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2008 EBM teachers meeting minutes

EBM Teachers Networking Session Sixth Annual

 

Meeting Minutes

 

Introduction by:

Dr. Colleen Kirkham, Curriculum Coordinator for EBM UBC Department of Family Practice ckirkham@interchange.ubc.ca

 

111 members now on EBM teachers list serve, 8 new members added at FMF 08

 

Introductions by all attendees, 24 people in attendance

 

This session is a forum for collaboration between EBM teachers from universities across Canada and more recently including some teachers from the USA and UK. 

 

Update on new teaching tools/strategies for EBM – a show and tell

(many presenters so each was asked to limit presentation to 7 min)

  1. Dr. Michel Labrecque, Laval: An evaluation of evidence-based content in CME activities and an RCT comparing trip database and infoclinique.

Dr Labrecque presented four websites devoted to EBM teaching.

1) InfoCritique, web-based interactive auto-tutorial, is combined with face-to-face journal clubs to teach critical appraisal. (http://infocritique.fmed.ulaval.ca)

2) InfoClinique, a medical search engine now freely accessible, is used to help clinician finding answers to their clinical questions. The interface is now available in English and the majority of resources are in English. (http://infoclinique.fmed.ulaval.ca)

3)  EBMSources provides an evaluation for clinical usefulness of EBM websites (http://www.ebmsources.fmed.ulaval.ca)  A new validated tool named “CLUE-W” will soon be used to this end. EBMsources evaluations are posted both on Tripdatabase and InfoClinique.

4) Critique et Pratique, an online journal club, has now over 700 articles available. (http://cetp.fmed.ulaval.ca/cetp).

All these sites are available on a single portal at http://erictis.fmed.ulaval.ca/

Dr. Labrecque also briefly discussed two recent studies done with residents who provide very positive feedback about their learning experience within these projects. The first one is an RCT where residents attempted to answer 30 clinical questions (generated by 15 residents) using Infoclinique (Laval) or Tripdatabase (UK). The results of finding the correct answer to the question were similar for both search engines. The second one was an evaluation of evidence-based content in CME activities related to therapy. The study revealed that the quality of 10 face-to-face CME presentations and 30 CME articles do not meet minimal standards to allow clinicians to discuss the benefits and risks associated with therapeutic options with their patients and to engage in shared decision making. 

  1. Dr. Fred Tudiver, East Tennessee State University: An OSCE for measuring skills of EBM /information mastery

Dr. Tudiver presented an OSCE he has developed for evaluating learners EBM skills. The OSCE is a 30 minutes station based on a clinical OSCE scenario that the learner would have just completed. The student has to form a PICO question and search for an answer. They are evaluated on efficiency and whether they were able to find the correct answer. Few existing tools measure the performance of evidence-based clinical maneuvers in practice. Dr. Tudiver noted that the tool was not strong in assessing critical appraisal skills, levels of evidence and relevance. The EBM OSCE can be found on the CHEWS website at http://ebm.oscarmcmaster.org/evaluation  

  1. Dr. Roland Grad, McGill: An update on CIHR funded research to validate the Information Assessment Method

Roland Grad discussed his work to validate the Information Assessment Method (IAM). Two posters of research in-progress were just presented at NAPCRG:

1.       Cognitive impact of research-based synopses delivered on email (PUSH) vs. retrieved on handheld computer (PULL)

2.      Negative cognitive impact reported by family physician users of Electronic Knowledge Resources

Both posters are available on the CHEWS site at http://ebm.oscarmcmaster.org/teachers/mcgill

 

 

 

IAM is a tool that can be used by clinical teachers or researchers. For teachers, IAM can help to build portfolios of brief self-directed e-learning. For researchers, IAM is used to study the relevance, cognitive impact, use and expected health benefits of information items derived from electronic knowledge resources. The Canadian Institutes of Health Research has posted a link to IAM as an example of tools used as part of KT interventions http://ktclearinghouse.ca/kttools/generictools/iam

 

4.      Dr. Cameron Ross, UBC : New complex care forms in an open source (free) electronic medical record that incorporate evidence –based care prompts at the point of care

Dr. Ross demonstrated new “eforms” developed in an open source (free) electronic medical record to support evidence based practice. The forms have been developed to support the care of 7 chronic diseases (CHF, DM, CKD, IHD, ASTHMA, COPD, cerebrovascular disease). The forms autopopulate with some pt data, then provide places for recording steps of care, clinical practice guidelines are imbedded into the forms as well as links to relevant EBM sources and handouts.  www.oscarcanada.org

  1. Dr. Michael Allen, Dalhousie, Canadian Academic Detailing Collaboration

Dr. Allen spoke about the Canadian Academic Detailing Collaboration. He noted that the collaboration had developed a clinical significance calculator which will be posted on the CHEWS website. http://ebm.oscarmcmaster.org/ebm-resources/canadian-academic-detailing-collaboration   The calculator calculates statistics that may not be given in all clinical trials: event rates, relative risk reduction, absolute risk reduction, and numbers needed to treat with 95% confidence intervals.  He asked if there would be interest in forming an evidence-based speakers bureau. There seemed to be much interest and this. The issue of what criteria would be used to determine if a speaker was “evidence-based” was raised. Dr. Labrecque expressed an interest in collaborating on this project. Several group members said they would be willing to be speakers. A tab on the CHEWS website could be made for this project.  Dr. Allen also asked if there was interest in forming an evidence-based educational interest group at CAME (Canadian Assoc of Medical Education). This would require at least 5 interested individuals to be CAME members. None of the teachers present were currently members of CAME.   

  1. Dr. Tom Elmslie, University of Ottawa: update on the accessibility of the ePearls Desktop to FM residency programs and its use in the ARC program

Dr. Elmslie reviewed that the epearls desktop had been piloted by residents at UBC, Ottawa and Laval. Since April 2008 it is a core part of the ARC program of the CFPC and 160 practice eligible candidates had participated. The College has set a goal of making the desktop available to all CFPC members by FMF 2009. A pilot project with College member is about to begin. Dr. Elmslie expects it will be open to all residency programs by July 2009.

  1. Dr. Michelle Howard, McMaster : A seminar on “selling sickness” about the pharmaceutical industry. It can be found at http://ebm.oscarmcmaster.org/teachers/mcmaster/selling-sickness

Dr. Howard described a seminar on selling sickness that they were using a McMaster.

  1. Dr. Inge Schabort and Michelle Howard, Mcmaster: An introduction to EBM for IMGs

Drs. Schabort and Howard described a seminar that use for introducing EBM concepts to IMGS. See  http://ebm.oscarmcmaster.org/teachers/mcmaster

  1. Brent Jensen Updates from RxFiles

A new EBM overview chart is available for RxFiles. Brent thanked members of the EBM teachers group who had provided feedback. A new RxFiles comparison book has been available since October 2008 and was selling very well at FMF. It is also available in a new larger size. The RxFiles website has been updated and improved and RxFiles newletters are available on the website. www.RxFiles.ca

  1. The group discussed planning for FMF 2009. Dr. Elmslie suggested that we might need to arrange a separate session in order to have time to discuss issues facing EBM teachers and barriers to teaching EBM. There was discussion about requesting time on the Wednesday during the section of teachers day. Martin Dawes is involved in organizing this and said he would look into it.  It was felt that the early morning meetings (1.25 hours) are too short to allow for a national show and tell and that we should continue to schedule the EBM teachers meeting during the day. Sessions called “meetings” are often moved outside the main conference centre during FMF.

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