LEARN | Module 1

Introduction to Evidence-Based Clinical Practice and Searching the Medical Literature

Welcome to Module 1 of LEARN! Please post any questions, comments or suggestions in the Disqus comment feed at the bottom of the module!

What is Evidence-Based Clinical Practice?

Evidence-based clinical practice, also known as evidence based medicine (EBM), has been described as “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients” (Sackett, et al 1996). The practice of evidence-based medicine requires the integration of best research evidence with clinical expertise and patient values.

Watch the video below before continuing with the module.

Becoming a better Doctor

In order to become a better, faster doctor, you need to become adept at finding the knowledge hidden amongst the wealth of information available to us in this modern era. However, before you can find the answers, you must first ask the right question. To construct an ideal question, remember the mnemonic PICO, outlined in the video below. In short, it ensures that your question refers to the Patient, Intervention, Comparison and Outcome.

Once you have formulated the perfect question, you need to consider which particular type of study will provide the best evidence for your particular type of question. It is useful to reflect on whether your question concerns Therapy, Harm, Diagnosis or Prognosis.

Different types of questions are best answered by different types of studies – the evidence pyramid illustrates the hierarchy of evidence in terms of relevance to a clinical scenario. The gold standard of evidence comes from randomised controlled trials, and the lowest tier of evidence is expert opinion.

With your question in mind and an idea of the type of study you are looking for, it is time to begin searching for the answer. Rushing in blindly without a strategy is a sure way to waste valuable time and end up with an imperfect answer; it is vitally important to understand how to search efficiently and effectively, by developing a search strategy. A demonstration of carrying out an effective search is outlined in the video below - for a step-by-step guide to this process please follow this link.

A search may be conducted using any database; for example, the freely available PubMed database, Cochrane Library or, should your University have access, Ovid MEDLINE (here for Monash students). The easy to use Trip Database allows you to simply input your PICO question.

Further reading

  • Chapter 2, 3 & 4 In: Guyatt G, Rennie R, Meade M, et al. (Eds). Users' guides to the medical literature: A manual for Evidence-Based Clinical Practice. (2nd ed). (pp. 9-16) New York: McGraw Hill Medical

  • Sackett D, et al. Evidence Based Medicine: What it is and what it isn’t. BMJ 1996;312:71.

  • TED talk by David H. Newman