Guide

Goal: To discuss the evidence for or against various emergency medicine practices by deriving clinically relevant questions utilizing independent review of multimedia, as in podcasts or videocasts, prior to a residency based group critical discussion of the primary literature referenced within the multimedia source.

Ideally, the questions posed and answered will be those that the learner can apply the very next shift, as in those that are relevant and impact daily clinical practice. Explicit effort will be made to include “landmark papers” within these discussions. The subjects covered in the EBM hour are not required to concur with the subject matter of the concurrent module, although this is preferable.

Contacts: If there are any issues, comments, or questions, please email the faculty leader of the EBM hour, Mark Courtney (dmarkcourtney@gmail.com), or both of the resident leaders, Evan Pushchak (evan.pushchak@gmail.com) and Charlie Pearce (cgrahampearce@gmail.com)

Format, expectations, and responsibilities: Recognizing that residents are busy adult learners that utilize many different types of media for their education, the EBM hour will assume the following format in an effort to facilitate the expansion of knowledge base while simultaneously improving EBM literacy:

2 weeks prior to the EBM hour at conference, residents will be emailed a link to a podcast, along with 2 pieces of primary literature for review. If the podcast is lengthy, as in greater than 30 or 40 minutes, the specific time marks at which the relevant information is discussed will be provided. At a minimum, residents are expected to review the suggested portions of the multimedia source and read the abstracts of the provided literature.

The residents involved in presenting the EBM hour will be expected to master the entirety of the assigned materials, and the other residents can choose, at their discretion, the depth of their study beyond the minimum expectations.

The EBM hour will consist of presentations from PGY 1, 2, and 3 residents. Intermittently, at the end of that presentation, Marc Courtney, Charlie Pearce, or Evan Pushchak will briefly review a relevant EBM topic such as statistical methods or study design, etc, when it is relevant and feasible. Afterwards, faculty members will be asked about their specific practice patterns in relation to the clinical question at hand. In an effort to allow for meaningful discussion, the slide limits for each presenter are:

PGY-3: 3 slides

PGY-2: 7 slides

PGY-1: 7 slides
-For each month, the responsibilities for each presenter are:

PGY-3:

-Derive and pose a clinical question for review and provide a multimedia source that addresses this question. The expectation is that the multimedia source is mainstream and provides literature based references for their discussion. The selected clinical question does not have to be the entire focus of the multimedia source, and the clinical question can be formulated in reverse. For example, if you have a podcast that you have listened to and find relevant and would like to discuss, generate a clinical question from the podcast and select the most relevant literature from the discussion.

-Find two references from the multimedia source to discuss at conference. Distribute the source and papers as described below in the deadlines section. Assign the papers to the pgy-1 and 2, giving the shorter or less important paper to the pgy-2, as they will be discussing other information besides only their assigned paper.

-Example: You listen to a podcast about subarachnoid hemorrhage that you think is a good overall review, poses interesting questions, and has references that you think are appropriate for EBM discussion. You come up with this case scenario: A 60 year old male with HTN comes in with a sudden onset worst headache of life that began 4 hours prior to arrival. Based on the content of the podcast, you derive the clinical question, “What is the utility of CT, CTA, and LP in diagnosing subarachnoid hemorrhage?”. It can also work in reverse, i.e. pose a question, find the podcast and references, etc. You find the 2 most relevant articles from the discussion, and select them for review.

-You are expected to be the leader for the individual month, meaning coordination between the junior residents, review of their slides, and ensuring adherence to the slide guidelines above.

-For the presentation:

-At the beginning of the EBM hour, introduce the topic generally (epidemiology, morbidity/mortality, etc), then describe a clinical case scenario that raises the clinical question, and explicitly state the clinical question that will be addressed. The method best suited for stating clinical questions during the presentation can be found at: http://ktclearinghouse.ca/cebm/practise
PGY-2:

-Master the information presented in the multimedia source and both of the assigned pieces of literature. You will be emailed the monthly clinical question and and the papers by the pgy-3 resident as outlined below in the deadlines section. You are responsible to present one of the two assigned pieces of literature at conference.

-If the multimedia presentation is lengthy, as in greater than 30 or 40 minutes, it is your responsibility to find the relevant time marks at which the relevant information is discussed, and email them to the pgy-3 resident.

-For the presentation:

-Briefly discuss the overall quality of the multimedia source in terms of who the presenters are, where they work and their credentials, their use of data versus anecdotal evidence using direct quotations, and any positive or negative aspects of the formatting.

-Discuss your assigned piece of literature in terms of its methods, results, conclusions, and internal or external validity. Discuss the relevance of the paper in relation to the posed clinical question.
PGY-1:

-Master the information presented in the multimedia source and both of the assigned pieces of literature. You will be emailed the monthly clinical question and the papers by the pgy-3 resident as outlined below in the deadlines section. You are responsible to present one of the two assigned pieces of literature at conference.

-For the presentation:

-Discuss your assigned piece of literature in terms of its methods, results, conclusions, and internal or external validity. Discuss the relevance of the paper in relation to the posed clinical question.

Deadlines:
Generally, 2 weeks prior to the EBM hour monthly lecture, the entire residency will be mailed out a link to a multimedia source, i.e. a podcast or videocast, and 2 pieces of selected literature referenced within or relevant to that discussion.

Individual resident deadlines

PGY-3:

-Review both your and the junior resident deadlines as below

-No later than 4 weeks prior to the EBM conference date, a clinical question must be formulated, and a link to a multimedia source with along with 2 selected pieces of literature must be emailed to evan.pushchak@gmail.com, cgrahampearce@gmail.com, and dmarkcourtney@gmail.com.

-3 weeks prior to the EBM conference date, the selected papers and multimedia source must be emailed out to the junior residents who will be presenting at conference.

-2 weeks prior to the EBM conference date, the multimedia source and references will be mailed out to the residency.

-5 days prior to the EBM conference date, the finalized combined powerpoint from the PGY 1, 2, and 3, must be emailed to the same people as above. It is your responsibility to formulate deadlines for the junior residents to get you their slides and to combine them in a single powerpoint to meet this deadline. You might want to arrange for an advance meeting with both of the junior residents to discuss the papers, the clinical question, and the make sure that the junior residents are aware of their specific deadlines.
PGY-2:

-No later than 3 weeks prior to the EBM conference date, you will be emailed the selected clinical question, papers, and multimedia source for review. Soon thereafter, email the pgy-3 resident with the relevant time marks within the multimedia source so that they can go out in the residency wide email which will happen 2 weeks before the conference.

-The pgy-3 resident will email you the specific deadline by which they expect to have your finalized slides.
PGY-1:

-No later than 3 weeks prior to the EBM conference date, you will be emailed the selected clinical question, papers, and multimedia source for review.

-The pgy-3 resident will email you the specific deadline by which they expect to have your finalized slides.



Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s