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Internal Medicine Portal: EBM Curriculum

About the Curriculum

Purpose:

EBM and Journal Club are combined for 2020-2021. These sessions are meant to develop residents' application of evidence-based medicine and critical appraisal skills. â€‹Residents will learn to apply evidence-based practice skills to patient care, close reading in journal clubs or for discussions with peers, and board questions. It is also an opportunity to further the ability to search for high-quality or evidence-based articles relating to a patient case or research project. These sessions will focus on enhancing understanding of research design, biomedical statistics, and clinical reasoning. 

If you have questions about the curriculum, please contact your clinical librarian, Emily Shohfi.

Objectives

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

Assessment

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. 

Preparation & Presentation

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. 

Schedule of learning objectives

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)

Module 1 Pre-Test

Contact your Clinical Librarian

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

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

Contact the Darnall Medical Library (DML)

For WRNNMC Patients

  • TRICARE Appointment Line: 855-227-6331
  • Walter Reed NMMC Main Phone: 301-295-4611
  • TRICARE Health Services (Includes phone numbers)

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Darnall Medical Library | Walter Reed NMMC | Building 1, Room 3458 | 8955 Wood Road | Bethesda, MD 20889 | 301-295-1184/85 | Open Monday-Friday, 0700-1730

After-hours access to the library is available to WRNMMC Staff via the CDO at 301-295-4611.