Objectives Teaching of Evidence Based Practice (EBP) is not standardised across health care professional training in Ireland. When EBP is a component of the training programme the apply domain is rarely taught. A core curriculum has been developed for clinical effectiveness in Ireland however this has yet to be widely implemented and many practicing professionals have no training in EBP. The National Cancer Control Programme (NCCP) has undertaken an initiative to teach Specialist Registrars (SpRs) in radiation oncology the steps of EBP. To base the teaching on real world guideline clinical queries identified by the national radiation oncology working group, and to utilise the skills obtained in the development of national clinical guidelines for cancer.
Method Approval for the initiative was sought from the NCCP guideline steering committee. Consultant supervisors were sought to provide clinical oversight for each SpR’s. Three cohorts of SpRs were recruited to partake in the initiative between 2018-2019. Two cohorts were provided with just in time training. Tutorials were provided at each stage of the process. The first was developing and refining their PICO question. They were encouraged to have a one-one session with a designated librarian. A tutorial was provided on critical appraisal and support and templates were provided for data extraction. The third cohort attended a formal three day EBP programme provided by the faculty of radiology in Ireland and received two teleconference tutorials. All students presented their findings to the guideline development group (GDG), including clinical members, research members and patient representatives.
Results The SpRs presentations followed the EBP paradigm including how they would apply the evidence in practice. All SpRs took part in the GDG and were accredited as members. This included discussing the quality of the evidence, the benefit and harm to patient, patient preferences and values and resources. The members of the third cohort also presented to faculty as part of the course requirements. A member of each of the cohorts was awarded an academic medal. Both approaches to teaching were equally successful in terms of competing the EBP tasks, making recommendations for practice and actively participating in the GDG. Students reported that knowing they would be participating with patients encouraged them to focus on patient important issues such as quality of life.
Conclusions Integrating the teaching directly into real world healthcare allowed the students to see the importance of putting evidence into practice. The SpRs gained experience in how use the EBP framework to make clinical practice recommendations. By attending meetings with a multidisciplinary group, including patients, they understood the importance of exploring patient values around interventions including the benefit and harm and quality of life issues.
Both the formal course and the just in time EBP tutorials were equally effective in preparing students to be active evidence based practitioners in the setting of guideline development. Training SpRs in EBP skills eased the guideline development workload on the consultants and is an initiative that is being continued.
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