Internal Medicine Portal: EBM Curriculum

Throughout the year, EBM and journal club will be led by teaching residents. Faculty will facilitate. Our learning objectives are the following

• Lead a journal club of no more than 45 minutes in length on the assigned study type that includes teaching on assigned block objectives
  • Critically appraise biomedical articles including an understanding of the methodology, sources of bias, and the results.
  • Define, teach, and critique biostatistical concepts used to report the results of clinical research studies.
  • Describe and analyze study methodologies used in clinical research.
  • Search more effectively for evidence-based literature to answer a clinical question based on a patient encounter
  • Present search strategy and explain how article was chosen. Contact your clinical librarian for assistance with a search.
  • Utilize critical appraisal with confidence

Residents will be assessed with a short pre- and post- class quizzes.

• Near the end of the year, the residents should expect a longer assessment through which the course directors can assess knowledge gaps that need addressing. 
• Residents will be assessed as a whole with a short post-session quiz for objectives learned through JC/EBM. 
• As time allows, the residents will discuss these same questions in a group setting at the end of the session. 
• Residents will be given an anonymous “Individual Assessment Pre-Test” prior to the Friday journal club/EBM session. 

There is no required format for presentation; only that it be done well. Examples of successful formats in the past include:

• Power Point
• Handouts (article, supplements, and additional take-aways for teaching points)
• Interactive quiz format
• Chalk Talk 
• General Talk with Q/A
• Talk with props/models/diagram

Articles selected for journal club should be pre-highlighted or commented for peers to read, and should be sent out to the cohort no later than Wednesday before the Friday morning session. 

• We ask that selected articles are sent to course facilitators at least one week prior to leading Journal Club, and that presenters meet with one of the course directors prior to teaching. 

Article types & learning objectives by block are listed below. Blocks 1, 9, and 10 may not have a journal club but may instead be overviews by faculty.

• AMB week 1. Structure for year; EBM: overview of study types and designs, why EBM matters; Mobile apps brief overview
• AMB week 2. RCT  - bias (must cover confounding), clinical significance, statistical significance/chance, power
• AMB week 3. RCT - sensitivity, specificity, PPV, NPV, Likelihood ratios, prevalence [use a diagnosis article for this week]
• AMB week 4. RCT - randomization, subgroup analysis, power, RR/RRR [use an article with a dichotomous outcome, not continuous outcome]
• AMB week 5. Cohort - survival curves, hazard ratio, exposure, relative risk + RRR
• AMB week 6. Case control - NNT, Odds Ratios
• AMB week 7. Meta-analysis - forest plots, heterogeneity, chi-square, confidence intervals, weight
• AMB week 8. Compare 2 study types on the same topic + Review week 
• AMB week 9. Searching & Publishing (PICO, tips for databases, forming clinical questions, identifying good quality articles; h-index, impact factor, predatory journal info, EndNote overview if time)

Emily Shohfi, MLIS, AHIP
Clinical Librarian; EBM Course Facilitator

301-295-2603
Building 1, Room 3456
emily.e.shohfi.civ@mail.mil

• TRICARE Appointment Line: 855-227-6331
• Walter Reed NMMC Main Phone: 301-295-4611
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