What we know about diseases, diagnosis, and effective treatments is growing rapidly. Today health professionals cannot solely rely on what they were first taught if they want to do the best for their patients. It has repeatedly been shown that clinical performance deteriorates over time.1 A commitment to lifelong learning must be integral to ethical professional practice. However, the speed of the increase in knowledge—more than 2000 new research papers are added to Medline each day—represents a challenge.2 The skills needed to find potentially relevant studies quickly and reliably, to separate the wheat from the chaff, and to apply sound research findings to patient care have today become as essential as skills with a stethoscope.

The advent of “evidence based medicine” saw an explosion of systematic reviews and guidelines but much less change in the medical curriculum.3 4 Although evidence based guidelines may help clinicians in selected areas, they cannot cover the range of questions or have the timeliness …