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A comprehensive
curriculum is proposed that will educate residents in evidence-based
medicine and the use of handheld databases of secondary literature,
along with increasing their efficiency in on-line access of clinical
databases, as a response to answering a substantial portion of their
identified learning needs. The proposal calls for the creation of a
didactic program spanning evidence-based medicine principles and
basic biostatistics and for the creation of library science
workshops with required on-line library science exercises to improve
residents’ capability to perform effective literature searches.
Laptop computers with broadband internet access will be used
extensively in the workshops, and handheld digital devices in
residents’ daily patient care activities. The project also takes
advantage of the advances that have occurred in the way research and
current findings are presented as structured abstracts and POEMS
(Problem Oriented Evidence That Matters).
Residents will be
supplied with CD-based vignettes of answerable, four-part, clinical
questions and will be assisted to recognize such questions
themselves by faculty observation and stimulated recall using
videotaping of resident clinical interactions, progressing to
independent recognition. In addition to the formal curriculum and
library science exercises, residents will also perform faculty
supervised chart audits of care within the family practice center to
evidence-based standards and the public presentation of their
results in a moderated, non-judgmental meeting will be incorporated
into the basic processes of the academic atmosphere. Formal audit
will give residents the opportunity to practice evidence-based
medicine, develop the skills necessary for non-judgmental
presentation of findings, and develop skills that will help them
monitor their performance in independent practice. By-products will
include the creation of standards of ambulatory care and the
creation of an evidence-based management guide for the commonest
inpatient service admissions. Extensive pre- and post testing at all
stages, including the efficiency of library searches, is planned.
The over-arching goals
are capable of being integrated within the basic educational
processes currently in place as part of an evidence-based continuum
and will involve routine audit, faculty supervision, journal club,
and routine academic evaluation of growing evidence-based skills.
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