Course Description

Come to McMaster University

Come to McMaster, the birthplace of evidence-based health-care, to join in one of two closely related workshops. The first caters to clinicians who wish to improve their clinical practice through enhanced skills in reading, interpreting, and applying the medical literature. The second is designed for clinician educators interested in enhancing their skills for teaching the principles of evidence-based practice to others. Both workshops are tailored to faculty and community internists, hospitalists, and senior and incoming chief residents.

The workshop accepts clinicians from a wide variety of backgrounds; there are typically attendees in each group from internal medicine, pediatrics, emergency medicine, surgery, family medicine, gastroenterology. This international workshop caters to all those interested in evidence-based practice and in medical education, and may be of particular interest to clinicians working in academic environments, program directors, chief residents, hospitalists, and educators with a focus on continuous quality improvement/quality assurance.

The workshop is aimed at clinicians, physicians, nurses, pharmacists, occupational and physiotherapists, dentists, naturopaths, chiropractors and other health-care professionals. The workshop uses small-group formats for participants to advance and practice their skills in using the medical literature and, for the teaching stream, to advance and practice their skills in teaching evidence-based practice to others.

EBCP Workshop Small Group Tutorial discussion at McMaster University.




Evidence-based clinical practice

Evidence-based clinical practice (EBCP) is an approach to health-care practice that explicitly acknowledges the evidence that bears on each patient management decision, the strength of that evidence, the benefits and risk of alternative management strategies, and the role of patients' values and preferences in trading off those benefits and risks.

This international workshop caters to all those interested in medical education, and may be of particular interest to program directors, chief residents, hospitalists, and educators with a focus on continuous quality improvement/quality assurance.

What is Evidence-Based Clinical Practice / Evidence-Based Medicine?

Evidence-based clinical practice (EBCP) is an approach to health-care practice that explicitly acknowledges the evidence that bears on each patient management decision, the strength of that evidence, the benefits and risk of alternative management strategies, and the role of patients' values and preferences in trading off those benefits and risks.

Evidence-Based Practice is a five-step process:

  • Construct a relevant, answerable question from a clinical case.
  • Plan and carry out a search of the literature for the best external evidence.
  • Critically appraise the literature for validity and applicability.
  • Apply the evidence to your clinical practice.
  • Evaluate your performance

See also: Evidence-Based Medicine: What it is and what it isn't


Why Are Evidence and Values or Preferences Important?

Clinicians are confronted daily with questions about the interpretation of diagnostic tests, the harm associated with exposure to an agent, the prognosis of a disease in a specific patient, the effectiveness of a preventive or therapeutic intervention, and the relative costs and benefits associated with these decisions. Both clinicians and policy makers need to know whether the conclusions of a primary study or a systematic review are valid, and whether recommendations in clinical practice guidelines are sound.

Members of the Department of Clinical Epidemiology and Biostatistics at McMaster University, in collaboration with other colleagues trained in both medicine and in clinical epidemiology, have developed a set of common sense strategies to assist in the critical appraisal of evidence. They have also developed approaches to explicitly considering values and preferences in clinical decision-making, thereby encouraging the practice of EBCP.

Evidence-based Medicine at McMaster University

"In 1992 [sic], medical researchers at McMaster University in Ontario, Canada first defined evidence-based medicine (EBM) in the biomedical literature. The concept was based on advances in clinical research - clinical trials, clinical epidemiology, and meta-analysis - in which the limits of individual expertise were recognized."

David A. Bradt,MD,MPH, FACEM,FAFPHM,FAAEM,DTM&H

In 2007, the British Medical Journal hailed the development of evidence-based medicine by researchers at McMaster University as one of the 15 greatest medical breakthroughs of the last 166 years... Experts at Johns Hopkins University, the University of Calgary and the University of California argued in support of evidence-based medicine as the top milestone. They said without this advance from McMaster University the health of many would have suffered.

What To Expect

Pre-Course

Additional Cost: $400 Cdn + 13% Harmonized Sales Tax

Session Summary:

The purpose of this half-day pre-course is to provide exposure to core concepts required to incorporate best evidence into practice and teaching prior to full the 4-day EBM workshop. The pre-course is intended for early learners who have limited experience with the critical appraisal process. The 4 hours will be structured in parts that mirror the evidence cycle:

  1. constructing a structured clinical question;
  2. assessing risk of bias;
  3. understanding results; and
  4. application.


Pre-Course Faculty

  • Pre-course Co-Directors: Sheri Keitz and Gordon Guyatt
  • The pre-course topics will be taught by a combination of experienced tutors for the main 4-day EBM workshop

Learning Objectives

Following the pre-course, participants will be able to:

  • Form a clinical question using a structured PICO framework
  • Describe concepts used to assess risk of bias in study design
    • Randomized Trials: why do we randomize?
    • Cohort Studies: Adjusted analysis
  • Demonstrate understanding of reporting of results
    • Calculate and interpret measures of association: risk ratio, odds ratio, risk difference, number needed to treat/harm
    • Demonstrate understanding of p-values and confidence intervals
    • Describe results of a systematic review when summarized in a Forest Plot
  • Demonstrate understanding of key principles in applying evidence
    • Describe when is it okay to generalize findings (or when it is not)

Who should attend?

  • Participants in the practice stream with minimal or no prior exposure to basic concepts in evidence-based practice
  • Participants in the teaching stream may wish to attend to see new techniques in interactive large group teaching and teaching tips for key concepts that are covered.

Teaching Method

  • The pre-course will be in a large group setting
  • Presenters will utilize interactive and active participant learning techniques

Pre-Course Registration Information

  • Pre-course Registration must occur at the same time as registration for the EBM course
  • Additional cost associated with attending the pre-course is $400 + 13% HST

What To Expect

EBCP Workshop Teaching and Practice Streams

$200 discount if registered before Dec. 31, 2018.
Registration Fees Cdn $*
One member from an institution $2800 PLUS 13% Harmonized Sales Tax
Two members from an institution $2500 each PLUS 13% Harmonized Sales Tax
Three or more members from an institution $2200 each PLUS 13% Harmonized Sales Tax
*PLUS 13% Harmonized Sales Tax (HST # R119-035-988). Tuition includes all workshop materials, photocopying services, access to computer literature searching and dinner on the first and last evenings.
To obtain the discount for multiple members from the same institution, all persons must register at the same time. Download our Brochure and distribute it to you colleagues to encourage them to register!

The Workshop Format

The workshop is offered as a four-day intensive course.  The workshop uses small-group formats for participants to acquire new EBP skills and to practice those skills.  The interactive small groups let by clinical epidemiologists and practitioners primarily from North America, but also from other parts of the world.  The workshop will also include some large group sessons and individual study time.

The course also offers and OPTIONAL additional 4-hour pre-course for individuals wishing for an overview or refresher on basic EBM concepts.  The pre-course requires separate registration and fees in addition to the main workshop registration.

Prior to and at the workshop, participants will have access on-line to educational materials that include literature on-line to educational materials that include literature on critical appraisal and EBCP, the small group learning format, a set of clinical problems, JAMAevidence, and a variety of other EBCP aids.

Faculty

Directors:  Sheri Keitz and Gordon Guyatt

The course is taught by outstanding educators with long experience in guiding clinicians in advancing their knowledge and skills in EBM.  Each small group will have two tutors, a Tutor Trainee, and a Librarian.





SmallGroupLearning


What to Expect EBCP Workshop
Practice Stream Specifics

Learning objectives

To help participants advance their skills in critically appraising the literature, and their skills in acknowledging and incorporating values and preferences in clinical decision making.  To acquire an understanding of common epidemiological concepts (e.g. interpreting hazard ratios, confidence intervals, critical appraisals of a systematic review) and advance their skills in using the literature for quality assurance, improving practice, and judging comparative effectiveness of health care interventions.

Who should attend

Clinicians Physicians, nurses, pharmacists, occupational and physiotherapists, dentists, chiropractors and other health-care professionals with limited prior exposure to concepts in evidence-based practice.

Practice stream format

The workshop uses small-group formats for participants to acquire new EBP skills, and to practice those skills.  Learners will be expected to actively engage in small group learning including identifying learning priorities and sharing responsibility for the learning environment in the small group.  For example, learners will be asked to identify key papers, concepts, and examples of evidence that matters to their home practice.  Learners will actively problem solve, critically appraise articles, and verbalize key EBM concepts to facilitate understanding.

What to Expect EBCP Workshop
Teaching Stream Specifics

 

Learning objectives

To help participants advance their skills in critically appraising the literature, and their skills in incorporating values and preferences in clinical decision making.

To help participants advance their skills in teaching EBCP using a variety of educational models in different settings, with different types of learners.

Who should attend

Physicians, nurses, pharmacists, occupational and physiotherapists, dentists, chiropractors and other health-care professionals who have an understanding of the fundamentals of EBCP who anticipate future opportunities to teach the skills of EBCP to their learners.

Teaching stream format

What many people don't realize:  If you enroll in the teaching stream, you will be doing some of the teaching.  The workshop uses small-group formats for participants to acquire new EBP teaching skills and to practice those skills.  Role play will simulate the teaching environments of the participants.