EBM Foundation Course

EBM Foundation Course - Curriculum Development

Presented by

National & Gulf Center for Evidence Based Health Practice
(NGCEBHP)

All Residents and Fellows are Invited to Attend this course

Date,Time and Venuecourses will be posted.

Schedulerefer to our calendar.

EBM Foundation Course Requirements
Minimal Criteria for approving Evidence-Based Medicine (EBM) courses for the Resident by the Saudi Council of Health Specialities

NGCEBHP

NGCEBHP is officially recognized by the GCC ministers of Health as an EBM referral center for Saudi Arabia and the Gulf region. A decree issued with this recognition during the 57th conference held in Geneva on 19th of May 2004 (Decree 6 item 3).

NGCEBM is an officially affiliated center to Evidence Based Clinical Practice Group in McMaster University- Canada. This Group is lead by Prof. Gordon Guyatt, the leader and one of the founders of EBM all over the world.

NGCEBM works in contact, coordination and collaboration with the National EBM committee, GCC Ministers of Health Executive Office, Arabian Gulf University EBM Center (Bahrain) and Sultan Qaboos University EBM Center (Oman).

Communications already started with the referral Cochrane Center for Arab region (UKCC), the Center of Health Evidence (Alberta) and the Eastern Mediterranean Regional Office (EMRO) of WHO to enhance future activities.

EBM & Residency Training Programs

Physicians have the commitment to quality care and to practice on the basis of their knowledge of the most effective management strategy for a particular condition. In the last few decades, the amount of information concerning available treatment and management options for many conditions has increased exponentially. Selection of best available evidence appropriate for individual patients’ care is the cornerstone of the Evidence Based Medicine (EBM) practice.

The importance of including EBHP in the residency curriculum is well recognized by many programs in developed countries namely USA, Canada, UK and Australia. Recently, the Saudi Council for Health Specialties (SCHS) has incorporated EBM in the residency curricula, as the EBM course is mandatory for all residents before their graduations. A well recognized program is needed to fulfill the requirement of such an important foundation course. The SCHS approached the NGCEBHP for conducting EBM courses directed to residents in various specialties with reduced fees (letter No. 1763/3 dated 6/4/1426 H, attachment I). Being a referral center in KSA and the Gulf region, the NGCEBHP in National Guard Health Affairs will assume such responsibility.

Aim

The ultimate purpose of teaching the residents the principles and practice of EBM is to foster life-long self-teaching, self-evaluation and to promote improvement of the care they provide to their patients.

Requirements
The key curriculum is design to fulfill the following:
1	Explicit-intended learning outcomes
2	Increased proficiency in the principles and practice of EBM
3	Faculty-qualified, able, willing and rewards in teaching practice EBM
4	Resources including time, physical space and tools necessary for EBM
5	Systematically developed content
6	Integration with other elements of residency training
7	Better transposition of EBM skills from the classroom to the bedside
8	Novel teaching strategies and more learner-centered education
9	Evaluation scheme and assessment tools

Learning objectives

1. Skills
By the end of the EBM foundation course the residents will be able to:
1	Translate the uncertainty into an answerable question
2	Devise a strategy and conduct efficient literature searches on a variety of available databases
3	Critically appraisal of the evidence for validity and clinical importance
4	Apply the appraised evidence to practice
5	Evaluation of the performance

2. Attitudes
By the end of the course, the residents will:
1	Appreciate the advantages of practicing EBM
2	Find the EBM curriculum to be a valuable educational experience.

3. Behavior
By the end of course, the residents will:
1	Increase their use of evidence from clinical research to help to solve the problems they may encounter
2	Continue to practice and teach EBM throughout their clinical careers.

4. Knowledge
By the end of course, the residents will have:
1	The skills to update their knowledge, as it evolves, over the time span of their careers.

Financial

The course fee is SR1,000 which is a round 70% of the regular fee for such course. Attendees will pay the fee to contribute to the cost of the course, which is a non-profit one. The course fees include Catering (Refreshment, Breakfast and Lunch) and the educational materials.

Faculty

EBM qualified teachers and instructors from all over the Kingdom will be involved with excellent experience in teaching EBM and search strategies (see attachment III).

Duration of the course
The course duration is 3 days with minimum 7 hours per day
1	Two and half days for the course
2	Half day for assessment.

Frequency of the courses

Excluding the Eid’s holiday, resident examination and summer vacations months, a minimum of five courses per year will be conducted, providing a minimum of 20 participants will be pre registered.

Venue and Space

NGCEBHP Center, 1st Floor, College of Medicine Building B, King Saud bin Abdulaziz University for Health Sciences. With facilities, including Computer laboratory will be the place to run the course, large auditorium and classrooms.

Computer Laboratory

There are 2 Computer Laboratories, connected to fast speed Internet .For teaching purposes a projection unit and Smart board is made available to enable facilitators to use his own computer or presentations and teaching sessions for search. At one time, no more than 2 candidates will be utilizing one (1) computer at the session of computer search. The following databases will be available: Midline, Cochrane Databases for Systematic Review, DARE, Clinical Evidence, Evidence Based Medicine, ACP Journal Club, TRIP Database, GACGUIDELINES and SUM Search.

Educational Material

A special scientific committee is responsible for the selection of high standard teaching materials as well as updating them on regular basis. The committee is working with the official affiliation and cooperation with McMaster University - Evidence Based Practice working group lead by Prof. Gordon Guyatt. The educational materials will be ready for collection by the participants at least one week before the course.

Contents outline
	EBM Steps	Theory/hr	Practice/hr
1	Translation of uncertainty into an answerable question	1	1
2	Search for and retrieval of evidence	1	3
3	Critical appraisal of evidence for validity and importance	1	8
4	Application of Appraised evidence to practice	1	2

Additional Notes

Study methodology & design was added in the first day with concentration on design of RCT
The 2 practical sessions on application of evidence will utilize pre-appraised papers (either the papers that were appraised during the course or from pre-appraise resources) and rigorously checking its applicability criteria on different patients’ Scenarios.

Evaluation

1. Pre-test

Set No. I
“Homework”
Aim: to test skills
*	A clinical scenario will be distributed at least one week before the course “included in the educational material”
*	Candidates will be asked to implement the 5 steps by using a computerized template form.
*	It’s homework to stimulate the candidate to the course.

Set No. II
“Homework”
Aim: to test skills
*	Another overnight homework material will be distributed in the 2nd day of the course in form of an article to appraise and bring in the following day.

2. Continuous assessment

Aim: to test the active participation of candidates

Main areas of assessment: knowledge, positive participation, attitude, and preparation

This can be achieved by supervision of candidates’ performance throughout the course.

3. Post- test "Final assessment"

Post- test
"Final assessment"
A Computer-based OSCE exam that will cover the following skills:
1	Formulating an answerable questions presenting a clinical scenario
2	Searching the evidence
3	Critically appraise the evidence
4	Putting evidence in to practice involving an active interaction (clinical simulation)
5	Assessment of performance.
Additional questionnaires may also be used

4. Evaluation of the course by participants

Standard forms will be distributed to all participants to evaluate the course, the instructors, the educational materials, the course organization, etc.

The candidate will be given the option to write 500-1000 words to describe his/her experience in the application of the 5 steps of EBM.

Certificate

All the attendees who pass the evaluation with marks above 75% will be given a certificate of successful completion of the EBM foundation course.

CME

The course will apply for accreditation from the SCHS for CME hours.

Conclusion

The development of EBM Fundamental course is essential step and cornerstone for the implementation and dissemination of Evidence Based Practice in the health care field in the KSA.

Referncences
1	Sackett, D.L. et al. (1997). Evidence-Based Medicine, How to Practice and Teach EBM. London: Churchill Livingstone.
2	Ayanian, J.Z. et al. (1994) Knowledge and Practices of Generalist and Specialists Physicians Regarding Drug Therapy for Acute MI. NEJM Vol. 331, 1136-42.
3	Brand, D.A. et al. (1995). Cardiologists' Practices Compared with Practice Guidelines: Use of Beta-Blockade after Acute MI. J Am Coll Cardiol Vol.26, 1432-6.
4	Soumerai, S.B. et al. (1997). Adverse Outcomes of Under use of Beta-Blockers in Elderly Survivors of Acute MI. JAMA Vol. 377, 115-21.
5	Covell, D.G. et al. Information Needs in Office Practice: Are They Being Met? Ann Intern Med Vol. 103, 586-9.
6	Osiobe, S.A. et al. (1985). Use of Information Resources by Health Professionals: A Review of the Literature. Soc Sci Med Vol. 21, 965-73.
7	McKibbon, K.A. et al. (1990). How Good are Clinical MEDLINE Searches? A comparative Study of Clinical End-User and Librarian Searches. Comput Biomed Res Vol. 23, 583-93.
8	Weiss, S.T. et al. (1980). An Assessment of Physician Knowledge of Epidemiology and Biostatistics. J Med Educ Vol. 55, 692-7.
9	Berwick, D.M. et al. (1981). When Doctors Meet Numbers. Am J Med Vol. 71, 991-8.
10	Barondess, J.A. (1981). The Future Physician: Realistic Expectations and Curricular Needs. J Med Educ Vol. 56, 381-9.
11	Rafuse, J. (1994). Evidence Based Medicine Mean M.D.s Must Develop New Skills and Attitudes, CMA Conference Told. CMAJ Vol. 150, 1479-80.
12	Accreditation Council for Graduate Medical Education. (1996-97). Program Requirements for Residency Education in Internal Medicine: Special Educational Requirements. In: The Graduate Medical Educator Directory. Chicago, Il: AMA.
13	Wiebe, S., and Demaerschalk, B. (1998). Evidence Based Neurology Comes of Age: Introduction to Residency Programmes. Canadian Journal of Neurological Sciences, Vol. 25, (Suppl 2):S80 Abstract.
14	Demaerschalk, B., Wiebe, S. (1998). Evaluating the Relevance of Evidence Based Medicine in a Neurology Residency Programme. Canadian Journal of Neurological Sciences, Vol. 25(Suppl 2):S79-S80 (Abstract).
15	Linzer, M. Et al. (1986). Role of a Medical Journal Club in Residency Training. J Med Educ Vol. 61, 471-3.
16	Sidorow, J. (1996). How are Internal Medicine Residency Journal Clubs Organized and What Makes Them Successful? Arch Intern Med Vol. 155, 1193-7.
17	Woods, J.R. et al. (1982). Journal Club Format Emphasizing Techniques of Critical Reading. J Med Educ Vol. 57, 799-801.
18	Kitchens, J.M. et al. (1989). Teaching Residents to Read the medical Literature: A Controlled Trial of Curriculum in Critical Appraisal/Clinical Epidemiology J Gen Intern Med Vol. 4, 384-7.
19	Gehlbach, S.H. et al. (1980). Teaching Residents to Read to Medical Literature J Med Educ Vol. 55, 362-5.
20	Inui, T.S. (1981). Critical Reading Seminars for Medical Residents: Report of a Teaching Technique Med Care Vol. 29, 122-4.
21	Green, M.L. and Ellis, P.J. (1997). Impact of an Evidence-Based Medicine Curriculum Based on Adult Learning Theory. J Gen Intern Med Vol. 12, No. 12, 742-50.
22	Kenney, A.F. et al. (1998). Introducing Evidence-Based Medicine into a Community Family Medicine Residency. J Miss State Med Assoc. Vol. 39, No. 12, 441-3.
23	DeLisa, J.A. et al. (1999). Evidence-Based Medicine in Physiatry: The Experience of One Department's Faculty and trainees. Am J Phys Med Rehabil. Vol. 78, No. 3, 228-32.
24	Norman, G.R. and Shanon, S.I. (1998). Effectiveness of Instruction in Critical Appraisal (Evidence-Based Medicine) Skills: A Critical Appraisal. CMAJ, Vol. 158, No.2., 177-181.
25	Swanson, D.B., Norman, G.R., and Linn, R.L. (1995). Performance-Based Assessment: Assessment: Lessons From the Health professions. Educ Res, Vol. 24, 5-11.
26	Knowles, M. (1984). The Adult Learner: A Neglected Species. Houston, TX: Gulf Publishing Co.
27	Brookfield, S.D. (1995) Becoming a Critically Reflective Teacher. San Francisco: Jossey-Bass Publications.
28	Cross, K.P. (1981). Adults as Learners. San Francisco: Jossey-Bass
29	Glasser, W. (1986). Control Theory in the Classroom. New York: Perennial Library.
30	Fortner, R. (1999). Using Cooperative Learning to Introduce Undergraduates to Professional Literature. Journal of College Science Teaching. 261-265.
31	Rolheiser-Bennet, N. (1986). Four Models of Teaching: A Meta-Analysis of Student Outcome, Unpublished Ph.D. dissertation, University of Oregon, Eugene.
32	Hansen, E.J. (1998). Creating Teachable Moments and Making Them Last. Innovative Higher Education, Vol. 23, No. 1, 7-26.
33	Demaerschalk, B., Wiebe, S., and Jenkins, M. (1999). Evaluating the Impact of an Evidence Based Medicine Curriculum in a Neurology Training Programme. Canadian Journal of Neurological Sciences Vol. 26, (suppl 1):S52 (Abstract).

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