Journal ArticleDOI
Evidence-Based Medicine: A New Approach to Teaching the Practice of Medicine
Gordon H. Guyatt,John A. Cairns,David N. Churchill,Deborah J. Cook,Brian Haynes,Jack Hirsh,Jan Irvine,Mark Levine,Mitchell Levine,Jim Nishikawa,David L. Sackett,Patrick Brill-Edwards,Hertzel C. Gerstein,James L. Gibson,Roman Jaeschke,Anthony Kerigan,Alan J. Neville,Akbar Panju,Allan S. Detsky,Murray Enkin,Pamela Frid,Martha S. Gerrity,Andreas Laupacis,Valerie A. Lawrence,Joël Ménard,Virginia Moyer,Cynthia D. Mulrow,Paul Links,Andrew D Oxman,Jack Sinclair,Peter Tugwell +30 more
TLDR
An important goal of the medical residency program is to educate physicians in the practice of evidence-based medicine, and strategies include a weekly, formal academic half-day for residents devoted to learning the necessary skills.Abstract:
A NEW paradigm for medical practice is emerging. Evidence-based medicine de-emphasizes intuition, unsystematic clinical experience, and pathophysiologic rationale as sufficient grounds for clinical decision making and stresses the examination of evidence from clinical research. Evidence-based medicine requires new skills of the physician, including efficient literature searching and the application of formal rules of evidence evaluating the clinical literature. An important goal of our medical residency program is to educate physicians in the practice of evidence-based medicine. Strategies include a weekly, formal academic half-day for residents, devoted to learning the necessary skills; recruitment into teaching roles of physicians who practice evidence-based medicine; sharing among faculty of approaches to teaching evidence-based medicine; and providing faculty with feedback on their performance as role models and teachers of evidence-based medicine. The influence of evidencebased medicine on clinical practice and medical education is increasing. CLINICAL SCENARIO A junior medical resident working in a teaching hospitalread more
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Users' Guides to the Medical Literature
Gordon H. Guyatt,Drummond Rennie +1 more
TL;DR: Without a way of critically appraising the information they receive, clinicians are relatively helpless in deciding what new information to learn and decide how to modify their practice.
Journal ArticleDOI
Randomized, controlled trials, observational studies, and the hierarchy of research designs.
TL;DR: The results of well-designed observational studies (with either a cohort or a case-control design) do not systematically overestimate the magnitude of the effects of treatment as compared with those in randomized, controlled trials on the same topic.
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Changing Physician Performance: A Systematic Review of the Effect of Continuing Medical Education Strategies
TL;DR: Widely used CME delivery methods such as conferences have little direct impact on improving professional practice, and more effective methodssuch as systematic practice-based interventions and outreach visits are seldom used by CME providers.
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Non-formal learning and tacit knowledge in professional work
TL;DR: It is argued that situated learning often leads not to local conformity but to greater individual variation as people's careers take them through a series of different contexts.
References
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The structure of scientific revolutions
TL;DR: The Structure of Scientific Revolutions as mentioned in this paper is a seminal work in the history of science and philosophy of science, and it has been widely cited as a major source of inspiration for the present generation of scientists.
Book
Clinical Epidemiology: A Basic Science for Clinical Medicine
TL;DR: Clinical Epidemiology is a book dedicated to H.L. Mencken, Kurt Vonnegut, Jr., Douglas Adams, and the Emperor's New Clothes and Physicians and others who wish to recognize key clinical epidemiologic features of the diagnosis and management of patients will benefit from reading.
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MRC European Carotid Surgery Trial: interim results for symptomatic patients with severe (70-99%) or with mild (0-29%) carotid stenosis
TL;DR: The main concern was to avoid disabling or fatal events, and, among severe stenosis patients, 3.7% had a disabling stroke (or died) within 30 days of surgery, an extra 1.1% surgery versus 8.4% control (p less than 0.0001).
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The nature of suffering and the goals of medicine.
TL;DR: In this article, a distinction based on clinical observations is made between suffering and physical distress, and a description of the nature and causes of suffering in patients undergoing medical treatment is given.