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Evidence-Based MedicineA New Approach to Teaching the Practice of Medicine
Evidence-Based Medicine Working Group;
Gordon Guyatt, MD, MSc;
John Cairns, MD;
David Churchill, MD, MSc;
Deborah Cook, MD, MSc;
Brian Haynes, MD, MSc, PhD;
Jack Hirsh, MD;
Jan Irvine, MD, MSc;
Mark Levine, MD, MSc;
Mitchell Levine, MD, MSc;
Jim Nishikawa, MD;
David Sackett, MD, MSc;
Patrick Brill-Edwards, MD;
Hertzel Gerstein, MD, MSc;
Jim Gibson, MD;
Roman Jaeschke, MD, MSc;
Anthony Kerigan, MD, MSc;
Alan Neville, MD;
Akbar Panju, MD;
Allan Detsky, MD, PhD;
Murray Enkin, MD;
Pamela Frid, MD;
Martha Gerrity, MD;
Andreas Laupacis, MD, MSc;
Valerie Lawrence, MD;
Joel Menard, MD;
Virginia Moyer, MD;
Cynthia Mulrow, MD;
Paul Links, MD, MSc;
Andrew Oxman, MD, MSc;
Jack Sinclair, MD;
Peter Tugwell, MD, MSc
JAMA. 1992;268(17):2420-2425.
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A NEW paradigm for medical practice is emerging. Evidence-based medicine de-emphasizes intuition, unsystematic clinical experience, and pathophysiologic rationale as sufficient grounds for clinical decision making and stresses the examination of evidence from clinical research. Evidence-based medicine requires new skills of the physician, including efficient literature searching and the application of formal rules of evidence evaluating the clinical literature.
An important goal of our medical residency program is to educate physicians in the practice of evidence-based medicine. Strategies include a weekly, formal academic half-day for residents, devoted to learning the necessary skills; recruitment into teaching roles of physicians who practice evidence-based medicine; sharing among faculty of approaches to teaching evidence-based medicine; and providing faculty with feedback on their performance as role models and teachers of evidence-based medicine. The influence of evidencebased medicine on clinical practice and medical education is increasing.
CLINICAL SCENARIO
A junior medical resident working in a teaching hospital
. . . [Full Text PDF of this Article]
Author Affiliations
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Departments of Medicine and Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario; Department of Medicine, McMaster University; Department of Clinical Epidemiology and Biostatistics, McMaster University and Departments of Health Administration and Medicine, University of Toronto (Ontario); Departments of Clinical Epidemiology and Biostatistics and Obstetrics and Gynaecology, McMaster University; Department of Pediatrics, Queen's University, Kingston, Ontario; Department of Medicine, University of North Carolina, Chapel Hill; Department of Clinical Epidemiology and Biostatistics, McMaster University and Department of Medicine, University of Ottawa (Ontario); Department of Medicine, University of Texas Health Science Center at San Antonio and Audie L. Murphy Memorial Veterans Hospital, San Antonio, Tex; Centre de Medicine Trezentize Cardio-Vasculaires, Paris, France; Department of Pediatrics, University of Texas, Houston; Department of Medicine, University of Texas, San Antonio; Department of Psychiatry, McMaster University; Departments of Clinical Epidemiology and Biostatistics and Family Medicine, McMaster University; Departments of Clinical Epidemiology and Biostatistics and Pediatrics, McMaster University; Department of Medicine, University of Ottawa (Ontario)
Footnotes
A complete list of members of the Evidenced-Based Medicine Working Group appears at the end of this article.
Reprint requests to McMaster University Health Sciences Centre, Room 3W10,1200 Main St W, Hamilton, Ontario, Canada L8N 3Z5 (Gordon Guyatt, MD).
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