EBM Foundation Course - Curriculum
Development
Presented by
National & Gulf Center for Evidence Based Medicine (NGCEBM)
NGCEBM:
NGCEBM 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 EBM 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 NGCEBM 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 NGCEBM 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 800 SR, 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.
Avenue and Space
The
Postgraduate Training Center (PTC) with all its facilities, including Computer
laboratory will be the place to run the course.
Computer Laboratory
The computer
laboratory has 24 computers, connected to fast speed Internet .For teaching
purposes a projection unit (LCD) 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”
·
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”:
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.
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