Rotation Expectations

Year One: Introduction to basic Evidence-based Medicine Principles

Goal: To ask an answerable clinical question in PICO format, to search effectively for an answer, and to critically appraise relevant articles.

Objectives:

  1. To ask a question in PICO format
  2. To complete a search using strategies such as PubMed Clinical Queries, PubMed MESH.
  3. To understand basic principles of critical appraisal, specifically, for each of four major topics (therapy, diagnosis, harm/prognosis, systematic review):
    1. Validity measures
    2. Evaluation of results
    3. Applicability

Administrative Details:

You will attend six small group sessions, spaced out throughout your intern year. Be aware that the groups will not always be the same, so please pay attention to your individual schedule.

The first two groups take place in the HSC library; sessions 3 – 6 take place in the pediatric department on the 11th floor. All materials are available on line on the curriculum website. You will also be given paper copies in folders. Please bring these to all classes.

Each small group follows the same format: a brief didactic introduction, followed by group practice. You will have homework after every session. Please do it within 1 – 2 weeks (maximum) from the end of the session. The material is only really learned through practice. Homework shouldn’t take a lot of time, but the longer you wait, the harder it is! If there is a senior TA for your session, you will hand your homework into that person for review. We will then review it all together during one of two group reviews.

In the event that you miss a session please let us know – you will need to make it up, and it is challenging to schedule this!

If you have any questions at any time, don’t hesitate to come to Drs. Boykan and Chitkara. It is our hope that you will learn to love EBM as we do!

Year Two: Critically Appraised Journal Club (CAT)

Goal: To present an evidence-based literature review on a relevant clinical question.

Objectives:

  1. To identify an answerable clinical question
  2. To do a comprehensive search for the clinical question
  3. To choose and evaluate appropriate articles to answer the clinical question, using the critical appraisal skills learned in the first year of the longitudinal curriculum.
  4. To synthesize findings and present the "clinical bottom line" to the department in a conference (journal club).
  5. To write an abstract for uploading to the "CAT bank."

Administrative Details:

Please see the CAT guidelines for full details.

Briefly, you will be scheduled a date for your CAT presentation. When possible, the chiefs schedule this after a two- month period that is not too busy for you, as you will need two full months to prepare for this. It is not a huge amount of work, if you schedule yourself enough time to achieve your goals.

We have created a timeline for you to use to guide your progress – please use it!

If you have a buddy, you will meet with that person to review all articles and power point prior to the presentation. If not, you will meet with Drs. Boykan and Chitkara. Please e -mail both of us with your topic, articles, and any questions you have along the way.

Year Three: Teaching EBM

Goal: To teach (and therefore truly understand) and use basic principles of EBM.

Objectives:

  1. To explain basic principles of EBM, and to assist junior residents in small group sessions.
  2. To mentor a junior resident in the preparation of a CAT presentation.
  3. To incorporate EBM principles into daily clinical practice.

Administrative Details:

You will be assigned at least one small group session to TA. You should review the basic principles and material prior to the session, as you will be asked to explain questions in the small group. You will grade any homework from the small group sessions, and then give to Drs. Boykan and Chitkara for final eval.

You will be a buddy for a second year resident doing a CAT presentation. Please pay attention to the date of your buddy’s presentation, and help them to prepare appropriately. Remember what happens when one doesn’t allow two full months! You will have to coordinate your schedules. You can be involved with the PICO and searching component of establishing a CAT topic, but most of your energy should be spent in assisting with the evaluation of each article. You should grade the worksheets completed for each article, so Drs. Boykan and Chitkara can review what you have done.

If possible, you should be present for the CAT presentation, and should be ready to back up your buddy with any questions or issues.

You may be assigned to TA a homework session. In this case, be prepared to review any of the homework from sessions 3 – 6 (critical appraisal).