TY - JOUR
T1 - Implementation of an evidence-based medicine curriculum in a fellowship program
T2 - Can it influence clinical practice?
AU - Ramaswamy, Ravishankar
AU - Leipzig, Rosanne M.
AU - Hung, William W.
N1 - Funding Information:
The authors report no external funding source for this study. We would like to thank Dr. David A. Feldstein from the University of Wisconsin-Madison for providing access to the online portal for EBM documentation and reporting.
Publisher Copyright:
© 2020 Taylor & Francis Group, LLC.
PY - 2022
Y1 - 2022
N2 - While evidence-based medicine (EBM) curricula improves knowledge scores, correlation with physician behavior, and patient outcomes are not clear. We established an EBM curriculum for Geriatrics and Palliative Medicine fellows that included didactic teaching, opportunity for deliberate practice and presentation, and coaching and feedback from faculty experts, to determine the impact on self-assessed confidence in teaching EBM, Practice-Based Learning and Improvement (PBLI) competency rating and patient care decisions. Seventeen fellows at a New York City academic medical center participated during 2014–2015 academic year. We analyzed pre-/posttest surveys for self-assessed confidence in teaching EBM concepts, EBM worksheets for content of clinical questions and impact on patient care, and PBLI competency ratings for overall impact. Posttest survey indicated that fellows’ self-assessed confidence in teaching EBM increased significantly. While most found Journal Club discussions and EBM case conferences valuable, only 36% of fellows found EBM worksheets completion to be good use of time (average completion time 89 minutes). EBM worksheets helped reinforce or change plan of care in 32 out of 50 cases. There was no impact on end-of-the-year PBLI ratings. This curriculum, integrating didactic, self-directed and peer learning with objective feedback, increased self-assessed confidence in teaching EBM, and influenced patient care plans.
AB - While evidence-based medicine (EBM) curricula improves knowledge scores, correlation with physician behavior, and patient outcomes are not clear. We established an EBM curriculum for Geriatrics and Palliative Medicine fellows that included didactic teaching, opportunity for deliberate practice and presentation, and coaching and feedback from faculty experts, to determine the impact on self-assessed confidence in teaching EBM, Practice-Based Learning and Improvement (PBLI) competency rating and patient care decisions. Seventeen fellows at a New York City academic medical center participated during 2014–2015 academic year. We analyzed pre-/posttest surveys for self-assessed confidence in teaching EBM concepts, EBM worksheets for content of clinical questions and impact on patient care, and PBLI competency ratings for overall impact. Posttest survey indicated that fellows’ self-assessed confidence in teaching EBM increased significantly. While most found Journal Club discussions and EBM case conferences valuable, only 36% of fellows found EBM worksheets completion to be good use of time (average completion time 89 minutes). EBM worksheets helped reinforce or change plan of care in 32 out of 50 cases. There was no impact on end-of-the-year PBLI ratings. This curriculum, integrating didactic, self-directed and peer learning with objective feedback, increased self-assessed confidence in teaching EBM, and influenced patient care plans.
KW - Evidence-based medicine
KW - curriculum development
KW - evidence-based decision making
KW - geriatrics fellowship
KW - graduate medical education
UR - http://www.scopus.com/inward/record.url?scp=85087006119&partnerID=8YFLogxK
U2 - 10.1080/02701960.2020.1777409
DO - 10.1080/02701960.2020.1777409
M3 - Article
C2 - 32524910
AN - SCOPUS:85087006119
SN - 0270-1960
VL - 43
SP - 92
EP - 101
JO - Gerontology and Geriatrics Education
JF - Gerontology and Geriatrics Education
IS - 1
ER -