Enhanced Informatics Instruction in Evidence-Based Medicine. (the Scholarship of Teaching and Learning)

Article excerpt

Abstract

The future of medical education may be dependent upon our ability to create a curriculum for adult learners that integrates competencies in the use of technology, evidence-based medicine and communication skills. This paper reports the development and implementation of an evidence-based medicine curriculum designed to teach not only traditional evidence-based medicine (EBM) skills, but also to enhance student use of the computer for communication and life-long learning and clinical problem solving. The EBM curriculum incorporates principles of teaching and learning including two instructional and four learning processes. These principles, utilizing a project-based curriculum with computer-mediated support, enhances self-directed learning and student mastery of informatics skills thereby expanding mechanisms for collaboration, communication, support and assessment.

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The future of medical education may be dependent upon our ability to create a curriculum for adult learners that integrates competencies in the use of technology, evidence-based medicine and communication skills. This paper reports the development and implementation of an evidence-based medicine curriculum designed to teach not only traditional evidence-based medicine (EBM) skills, but also to enhance student use of the computer for communication and life-long learning, and clinical problem solving. A project-based curriculum utilizing computer-mediated support enhances self-directed learning and student mastery of informatics skills, thereby expanding mechanisms for collaboration, communication, support and assessment.

Students learn best by observing and doing work, by engaging in a community of knowledge-seekers, and by being challenged to actively solve problems that are engaging and important to them. Medical educators are challenged to create an academic environment where students obtain knowledge and build skills by participating in authentic, context-based inquiry. In the clinical years this challenge is easily addressed by the student's active pursuit of knowledge in the clinical setting, where real patient problems are the focus of learning and mastery. In the didactic setting, this challenge proves to be more difficult, although some programs have attempted to address this issue through the instructional methodology of problem-based learning where real patient scenarios guide the student through a process of self-directed inquiry. Unfortunately, traditional structures and practice often do not support or encourage the mastery of context-based informatics skills or the practice of EBM, as much of the knowledge, skills and attitudes we hope to impart to our students do not yet exist either in the clinical or didactic setting.

Medical informatics is the rapidly developing scientific field that deals with resources, devices and formalized methods for optimizing the storage, retrieval and management of biomedical information for problem-solving and decision-making (1). There is increasing awareness that biomedical knowledge and clinical information about patients can no longer be managed and accessed by traditional paper and pencil strategies. The emergence of advanced technologies for management and retrieval of the rapidly-changing information data base that forms the basis of medical practice has led to a strong conviction that education in knowledge retrieval and expert decision-making are of utmost importance in the practice of medicine. In fact, mastery of this "process" is now seen at least as equally important to practice as the fact base on which clinical decisions are made. This process of knowledge retrieval is highly relevant to the dynamic practice of evidence based medicine.

Traditional EBM instruction focuses on the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients. Traditional instruction focuses on constructing researchable clinical questions, searching for relevant literature and applying that information to patient care. …