Health and Medical News and Resources

General interest items edited by Janice Flahiff

Should we be teaching information management instead of evidence-based medicine?

From the full text article at the publisher’s Web site

[via a Medlib-L posting on November 29, 2010 by Julie Esparza, Clinical Medical Librarian, LSU]

Shepard R. Hurwitz1 and David C. Slawson2

(1) Department of Orthopaedic Surgery, University of North Carolina, Chapel Hill, NC 27599-7055, USA
(2) University of Virginia School of Medicine, Charlottesville, VA, USA

Shepard R. Hurwitz
Published online: 22 May 2010

To encourage high-quality patient care guided by the best evidence, many medical schools and residencies are teaching techniques for critically evaluating the medical literature. While a large step forward in many regards, these skills of evidence-based medicine are necessary but not sufficient for the practice of contemporary medicine and surgery. Incorporating the best evidence into the real world of busy clinical practice requires the applied science of information management. Clinicians must learn the techniques and skills to focus on finding, evaluating, and using information at the point of care. This information must be both relevant to themselves and their patients and be valid.
Where are we now?
Today, orthopaedic surgery is in the post-Flexner era of passive didactic learning combined with the practical experience of surgery as taught by supervising experts. The medical student and house officer fill their memory with mountains of facts and classic references ‘just in case’ that information is needed. With libraries and now internet repositories of orthopaedic information, all orthopaedic knowledge can be readily accessed without having to store much in one’s memory. Evidence is often trumped by the opinion of a teacher or expert in the field.
Where do we need to go?
To improve the quality of orthopaedic surgery there should be application of the best evidence, changing practice where needed when evidence is available. To apply evidence, the evidence has to find a way into practice without the long pipeline of change that now exists. Evidence should trump opinion and unfounded practices.
How do we get there?
To create a curriculum and learning space for information management requires effort on the part of medical schools, residency programs and health systems. Internet sources need to be created that have the readily available evidence-based answers to patient issues so surgeons do not need to spend all the time necessary to research the questions on their own. Information management is built on a platform created by EBM but saves the surgeon time and improves accuracy by having experts validate the evidence and make it easily available.
Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. Dr. Slawson is a paid consultant for Wiley & Son publisher.

November 30, 2010 Posted by | Biomedical Research Resources, Librarian Resources, Professional Health Care Resources | , , , | Leave a comment


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