Table 1

Past and current evidence-based practice curriculum

Curriculum 2005Rationale for continuation or changesCurriculum 2020
Two-day evidence-based practice workshop
Four half day sessions including general introduction to the curriculum, how clinicians use evidence and how they can be misled. This is followed by 1 hour of large group lectures and 2 hours of small group sessions focussing specifically on appraisal of:
  1. Therapy papers,

  2. Diagnostic papers,

  3. Systematic reviews and

  4. A small group session on searching skills (eg, optimising Pubmed searches)

Highest rated component of the curriculum*
Informal feedback and qualitative comments on evaluations suggested that the session on searching skills was redundant and not necessary. This was eliminated and replaced with a clinician led small group on the identification and use of pre-appraised and summarised evidence.
Residents continually re-affirmed that a full 2 days was required to feel comfortable with EBP basics
Two-day evidence-based practice workshop
Small group session on searching skills replaced with small group session on locating and using preappraised evidence sources (eg, Tools for Practice, Rxfiles, InfoPoems, ACP Journal Club)
Quarterly Didactic Lectures
Four 1 hour of lectures per year. Lectures are presented during academic days and cover 5–7 new high-quality studies (example randomised controlled trials) with potential practice changing/reaffirming evidence. This is presented in the context of evidence appraisal review.
Ongoing strong evaluations in the context of academic day*Quarterly didactic lectures
No change
Journal club
One-hour review of 2–3 preappraised papers chosen from ACP journal club or Evidence Based Medicine. This occurs during monthly academic days. Residents are in groups of 10–20 and often further divided into smaller groups that each review one resource then return to the larger group to discuss. Often led or facilitated by clinician leaders at each academic teaching site.
Consistently the most poorly rated component.*
Faculty development has been offered but poorly attended.
The clinical relevance of this session has been questioned in qualitative feedback.
Over the years there has been increasing availability of practical, evidence-based tools for shared informed decision-making.
Journal club
Increasing availability of preappraised summarised resources allows greater variety (eg, Tools for Practice). 4–5 are reviewed each session.
Increasing focus on incorporation of shared informed decision-making resource (eg, pain-calculator.com) each session.
BEARs
One-page worksheets to be completed using preappraised evidence at the point of care. (Template previously published)17
Minimum of four required to be completed during family medicine clinical rotation
BEARs are frequently presented by the residents at weekly clinic rounds and provide a good starting point for discussion around practical clinical questions and relevant evidenceBEARs
No change
Evidence-based practice desktop
Graphically displayed front page with links to relevant resources (eg, Cochrane, Pubmed, Google, ACP Journal Club), Guides (example User’s Guides to Medical Literature), Clinical resources (eg, Guidelines) and an e-library with an extensive list of internet resources.
Anecdotal evidence suggested that residents were using internet search engines to access the sites they needed and there was little demand for an additional desktop.Desktop has been removed.
All residents all have free access to University of Alberta library resources including Pubmed, Cochrane, Dynamed and e-journals.
Growing awareness that brief, summarised evidence focusing on relevant primary care topics from non-industry funded sources (free of cost) are not always readily available.
Recognition that modelling of EBP by community clinicians/preceptors is necessary to demonstrate feasibility beyond residency.
Tools for practice†
All residents encouraged to sign up for the one-page evidence summaries at the beginning of residency during the EBP workshop.
Residents also have the opportunity to complete an elective during which they would further develop their EBP skills through contribution to the development of a ‘Tools for Practice’.
  • *Programme components were inconsistently evaluated and thus quantitative evaluation summaries are not reported.

  • †Tools for practice were developed in collaboration with the Alberta College of Family Physicians.

  • BEAR, brief evidence-based assessments of research; EBP, evidence-based practice.