Institute:Office of National Coordinator (ONC) Workforce Training Curriculum
Component:The Culture of Health Care
Lecture:Definition and application of EBM
Phrasing the clinical question
Slide content:The Changing Nature of EBM (Hersh, 1999) Initial approach ( first generation) was for clinician to find and critically appraise evidence Too time consuming; clinicians lack expertise More recent approach ( next generation) is synthesis and synopsis of evidence for clinician Access to online, up-to-date information makes easier Slawson & Shaughnessy (2005) argue for more emphasis on teaching information management (seeking) than on techniques of EBM 6
Slide notes:6 Evidence-based medicine has been evolving for nearly three decades. A paper in 1999 by Hersh observed this trend, referring to the initial approach to evidence-based medicine as first-generation EBM. The concept was that a clinician would actually find and critically appraise evidence as he or she was applying it in the clinical setting. The clinician would go out, find the article, critically appraise it, and then make the clinical decision. It became readily apparent, however, that the process took too much time, especially in the busy clinical setting, and that not all clinicians had the expertise to really understand study design, the nuances of statistics, and so forth. The more recent approachthe next generation of evidence-based medicinefocuses on synthesizing [sin- thuh - si -zing] and synopsizing [ si - nop - si -zing] evidence and making it available to clinicians. The goal is to provide up-to-date information, accessible online, that assists the clinician in decision making. Slawson takes this a step further, arguing that we should not be discussing the different kinds of evidence and how to critically appraise it, but instead, we should put more emphasis on teaching clinicians better information management, or information-seeking skills.