Overview of the Evidence Based Medicine Process

Lecture Objectives with Bloom's Level Taxonomy

• Analyze what personal areas of deficiency exist in understanding EBM and Information mastery concepts (B2) (std  B1.07)

• Identify concepts to be learned and applied over the semester (B1) (std  B1.07)

• Define and discuss the elements of evidence-based medicine (including the limitations) (B1) (std  B2.10)

•Identify evidence based resources that evaluate population based health care interventions (B1)  (std  B2.10)

•Identify strengths/weaknesses in study designs involving population based interventions (B1)  (std  B2.10)

•Analyze population based data to determine whether or not an intervention is feasible for a medical practice (B2)  (std  B2.12)

•Justify why patient preferences and values are a necessary part of EBM (B3) (std. B2.10)

ASK--Identification of Knowledge Gaps \\ Foreground/Background questions \\ PICO questions

Lecture Objectives with Bloom's Level Taxonomy

• Define information deficits, specifically as opposed to information gaps (B1)  (std  B1.07)

• Explain the difference between and value of background and foreground questions (B1)  (std  B2.10)

• Illustrate the process of moving from deficits to questions (B2)  (std  B1.07)

• Create a clinical question which will lead to an effective search strategy for a clinical question(B3)  (std  B2.10)

• Integrate clinical question development into the EBM framework (B3)  (std  B2.10)

ACQUIRE--Resources

Lecture Objectives with Bloom's Level Taxonomy

•Appropriately cite an article in AMA format (B2) (std B1.05)

• Select the best type of resource to answer a particular clinical question (B1)  (std  B2.10)

•Demonstrate understanding of effective search terms that will yield the highest quality results (B2)  (std  B2.10)

•Demonstrate the ability to quickly and effectively find and verify an answer to a clinical question (B2)  (std  B2.10)

APPRAISE--Statistics I

Lecture Objectives with Bloom's Level Taxonomy

•Identify the appropriate statistical test based on the type of study design (B1)  (std  B2.10)

•Recognize underlying concepts of biostatistical measurements such as NNT, likelihood ratios; odds ratios; sensitivity; specificity; PPV, NPV (B1)  (std  B2.10)

• Apply calculations to patient care decisions (B2)  (std  B2.10)

APPRAISE--Study Design 

Lecture Objectives with Bloom's Level Taxonomy

•Identify the potential strengths/weaknesses of different study designs (B1)  (std  B2.10)

•Identify data collection methods and ways in which data is presented (B1)  (std  B2.10)

•Articulate what is bias and how can it effect the validity and reliability of the results (B1, B2)  (std  B2.10)

•Describe what is a counfounder and how can it effect the validity and reliability of the results (B1, B2)  (std  B2.10)

•Identify which type of study best answers a clinical question of therapy, diagnosis, prognosis, harm, prevention, cost, clinical exam (B1)  (std  B2.10)

•Identify the highest quality of study to answer a clinical question (B1)  (std  B2.10)

• Explain the validity of each level of evidence heirarchy (B1)  (std  B2.10)

•Identify the components of a high quality comparative effectiveness study (B1)

•Describe how comparative effectiveness research can be applied in the context of patient care (B2)

APPRAISE--Statistics II

Lecture Objectives with Bloom's Level Taxonomy

•Calculate sensitivity, specificity, NPV, and PPV (B2)  (std  B2.10)

•Recognize how prevalence affects sensitivity, specificity, NPV, PPV (B1)  (std  B2.10)

•Explain the relationship between specificity and sensitivity (B1)  (std  B2.10)

•Apply concepts of sensitivity and specificity to patient care decisions (B2)  (std  B2.10)

APPRAISE--Critical Appraisal I

Lecture Objectives with Bloom's Level Taxonomy

•Locate appropriate clinical article to answer clinical question (B1)  (std  B2.10)

•Analyze scholarly articles for strengths/weaknesses (B2)  (std  B2.10)

•Analyze articles for applicability to specific patient populations and feasibility of intervention (B2)  (std  B2.10)

•Appropriately cite article source (B1)  (std  B1.05)

•Develop a well-constructed PICO question to guide searching for clinical questions (B3)  (std  B2.10)

APPRAISE--Critical Appraisal II

Lecture Objectives with Bloom's Level Taxonomy

•Locate appropriate clinical article to answer clinical question (B1)  (std  B2.10)

•Analyze scholarly articles for strengths/weaknesses (B2)  (std  B2.10)

•Analyze articles for applicability to specific patient populations and feasibility of intervention (B2)  (std  B2.10)

•Appropriately cite article source (B1)  (std  B1.05)

•Develop a well-constructed PICO question to guide searching for clinical questions (B3)  (std  B2.10)

APPRAISE--Guidelines

Lecture Objectives with Bloom's Level Taxonomy

•Identify credible sources for finding guidelines (B1)  (std  B2.10)

•Describe how guidelines are established (B1)  (std  B2.10)

•Describe the challenges of using guidelines in practice (B1)  (std  B2.10)

•Discuss how to make patient care decisions when guidelines have conflicting recommendations (B1)  (std  B2.10)

•Utilize guidelines to justify patient care decisions (B3)  (std  B2.10)

APPLY--General Communication of Information/Rhetoric

Lecture Objectives with Bloom's Level Taxonomy

• Identify different types of presentation of information (B1)  (std  B2.04)

•Discuss the elements of effective visual communication (B1)  (std  B2.04)

•Discuss some theoretical basics of rhetoric and communication (B1)  (std  B2.04)

•Discuss how to elicit questions from patients to determine healthcare preferences (B1)  (std  B2.04)

•Articulate the ways in which cultural understanding contribute to patient care and education (B2)  (std  B2.09)

Statistical significance vs. Clinical significance; Health literacy

Lecture Objectives with Bloom's Level Taxonomy

•Explain the meaning of statistical significance (B1) (std. B2.10)

•Recognize measures of statistical significance (B1) (std B2.10)

•Discuss how to communicate at the appropriate health literacy level of a patient (B1) (std B2.04)

•Compare and contrast statistical vs. clinical significance (B2) (std B2.10)

•Justify categorizing articles into statistical vs. clinical significance (B3) (std B2.10)

•Explain the importance of linking evidence to specific patients or patient problems (B1)  (std  B2.10)

•Create strategies for ensuring audience understanding for various sizes and levels of audiences (B3) (std. B2.09)

APPLY--Conveying the evidence in a meaningful way for the patient

Lecture Objectives with Bloom's Level Taxonomy

•View communication as a teaching opportunity (B1)  (std  B2.09)

•Discuss how to communicate at the appropriate health literacy level of a patient (B1) (std B2.04)

•Articulate the ways in which cultural understanding contribute to patient care and education (B2)  (std  B2.09)

•Describe how to encorporate provider expertise and patient preferences in the shared-decision making process (B1) (std B2.04)

APPLY--Critical Appraisal III and shared decision making

Lecture Objectives with Bloom's Level Taxonomy

•Analyze scholarly articles for strengths/weaknesses (B2)  (std  B2.10)

•Analyze articles for applicability to specific patient populations and feasibility of intervention (B2)  (std  B2.10)

•Appropriately cite article source (B1)  (std  B1.05)

•Describe how to encorporate provider expertise and patient preferences in the shared-decision making process (B1) (std B2.04)

•Discuss how to communicate at the appropriate health literacy level of a patient (B1) (std B2.04)

APPLY--Information Mastery--keeping current on the literature \\ ASSESS--Administration of survey tool

Lecture Objectives with Bloom's Level Taxonomy

•Identify and apply strategies for keeping up to date with current best evidence (B1, B2)  (std  B2.10)

•Demonstrate proficiency in EBM techniques and application of concepts to patient care scenarios (B2)  (std  B2.10)

SOWK 4901 - Applied Practice Evaluation research

Week 1. Lab:Statistical Techniques 1

• Review syllabus and course expectations
• Review descriptive statistics
• Introduction to SPSS/SOFA/socscistatistics.com
• Entering Data
• Creating a Data File
• Generating Descriptive Statistics
• Presenting Your Data in Graphic Form

Week 2. lab: Qualitative Analyses

• Qualitative Data Analyses
• Analyzing qualitative interviews

Week 3. Lab. Statistical techniques

• Measures of association
• Tests of significance
• Conducting statistical tests
• Crosstabulation
• Correlation
• T test
• ANOVA

Week 4

• Individual Consultations

Week 5

• Individual Consultations

Week 6

• Individual Consultations

Week 7

Weekly Learning Objectives

• Individual Consultations

Week 8

Weekly Learning Objectives

• Individual Consultations

Week 9

• Project Presentations for Groups A and B

Week 10

• Project Presentations for Groups C and D

Individual Consultations with instructor

Weeks 4-8 of this course are dedicated to data collection, analysis, and project write up.  As students work on these aspects of their evaluation they sign up for individual consultations with me.