Evidence-Based Medicine:  A New Approach to Teaching the Practice of Medicine

Gordon Guyatt, MD, MSc; John Cairns, MD; David Churchill, MD, MSc; Deborah Cook, MD, MSc; Brian Haynes, MD, MSc, PhD; Jack Hirsh, MD; Jan Irvine, MD, MSc; Mark Levine, MD, MSc; Mitchell Levine, MD, MSc; Jim Nishikawa, MD; David Sackett, MD, MSc; Patrick Brill-Edwards, MD; Hertzel Gerstein, MD, MSc; Jim Gibson, MD; Roman Jaeschke, MD, MSc; Anthony Kerigan, MD, MSc; Alan Neville, MD; Akbar Panju, MD; Allan Detsky, MD, PhD; Murray Enkin, MD; Pamela Frid, MD; Martha Gerrity, MD; Andreas Laupacis, MD, MSc; Valerie Lawrence, MD; Joel Menard, MD; Virginia Moyer, MD; Cynthia Mulrow, MD; Paul Links, MD, MSc; Andrew Oxman, MD, MSc; Jack Sinclair, MD; Peter Tugwell, MD, MSc
JAMA. 1992;268(17):2420-2425. doi:10.1001/jama.1992.03490170092032.
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A NEW paradigm for medical practice is emerging. Evidence-based medicine de-emphasizes intuition, unsystematic clinical experience, and pathophysiologic rationale as sufficient grounds for clinical decision making and stresses the examination of evidence from clinical research. Evidence-based medicine requires new skills of the physician, including efficient literature searching and the application of formal rules of evidence evaluating the clinical literature.

An important goal of our medical residency program is to educate physicians in the practice of evidence-based medicine. Strategies include a weekly, formal academic half-day for residents, devoted to learning the necessary skills; recruitment into teaching roles of physicians who practice evidence-based medicine; sharing among faculty of approaches to teaching evidence-based medicine; and providing faculty with feedback on their performance as role models and teachers of evidence-based medicine. The influence of evidencebased medicine on clinical practice and medical education is increasing.

CLINICAL SCENARIO  A junior medical resident working in a teaching hospital


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