Resources Relevant to the Implementation
of Core ACGME-Required Competencies

Module II
    Practice-based learning & improvement
          Resources
Using evidence        As the developers of the Abstracts of the Cochrane Reviews stated:

      “[evidence] is essential but not sufficient for improving decisions
     about health care.
      Well-informed decisions also require information, and judgements
     about needs, resources, and values; as well as judgements about
     the quality and applicability of evidence.
      Relying only on evidence about the effects of health care can be
     inappropriate.
      Care and compassion are vital, and understanding the nature and
     basis of disease and the way that interventions work remains
     important.”

The resources selected for this section of the module are designed to provide learners with information on locating, appraising, and using evidence.
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Introduction to
Evidence-based Medicine		 The optimal use of evidence begins with acquiring the knowledge and skills needed to construct clinical questions and searches, and evaluating the evidence obtained as a result. Duke University Medical Center and the University of North Carolina have collaborated to produce this tutorial on the use of evidence-based medicine.

This well-constructed site provides clear information and examples, as well as several exercises where one can test one’s skill at locating the best evidence.

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SUNY Health Sciences
Evidence-based
Medicine Course		 In-depth information about understanding and interpreting evidence is available from SUNY Health Sciences Evidence-based Medicine Course.

This site is a useful resource for information on topics such as constructing effective searches for a variety of types of questions and on evaluating the results of various types of studies such as prognosis and harm studies and meta-analysis.
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University of Toronto Health Network
Centre for
Evidence-based Medicine		 The University of Toronto Health Network’s Centre for Evidence-based Medicine site provides extensive resources for learning and using evidence-based medicine.

Sections such as the one on child health provide the user with information about EBM specific to the domain in question. The learner is guided through the process of formulating clinical questions from a case, locating evidence resources, then analyzing the information obtained. A number of worksheets, designed to be used with studies of diagnosis, harm, prognosis, systematic review, and therapy are available to download and use.

These worksheets provide an excellent resource that may be used to document use of evidence.
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NHS Centre
for Evidence-based Medicine		 The NHS Centre for Evidence-based Medicine has been developed in Oxford, UK as a free resource.

The site includes an EBM toolbox containing resources such as spreadsheets and calculating programs, as well as information on study designs and tips to increase the utility of searches. The site also contains materials for teaching EBM, including worksheets and practice scenarios.
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Netting the Evidence:
A ScHARR Introduction
to Evidence-based Practice on the Internet		 Netting the Evidence is produced by the School of Health and Related Research at the University of Sheffield, UK.

This site provides a wealth of resources including information about the most effective ways to search for evidence and how to appraise evidence. It includes a set of self-assessment exercises.
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Sources of evidence Most academic health care center libraries provide access to a variety of evidence-based medicine resources to users registered within their system,. However, there may be occasions when one wants to access these resources but is not connected to the library’s system. In these instances, many of these resources are freely available to all users through the Web.
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Abstracts
of Cochrane Reviews		 The Cochrane Database of Systematic Reviews may be the most well-known source of evidence-based reviews. Abstracts of Cochrane Reviews is a free site providing abstracts only, not full text. The site serves as a portal for accessing a variety of collaborative review groups, including the Cochrane Airways group.
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ACP Journal Club The ACP Journal Club provides access to articles published in two journals, Evidence-based Medicine and the ACP Journal Club. This site can be browsed for recent updates or searched for specific topics.
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Database of Abstracts
of Reviews of Effectiveness
(DARE)		 The National Health Services' Centre for Reviews and Dissemination at the University of York produces the Database of Abstracts of Reviews of Effectiveness (DARE). This site contains is searchable by topic.
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PubMed PubMed is the National Library of Medicine’s free MEDLINE site. Tips for searching for the best evidence-based information are provided on the site
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National Guideline Clearinghouse The Agency for Health Care Policy and Research (AHCPR), along with the American Medical Association (AMA) and the American Association of Health Plans (AAHP) produces the National Guidelines Clearinghouse. This site provides access to evidence-based clinical guidelines. It can be searched by disease or condition, or by treatment or intervention.
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TRIP
(Turning Research into Practice)
Database		 The TRIP (Turning Research into Practice) Database searches 60+ evidence-based medicine sites simultaneously. Results are sorted into categories including direct links, peer-reviewed journals, e-textbooks, and guidelines.
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