TY - JOUR T1 - Teaching evidence-based practice on foot JF - Evidence Based Medicine JO - Evid Based Med SP - 98 LP - 101 DO - 10.1136/ebm.10.4.98-a VL - 10 IS - 4 AU - W Scott Richardson Y1 - 2005/08/01 UR - http://ebm.bmj.com/content/10/4/98.2.abstract N2 - Come along to watch some clinical teachers in action: 1. A hospital physician rounding with the team’s medical students examines a middle aged woman with upper extremity deep vein thrombosis. After the bedside visit, the attending asks aloud about the frequency of underlying diseases associated with this condition, admits aloud he doesn’t know the answer, and records the question concisely in his PDA.1 After rounds, the attending invites the students along as he finds and appraises evidence about this topic and “thinks aloud” about how he’ll use this knowledge in planning further testing. 2. An attending physician and 2 learners examine a patient with new onset congestive heart failure. After teaching how to hear a subtle S3 gallop with the stethoscope’s bell, the physician explains the accuracy and precision of this finding as a test for heart failure and provides a reference for further learning.2 3. After starting emergent therapy for a patient’s thyroid storm, an attending physician guides the team through the quantitative results of prognostic studies of this condition. The team then discusses how to use this evidence in counselling the patient.3 These teaching moments share 4 important features. Firstly, notice that the teaching is actually happening, despite the several barriers and disincentives clinical teachers face.4,5 Secondly, the teaching happens “on foot”—that is, during the course of busy clinical work, rather than off site.6 Thirdly, while not exclusively so, these episodes involve teaching-in-context at the bedside.7,8,9,10 This essay examines a fourth shared feature, the use of evidence from clinical care research. In all 3 episodes, the attending made conscientious, explicit, and judicious use of either the process of evidence-based learning or its yield.11 The subtle but important variations in how this was done can be described as … ER -