An Integrated Practical Evidence-Based Medicine Curriculum, Critical Appraisal: Systematic Reviews and Meta-analyses

Abstract

Abstract Introduction The need to teach evidence-based medicine (EBM) goes beyond meeting the requirements of residency. For residents and all practicing physicians there must be a process to ensure that doctors know the latest and best information to apply to the care of their patients. Typically, in the majority of pediatric training programs, EBM is taught in the context of a journal club, which may not develop the skills needed to integrate EBM into one's own clinical practice. Methods This small-group session is intended for use in a longitudinal EBM curriculum. The first three sessions, how to develop an answerable clinical question, how to utilize evidence-based resources, and how to appraise an article about a diagnostic test have been published in separate MedEdPORTAL publications. In this 1-hour session, residents are reintroduced to basic EBM principles and given instruction regarding the appraisal of an article about systematic reviews and meta-analyses. Guided practice both during and after the sessions reinforces skills learned. Results At our training program, participants in the curriculum were evaluated using a quiz comprised of true/false, matching, and multiple-choice questions prior to the initiation and at the completion of all small-group sessions. Evaluation of the first two cohorts of residents revealed overall improvement in EBM knowledge. Discussion While the curriculum was designed for and has been studied on pediatric residents, it could easily be adapted for use by a broader audience including residents of any specialty, and medical students in their last 2 years of medical school.

Keywords

• Evidence-Based Medicine
• Meta-Analysis
• Pediatrics
• Systematic Review
• Critical Appraisal