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Practising EBM

Formulating Answerable Clinical Questions

Searching for the Best Evidence

Critical Appraisal of the Evidence

Applying Evidence to Patients

Evaluation

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Teaching EBM
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Practising EBM > Evaluation
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The fifth step in practising EBM is self-evaluation and we've suggested some approaches for doing this in the tables that follow.
SELF-EVALUATION TABLES

Self-evaluation in asking answerable questions
Self-evaluation in finding the best external evidence
Self-evaluation in critically appraising the evidence for its validity and potential usefulness
Self-evaluation in integrating the critical appraisal with clinical expertise and applying the result in clinical practice
Self-evaluation in teaching EBM
Self-evaluation of continuing professional development

Self-evaluation in asking answerable questions
  1. Am I asking any clinical questions at all?
  2. Am I asking well-formulated (3-part) questions?
  3. Am I using a "map" to locate my knowledge gaps and articulate questions?
  4. Can I get myself unstuck when asking questions?
  5. Do I have a working method to save my questions for later answering?
  6. Is my success rate of asking answerable questions rising?
  7. Am I modeling the asking of answerable questions for my learners?
  8. Am I writing any educational prescriptions in my teaching? Are they being filled?
  9. Are we incorporating question asking and answering into everyday activities?
  10. How well am I guiding my learners in their question asking?
  11. Are my learners writing educational prescriptions for me?

Self-evaluation in finding the best external evidence
  1. Am I searching at all?
  2. Do I know the best sources of current evidence for my clinical discipline?
  3. Have I achieved immediate access to searching hardware, software and the best evidence for my clinical discipline?
  4. Am I finding useful external evidence from a widening array of sources?
  5. Am I becoming more efficient in my searching?
  6. Am I using MeSH headings, thesaurus, limiters, and intelligent, free text when searching MEDLINE?
  7. How do my searches compare with those of research librarians or other respected colleagues who have a passion for providing best current patient care?

Self-evaluation in critically appraising the evidence for its validity and potential usefulness
  1. Am I critically appraising external evidence at all?
  2. Are the critical appraisal guides becoming easier for me to apply?
  3. Am I becoming more accurate and efficient in applying some of the critical appraisal measures? (such as likelihood ratios, and NNTs)
  4. Am I creating any CATs?

Self-evaluation in integrating the critical appraisal with clinical expertise and applying the result in clinical practice
  1. Am I integrating my critical appraisals into my practice at all?
  2. Am I becoming more accurate and efficient in adjusting some of the critical appraisal measures to fit my individual patients? (such as pretest probabilities, NNTs etc)
  3. Can I explain (and resolve) disagreements about management decisions in terms of this integration?
  4. Have I conducted any clinical decision analyses?
  5. Have I carried out any audits of my diagnostic, therapeutic or other EBM performance?

Self-evaluation in teaching EBM
  1. When did I last issue an educational prescription?
  2. Am I helping my trainees learn how to ask answerable questions?
  3. Am I teaching and modeling searching skills?
  4. Am I teaching and modeling critical appraisal skills?
  5. Am I teaching and modeling the generation of CATs?
  6. Am I teaching and modeling the integration of best evidence with my clinical expertise and my patients' preferences?
  7. Am I developing new ways of evaluating the effectiveness of my teaching?
  8. Am I developing new EBM educational material?
    **if so, please share them with others and add them to the bank of resources available on this site**

Self-evaluation of continuing professional development
  1. Am I a member of an EBM-style journal club?
  2. Have I participated in or tutored at one of the workshops on how to practice or teach EBM?
  3. Have I joined the evidence-based health e-mail discussion group?
  4. Have I established links with other practitioners or teachers of EBM?

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