Development of an evidence-based curriculum using Cochrane systematic reviews and tools in a learning healthcare system

Article type
Authors
Gupta A1, Ironside KR1, Koster MA1, Sim JJ1
1Kaiser Permanente
Abstract
Background: Evidence-based medicine (EBM) education is an integral component of a rapid-learning system. With access to electronic health records and integrated data systems, Kaiser Permanente physicians and researchers are positioned to take advantage of unique opportunities to conduct research, develop best practices, and improve healthcare quality. However, access to data alone is not enough. Researchers and physicians also need guidance on how to design optimal studies, critically appraise results, and interpret findings. Cochrane tools are a critical resource in developing these skills and supporting the continuous development of an evidence-based, rapid-learning health system.
Objectives: To describe an EBM Mini-Course designed to train physicians in critical appraisal and EBM methodology.
Methods:The objectives of the EBM Mini-Course are to 1) provide physicians with skills necessary to conduct high-quality evidence-based research, 2) encourage the incorporation of EBM principles into daily clinical practice, and 3) accelerate implementation of best practices across the organization. To develop a curriculum that would achieve these goals, a comprehensive search of the literature was conducted to identify key components of an effective EBM curriculum. Online EBM resources were also reviewed, including the Cochrane Interactive Learning Modules.
Results: Based on the results of research findings, a six-session, interactive EBM course curriculum was developed. The curriculum 1) introduced participants to the 5As of EBM methodology, 2) provided training on how to conduct a comprehensive literature search using public and Kaiser Permanente research resources, 3) included instruction on how to critically appraise research publications, and 4) provided training on interpreting a systematic review or meta-analysis. The course included lectures, group exercises, and knowledge checks. The Cochrane Handbook and Cochrane Risk of Bias Tool served as reference material for critical appraisal exercises. Cochrane systematic reviews were used as examples and standards. While the course was originally offered only to staff physicians, it was later expanded to nursing researchers, clinical trial managers, research project managers, and staff supporting clinical teams. Using skills gained from the course, class participants are currently in the process of conducting or supporting research in the areas of sepsis, cardiovascular disease, obstetrics, and patient safety
Conclusions: Access to electronic health records and integrated data systems puts Kaiser Permanente in a unique position is to rapidly conduct evidence-based research and spread best practices. Training in EBM methodology, using Cochrane as well as other EBM tools, provides physician and other clinical researchers with the skills needed to efficiently harness the opportunities provided by access to data. Prioritizing evidence-based teaching can accelerate the production of high-quality research and promote rapid learning of best practice.
Patient or healthcare consumer involvement:No