Teaching evidence based medicine

Should be integrated into current clinical scenarios

Teaching clinical epidemiology has always been challenging, seen as too mathematical and remote from normal clinical practice. Evidence based medicine (EBM) evolved to provide the skills needed to manage the potential information overload of modern medical schools, especially at McMaster, the shortest medical programme in the world. Students have to grasp two essential principles of EBM: its empirical approach to optimal clinical decisions (regardless of pathophysiology, does the bottom line of the balance sheet show gain or loss?); and its quantitative expression (how big is that gain or loss?). These require some mastery of epidemiology and statistics, both repellent to many doctors, even in teaching hospitals.1 2 Now most medical programmes in the United States attempt to teach EBM, although few succeed (the two most important barriers being inadequate access to electronic information at the point of care, and inadequate faculty training).3

What are the best ways of teaching this stuff? By breaking its elements …