Peer Review

EBM Tutorial One: Introduction to Evidence-Based Medicine (EBM)

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Reviewed:: Feb 2, 2012 by Health Sciences

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Ratings

Overall Rating:

Content Quality:

Effectiveness:

Ease of Use:

Overview:: This brief (5-minute) tutorial introduces the basic concept of practicing evidence based medicine (EBM), and includes the purpose, common terminology and recommended steps for finding evidence. Freely available via Internet, it is one component of a series of brief tutorials on evidence based medicine, and is intended to be followed by part 2 which covers the development of a clinical question. It is comprised largely of textual outlines and steps, with opportunity for the user to try answering a few questions about EBM, questions which are then answered through demonstration of the concepts and steps. Keywords: evidence-based medicine, evidence-based practice, outcome assessment (health care)
Type of Material:: This learning resource is classified as a tutorial.
Recommended Uses:: Material in this tutorial can be used independently as an introduction to the concepts and resources related to evidence based practice in healthcare, or as a preliminary presentation in class. It could be used for any scholarly inquiry or evidence-based care class.
Technical Requirements:: The technical requirements include a computer with an Internet browser, such as Internet Explorer 7 or higher or Mozilla Firefox, with JavaScript enabled.
Identify Major Learning Goals:: The stated learning objectives are that the user will learn: -How EBM is defined -About clinical evidence resources -The scope of EBM practice -The steps in the EBM process
Target Student Population:: The targetaudience is largely upper level health professions or medical students affiliated with Boston University (BU), since links are provided to proprietary databases and resources subscribed by that institution. The general concepts are instructive for learners outside of BU. It is designed for independent viewing or classroom demonstration.
Prerequisite Knowledge or Skills:: Familiarity with use of online databases would be helpful to the student.

Content Quality

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Strengths:: The tutorial presents a clear and concise flow chart of information that is used to answer a clinical question, beginning with background information and progressing through filtered sources to unfiltered information. Part One provides accurate description of evidence based medicine with references to the key terms and key literature on the subject. Provides the basis to learn steps and resources for the EBM process. The student will learn about common EBM resources, e.g. ACP PIER, Cochrane Database of Systematic Reviews and BMJ’s Clinical Evidence. Includes significant, relevant examples justifying the need for EBM.
Concerns:: This tutorial could be improved by a better description of sources of clinical questions, including examples. There is an absence of newer filtering or pre-appraised sources, such as DynaMed, UpToDate,or Wiley’s Essential Evidence Plus, leads the outlined EBM process to be behind state of the art research practices. Content labeled “Where is EBM practiced?’ is unnecessary and misnamed, implying that EBM is only practiced at the sites included on the map. Following a sentence on clinical practice guidelines, there is a link to the AHRQ webpage on evidence based practice, but there is no mention of, or link to, the AHRQ’s National Guideline Clearinghouse, an important freely accessible database of clinical practice guidelines from global sources.

Potential Effectiveness as a Teaching Tool

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Strengths:: EBM Tutorial One provides a clear and concise depiction of evidence based medicine, making the case for the importance of this contemporary emphasis in health care practice. Learning goals are stated at the outset as well as the short estimated time for this segment of the tutorial series. The outline and graphical format quickly convey concepts better than narrative text or a lecture could do. The Q & A portions are useful to engage the learner in self assessment of prior knowledge, yet responses are not necessary to proceed through the material.
Concerns:: The tutorial would benefit from inclusion of the top-level, pre-appraised tools that students may encounter in health care practice. There are issues with embedded links that decrease the potential effectiveness of the tutorial.

Ease of Use for Both Students and Faculty

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Strengths:: The self-paced format is easy to browse and is flexible for the student. Navigation back and forth is simple and error free. The visual design is simple and non-distracting from the content. Relevant terms are clearly defined. Because parts of this series can be reviewed separately and references to documentary literature are included, the tutorial is a good study aid on the basics of evidence based medicine. The tutorial is short, requires no add-ons, and works with many browsers. Buttons to advance from slide to slide are easily recognized.
Concerns:: Applicability outside of Boston University is diminished by the links to subscription-based resources, which do not work for other learners. Students who are not technically savvy may not realize the presence of the embedded links as these are not introduced overtly.

Other Issues and Comments:: Reference to similar and newer information resources that might be subscribed in current and future work settings of students would be helpful. There is a minor typo on the slide "Background Information Sources," above the first bullet: "Evidence based topic oveviews broadly summarize..."
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