EVIDENCE-BASED CLINICAL PRACTICE WORKING GROUP(EBCP)

This initiative is lead by Gord Guyatt, Deborah Cook and colleagues. It is a multi-institutional collaboration designed to facilitate the use of clinical scientific literature. One highlight of the group's work a series of articles published in JAMA, the Users' Guide to the Medical Literature in health-care decision making. Another highlight has been implementation of an evidenced based residency program in the Department of Medicine. This initiative has had a major influence on North American clinical practice, and has promoted the leadership of the Faculty in educational innovation. We thank our colleagues in the Department of Medicine and throughout the Faculty of Health Sciences for their participation in this initiative.

EVIDENCE-BASED CLINICAL PRACTICE WORKSHOP

Clinicians who wish to practice evidence-based health care require the following skills. 
  • Defining clinical questions in a way that allows clear answers
  • Efficient searching for the best information to answer the question
  • Appraising the evidence to determine its strength
  • Extracting the clinical message from the information
  • Applying that information to ones' patients
Much of the ongoing work in evidence-based health care at McMaster involves developing strategies to deal with these challenges, and communicating them to clinicians. The Users' Guide series in JAMA, and spin-off series of similar articles in critical care and gastroeneterology, is one important strategy for this educational activity. The yearly How to Teach Evidence-based Medicine workshop is another.

The workshop is designed for educators who already understand the basics of evidence-based practice and wish to do a better job as the role models and teachers of evidence-based practice. The workshop is designed to help participants improve their skills in teaching evidence-based medicine in different educational settings (small groups, large groups and grand rounds), develop educational packages for use at their home institutions, and to improve their skills in teaching and learning in the small-group format.

In the workshop small groups, we use role play to demonstrate how we teach principles of evidence-based practice, and provide an opportunity for participants to lead the small groups. The participants then benefit from the feedback of their colleagues, and of the tutors and tutor-trainees. The latter group are drawn from outstanding participants from previous years, and usually graduate to become tutors for others who desire to learn how to teach evidence-based medicine. The cadre of McMaster-trained educational EBM leaders is thus constantly growing.

The workshop enrollment is limited to 80 participants, most of whom come from the United States. However, we usually have someone from Australia or New Zealand, several Europeans, and are seeing an increasing number of participants from Japan. The variety of participants enriches the workshop, while providing stimulating challenges for the tutors.

The largest number of participants practice in primary and secondary care internal medicine. However, we have always had groups in primary care and in pediatrics. More recently, the interest in evidence-based practice is growing in other specialty areas, and we have formed groups of emergency physicians and intensivists. Most recently, we have collaborated with colleagues in the school of nursing to conduct a group for nurse-educators, and plan to integrate nurses in to subsequent workshops.

We also take our workshops on the road, providing education both in the basics of practicing evidence-based care, and more advanced training in how to teach EBC. We see the interest growing in a variety of areas, and our efforts at evidence-based education reaching a progressively wider audience. 

Department of Clinical Epidemiology and Biostatistics 
Faculty of Health Sciences 
McMaster University 
Last modified: February 2, 1999