Document Detail


Should we be teaching information management instead of evidence-based medicine?
MedLine Citation:
PMID:  20496022     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Shepard R Hurwitz; David C Slawson
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  468     ISSN:  1528-1132     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-15     Completed Date:  2010-10-04     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2633-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Orthopaedic Surgery, University of North Carolina, Chapel Hill, NC 27599-7055, USA. shurwitz@abos.org
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MeSH Terms
Descriptor/Qualifier:
Access to Information
Clinical Competence
Curriculum
Education, Medical, Graduate*
Education, Medical, Undergraduate*
Evidence-Based Medicine / education*
Health Knowledge, Attitudes, Practice
Humans
Information Dissemination
Information Management / education*
Internship and Residency
Orthopedic Procedures / education*
Quality of Health Care
Students, Medical
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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