◽

10.1093/ije/dyab168.008 ◽

2021 ◽

Vol 50 (Supplement_1) ◽

Author(s):

Deonna Ackermann ◽

Fiona Blyth ◽

Annette Burgess ◽

Sharon Reid

Keyword(s):

Medical Education ◽

Medical Students ◽

Evidence Based Medicine ◽

Learning Strategy ◽

Clinical Epidemiology ◽

Evidence Based ◽

Graduate Medical ◽

Team Based Learning ◽

Acceptable Method ◽

Based Medicine

Abstract Background Evidence-based medicine (EBM) teaching in medical education programs introduces key clinical epidemiology concepts to the future medical workforce. Team-based learning (TBL) is a student-centred learning strategy increasingly used in medical education. We adapted the TBL framework into Rapid Evidence for Practice (REP) modules which will provide students with EBM knowledge and skills and prepare them to apply evidence within short timeframes, simulating real world clinical contexts. Methods Year 2 graduate medical students completed a REP module on randomised controlled trials (RCTs) comprising: online informational content, an individual readiness quiz; a forum featuring a critical appraisal demonstration, and a team-based rapid appraisal and application of a published RCT to a clinical scenario. Student feedback was collected by questionnaire, using closed and open-ended items. Data will be analysed using descriptive statistics and thematic analysis. Results In total, 54/259 (20%) of participants completed a questionnaire regarding the REP module. Summary quantitative results found 91% of students agreed that REP helped them develop a way to use evidence to approach clinical questions and 81% agreed they were satisfied with this method of teaching. Complete quantitative and qualitative analysis results will be presented at the congress. Conclusions Our adaption of the TBL framework into a REP module addressing RCTs was highly rated by medical students. Further evaluation of REP for other study types is planned. Key messages REP appears to be an acceptable method of delivering EBM teaching to graduate medical students.

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Examining aptitude and barriers to Evidence Based Medicine among trainees at an ACGME-I accredited program

10.21203/rs.3.rs-35398/v3 ◽

2020 ◽

Author(s):

Mai Mahmoud ◽

Saad Laws ◽

Antoun Kamal ◽

Dabia Al Mohanadi ◽

Ahmed Al Mohammed ◽

...

Keyword(s):

Medical Education ◽

Middle East ◽

Graduate Medical Education ◽

Evidence Based Medicine ◽

Clinical Decision Making ◽

Educational Background ◽

Average Score ◽

Evidence Based ◽

Graduate Medical ◽

Based Medicine

Abstract BackgroundThe aims of Evidence-Based medicine (EBM) are to promote critical thinking and produces better patients’ outcome1. Accreditation Council for Graduate Medical Education (ACGME) competencies require trainees to locate, appraise and apply clinical evidence to patients’ care. Despite the emphasis that ACGME place on EBM, few organizations provide adequate training in EBM. This is even more critical in regions where medical trainees matriculate from diverse backgrounds of undergraduate medical education, where EBM may not be emphasized nor taught at all. EBM practice has a history of research in the West, however, EBM has not been widely studied in the Middle East. MethodsClinicians and trainees at Hamad Medical Corporation (HMC) matriculate from many countries in the Middle East and North Africa (MENA) and Asia. Because trainees in Graduate Medical Education (GME) come to HMC from a variety of geographic backgrounds, it is assumed that they also have a variety of experiences and aptitudes in EBM. To assess trainees EBM attitudes and knowledge in the internal medicine department at HMC in Doha, Qatar, the authors surveyed residents and fellows using a two-part survey. The first part was adapted from the evidence-based practice inventory by Kaper to assess trainees’ attitudes and perceptions of EBM. Trainees were also asked to complete the Assessing Competency in Evidence Based Medicine (ACE) tool to evaluate their aptitude in different elements of EBM. The results from the two parts were analyzed.Results The average score on the ACE tool among the participants was 8.9 (±1.6). Most participants rated themselves as beginners or intermediate in their EBM capabilities. Higher ACE scores were observed from participants with educational background from South Asia, and among those with more favorable attitudes towards EBM. There was no clear pattern that early incorporation of EBM into practice will result in better ACE score. Participants also reported reasonable abilities in EBM tasks and a favorable work atmosphere for EBM implementation. Lack of knowledge, resources, and time were the most reported barriers to utilizing EBM. ConclusionsWhile it is clear that participants are enthusiastic about EBM and see it as a useful method for clinical decision making, their aptitude in EBM is not optimal and there are gaps and barriers for them to practice. Although structured EBM teaching is usually a part of the graduate training, the institutions should make sure that trainees have the needed resources and the protected time to effectively implement learning and practicing EBM

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Faculty Opinions recommendation of Decreasing electrosurgical transurethral resection of the prostate surgical volume during graduate medical education training is associated with increased surgical adverse events.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.2970962.2643063 ◽

2010 ◽

Author(s):

Peter Gilling ◽

Liam Wilson

Keyword(s):

Medical Education ◽

Adverse Events ◽

Graduate Medical Education ◽

Transurethral Resection ◽

Surgical Volume ◽

Graduate Medical ◽

Education Training ◽

Surgical Adverse Events

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Evidence-Based Alignment of Pathology Residency With Practice II: Findings and Implications

Academic Pathology ◽

10.1177/23742895211002816 ◽

2021 ◽

Vol 8 ◽

pp. 237428952110028

Author(s):

W. Stephen Black-Schaffer ◽

Stanley J. Robboy ◽

David J. Gross ◽

James M. Crawford ◽

Kristen Johnson ◽

...

Keyword(s):

Medical Education ◽

Graduate Medical Education ◽

Evidence Based ◽

Donor Center ◽

Laboratory Management ◽

Banking Services ◽

Graduate Medical ◽

Pathology Informatics ◽

Billing And Coding ◽

Future Practice

This article presents findings from a 4-year series of surveys of new-in-practice pathologists, and a survey of physician employers of new pathologists, assessing how pathology graduate medical education prepares its graduates for practice. Using the methodology described in our previous study, we develop evidence for the importance of residency training for various practice areas, comparing findings over different practice settings, sizes, and lengths of time in practice. The principal findings are (1) while new-in-practice pathologists and their employers report residency generally prepared them well for practice, some areas—billing and coding, laboratory management, molecular pathology, and pathology informatics—consistently were identified as being important in practice but inadequately prepared for in residency; (2) other areas—autopsy pathology, and subspecialized apheresis and blood donor center blood banking services—consistently were identified as relatively unimportant in practice and excessively prepared for in residency; (3) the notion of a single comprehensive model for categorical training in residency is challenged by the disparity between broad general practice in some settings and narrower subspecialty practice in others; and (4) the need for preparation in some areas evolves during practice, raising questions about the appropriate mode and circumstance for training in these areas. The implications of these findings range from rebalancing the emphasis among practice areas in residency, to reconsidering the structure of graduate medical education in pathology to meet present and evolving future practice needs.

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