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

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

Academic Medicine ◽

10.1097/00001888-199906000-00017 ◽

1999 ◽

Vol 74 (6) ◽

pp. 686-94 ◽

Cited By ~ 104

Author(s):

M L Green

Keyword(s):

Medical Education ◽

Graduate Medical Education ◽

Evidence Based Medicine ◽

Critical Appraisal ◽

Clinical Epidemiology ◽

Evidence Based ◽

Graduate Medical ◽

Education Training ◽

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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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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