10 - Integrating clinical practice and evidence: how to learn and teach evidence-based medicine

Summary

Integrating the principles of evidence-based medicine (EBM) into daily practice is an important but often difficult task. Despite the obstacles due to lack of knowledge, skills and resources, many tools exist to help learn and teach EBM. Educational programmes in EBM have been shown to change the behaviour of clinicians, improving critical appraisal skills and improving the implementation of EBM in the clinical workplace. Established educational activities, such as the journal club, can be modified to place EBM at their core. Access to sources of evidence at the point of delivering care to patients can assist evidence-based decision-making. Sources of pre-appraised evidence, including evidence-based guidelines, can speed up the process of applying evidence to practice. Strategies to disseminate evidence, such as educational programmes, clinical decision support systems and audit, can be useful tools to help change the practice of colleagues.

Introduction

The principles of evidence-based medicine (EBM) are well described [1] and the integration of these principles into practice is an important part of the daily work of clinicians [2]. However, three conditions need to be satisfied before EBM will work in practice. First, practitioners need the motivation to look for the evidence base for their work. The benefits of EBM have been outlined previously in this book, but for us, keeping up to date with relevant research is primarily a matter of professional pride.