BEST has recently had a series of engaging tutorials focused on Evidence-based Medicine contributed by Dr Rachel Thompson (UNSW Sydney) and her colleagues from UNSW and Prince of Wales Clinical School (POWCS). Rachel was kind enough to answer a few questions for us to discuss the importance of Evidence-based Medicine, what they’ve developed and how it is being used.
Stephanie: What is Evidence-based medicine and why is it so important?
Rachel: Evidence-based practice (EBP) is the fundamental way of practising professionally in the modern day. In health care, this focuses on ensuring that practitioners use the best, most up-to-date and relevant evidence to support shared decision-making for patients for all aspects of their care. “Evidence-based medicine” was coined for the medical profession.
S: Thank you for sharing the tutorials with the BEST Network. What have you and your team created?
R: We’ve developed a series of Smart Sparrow tutorials breaking down Evidence-based Practice (EBP) into its elements. The first tutorial introduces the basics of EBP for our first-year medical students at UNSW. There are two further tutorials where students can learn about key elements of EBP: 1) Asking clinical questions (focusing on learning how to structure clear clinical questions); and 2) Becoming a critical reader (focusing on critical appraisal skills using the UNSW critical appraisal worksheet).
The fourth tutorial (coming soon) is designed to assist first year students to learn about the EBP screening principles of sensitivity, specificity, and positive predictive and negative predictive values.
S: Why were the tutorials created?
R: Evidence-based Practice has been part of the Quality of Medical Practice element in the Undergraduate Medical Program at UNSW Sydney for 15 years. The program originally incorporated older style online tutorials that were developed 14 years ago and have been used by Medical, Optometry and Exercise Physiology students locally as well as by many students internationally. The newly developed tutorials have been revised and updated into the Smart Sparrow adaptive platform to provide a more interactive and tailored learning experience for students.
S: What process did you go through to create the tutorials?
R: We took the best elements of the old-style online tutorials and other learning materials used in classes and storyboarded these clinically relevant scenarios and examples onto PowerPoint slides, adding in extra explanations, diagrams, quizzes or interactive elements. We specifically targeted those concepts that we considered were most difficult for students or “threshold concepts” which most students struggle with and fail to understand fully when they first meet them. We had funding that enabled us to employ Smart Sparrow designers for structure and formatting as well as to develop a stylish CSS background element to unite the lessons. We were also able to engage student partners for invaluable input in development and testing.
S: I always find it interesting to discuss what the most challenging part of developing the tutorials was because I hear such a variety of answers. What was it for you and your team?
R: Finding the time to spend thinking about the content and concepts, identifying the difficult concepts, and developing the content structure to maximise student learning. After working that out, it was surprisingly easy to get the tutorials to flow.
S: In the tutorials you’ve developed what is your favourite feature?
R: I really like how the UNSW QMP critical appraisal worksheet works within the tutorial: Becoming a critical reader. Students appreciate the chance to think for themselves and then see what the expert thinks.
I’ve had great feedback from students about the inclusion of the quizzes and interactive elements that we built in, saying that these helped them to think for themselves. The various quizzes and interactive nature of the tutorials work much better for learning than our old-style tutorials, where students could just move on to the answers without really considering the question.
Figure: Sample screens that demonstrate the interactive nature of the tutorials.
“Providing feedback after each submission of answers was helpful in enhancing my understanding” – Anonymous student
Note – The Introduction to Evidence-based Practice tutorial includes an excellent section on conducting a Medline search involving planning search terms and narrowing the results. This has also been well received by the students.
S: Are you planning to build more?
R: Yes – we are planning at least 2 more on EBP and maybe a series with embedded videos covering basic biostatistics. The next 2 will be: “Understanding study design” (which will introduce the basic study designs and what they are useful for, plus pyramid of evidence) and “Applying evidence clinically” (which will introduce the concept of risk and risk assessment from an EBP point of view).
To access the tutorials and adapt them for your own students visit the Quality Practice Loop on BEST. The Quality Medical Practice (QMP) team who developed and contributed the tutorials would like to acknowledge the UNSW Learning and Teaching Innovation Grant that made the work possible, as well as the following people:
QMP tutorial content development: Dr Rachel Thompson, UNSW
(Acknowledgements: Dr Barbara-Ann Adelstein POWCS, Professor Mike Bennett POWCS, Dr Ed Loughman POWCS)
Adaptive tutorial design: Suzanne Mobbs, UNSW
Student partners in tutorial content and development: Jesse Ende and Erica Strazdins, the QMP tutors, and feedback kindly provided by UNSW medical students in the courses.
QMP Blended Project development: Jake Halliday (student), Peter Zarzour (student), Kirsten Challinor, Elizabeth Davey
QMP logo graphic design: Lisa Petroff www.lisapetroffdesign.com
QMP Blended Project management: Diane Vukelic
Smart Sparrow project lead: Martin van der Weyer