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EBM, CME and the EMR
  1. Roland M Grad1,
  2. Pierre Pluye1,
  3. Michael Shulha2,
  4. David L Tang2,
  5. Karen Tu3,
  6. Ken Goodman4,
  7. Jamie Meuser5
  1. 1Department of Family Medicine, McGill University, Montreal, Quebec, Canada
  2. 2Herzl Family Practice Centre, Montreal, Quebec, Canada
  3. 3Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
  4. 4Cleveland Clinic, Center for Continuing Education, Cleveland, Ohio, USA
  5. 5The College of Family Physicians of Canada, Mississauga, Ontario, Canada
  1. Correspondence to : Dr Roland M Grad
    Department of Family Medicine, McGill University, 3755 Cote Ste Catherine Road, Montreal H3T 1E2, Quebec, Canada; roland.grad{at}

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Physician organisationsi recognise that searching quality knowledge resources at the point of care is important for continuing medical education (CME).1 However, those physicians inclined to occasionally search for an answer to a clinical question do not have systems such as a CME module to integrate the key tasks of searching for clinical information in their electronic medical record (EMR) and reporting CME outcomes for credit. In regard to the task of searching for information, we acknowledge that some clinical questions remain difficult to answer, while other search tasks have become simpler (table 1). Among barriers to searching at the point of care is the perception that knowledge resources are too complicated to use.2 This perception is supported by an ethnographic study of general practitioners at work.3 However, knowledge resources are continuously improving and bandwidth is no longer an issue; so this perception may be regarded as anachronistic.

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Table 1

The complexity of searching during the consultation and relative frequency of task performance

How do we facilitate the process of searching in the clinical encounter?

One way to facilitate searching in the encounter is to conceptualise the EMR as a venue for documentation of learning. By EMR, we mean a system whose primary function is the documentation of clinical encounters and the management of related patient health information including laboratory results and referral letters. In North America, organisations that accredit CME programs encourage physicians to …

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