Educational theories' application to teaching EBM

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Credit: Duncan Dixon for Dean Giustini
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Contents

Introduction

See also Evidence-based health care | Evidence-based practice workshops | Systematic review searching

This page is a list of research questions that pertain to the application of education theories to teaching EBM

Clinical question(s)

  • Given the barriers to knowledge transfer of the best evidence in medicine, do educational theories play a role in facilitating the teaching of evidence-based medicine (EBM)?
  • What major educational theories have been evaluated for use in teaching EBM principles in the undergrad years, post-grad to professional practice?
  • What can reasonably be expected of learning theories as they apply to EBM teaching?
  • Which learning theories have some potential application to inform future, efficient means of EBM teaching?
  • Perhaps the reasons as to why learning theories appear not to have served EBM well should be part of the research conducted (if indeed that is the case).
  • Are EBM teachers required to understand learning theory to be good teachers?

Observations

  • there seems to be a paucity of discourse and research regarding educational theories' application to EBM; what are the reasons for this? (Medicine seems to rely mostly on mentored values and students are generally encouraged to adopt philosophical orientations to learning how to practice.)
  • significant amounts of time are spent teaching in medicine; physicians are content experts with little background in learning theory (itself not mentioned as a barrier); residents say they recognize the importance of their teaching (and interactions with medical students), but do not feel well prepared to do it effectively;
  • medical students report that much of their clinical learning is experiential, and takes place in situ during interactions with attending and chief residents, and expert clinicians; zone of proximal development;
  • is this area of medical education under-researched? (Literature suggests, yes.)
  • problem-based learning (PBL) has much in common with EBM; yet, "intransigent patriarchies" translate into an emphasis on behaviourist and "sage on the stage" techniques;
  • residents and clinicians from around the world attend "How to Teach Evidence-Based Practice" at McMaster University, arguably the birthplace of EBM - to learn how to teach;
  • teaching at McMaster is not evidence-based (ie. no rigorous assessment/evaluation of teaching methods seems to be systematically undertaken); little discourse about pedagogical (or, androgogical) methods as a means to inform teaching;
  • EBM basics are the focus at the University of Alberta's "Putting Evidence into Practice" Conference (no teaching component);
  • effective teaching at McMaster is described as an iterative process, akin to "practicing"; while that may be true, is this an efficient means to learn how to teach?
  • socio-cultural or situated learning theories seem especially relevant to EBM; in hospital environments, the model is reminiscent of Lave and Wenger's "community of practice";
  • the social and cognitive experience of EBM is situated; for example, there is explicit use of mentoring techniques, and cognitive apprenticeship, facilitated by experts;

Information retrieval

  • cumulating the best evidence is critical to EBM; there are some information retrieval experts (librarians and clinicians) who suggest that EBM should shift its attention toward knowledge management, using innovative methods of searching point-of-care decision-making tools, and electronic alerting techniques in Web 2.0.
  • my interest lies in using adult learning theories to transmit essential EBM search skills to clinicians; my research would focus on what theories would be most suitable to impart these information technology skills to clinicians; and, the major contexts for teaching.

References

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