EBHC Competencies

4th June 2018

Introductory

• Understand evidence-based practice (EBP), defined as the integration of the best research evidence with our clinical expertise and our patient’s unique values and circumstances.
• Recognise the rationale and origin of EBP.
• Practice the 5 steps of EBP: Ask, Acquire, Appraise and Interpret, Apply, and Reflect.
• Identify the preferred order of study designs for each type of clinical question, including the pros and cons of the major study designs
• Describe the distinction between using research to inform clinical decision making and practice vs. conducting research.

Ask

• Identify the difference between the types of questions that cannot typically be answered by research (background questions) and those that can (foreground questions)
• Identify different types of clinical questions, such as questions about treatment, diagnosis, prognosis, and aetiology
• Convert clinical questions into structured, answerable clinical questions using PICO

Acquire

• Outline the different major categories of sources of research information, including traditional biomedical bibliographic databases or database resources which filter or pre-appraise research
• Design and conduct an appropriate search strategy for clinical questions
• Recognise the differences in broad topics covered by the major traditional databases
• Define strategies to obtain the full text of articles and other evidence resources

Appraise and Interpret

1. Identify key competences relevant to the critical evaluation of the integrity, reliability, and applicability of health related research.
2. Interpret different measures of association and effect, including key graphical presentations
3. Critically appraise and interpret a systematic review
4. Critically appraise and interpret a treatment study.
5. Critically appraise and interpret a diagnostic accuracy study.
6. Distinguish evidence-based from opinion-based clinical practice guideline.
7. Identify the key features of, and be able to interpret, a prognostic study.
8. Explain the use of harm/aetiologies study for (rare) adverse effects of interventions.
9. Explain the purpose and processes of a qualitative study.

Apply

1. Engage patients in the decision making process, using shared decision making, including discussing the evidence and their preferences
2. Outline different strategies to manage uncertainty in clinical decision-making in practice
3. Explain the importance of baseline risk of individual patients when estimating individual expected benefit.
4. Interpret the grading of the certainty in evidence and the strength of recommendations in health care

Reflect

• Recognise potential individual-level barriers to knowledge translation and strategies to overcome these.
• Recognise the role of personal clinical audit in facilitating EBP