A contemporary EBP workshop for clinicians with a focus on pre-appraised evidence and shared decision-making

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This is a booklet of a half-day EBP workshop for clinicians with a focus on pre-appraised evidence and shared decision-making.

• Format Lessons
• Language/s English
• Target Audience Further education, Researchers
• EBM Stage 1 - Asking focused questions, 3 - Appraising evidence, 4 - Decision making
• Duration >15 mins
• Difficulty Introductory

Key Concepts addressed

• Make well-informed treatment choices
• What is the problem and what are the options?
• 3-1a The clinical problem and treatment options should be clear
• Is the evidence relevant?
• 3-3b How certain is the evidence?
• Don’t be misled by unreliable summaries of treatment comparisons
• Don’t be misled by how treatment effects are described

Details

This workshop focuses on integrating Shared Decision Making (SDM) training and Evidence-Based Practice (EBP) training through providing video demonstration (to model the skills) followed by teaching how to interpret and communicate research evidence and decision aids.

This workshop booklet includes activities related to:

1. Clinical Scenario considering the benefits and harms of knee arthroscopy [Small-group exercise]: We started the workshop by presenting a clinical scenario of a patient presenting to a GP with knee osteoarthritis and requesting arthroscopic surgery
2. BMJ Rapid Recommendations Clinical Practice Guideline [Small-group exercise]: Participants were presented with a relevant BMJ Rapid Recommendation Guideline (i.e. a trusted reliable source of pre-appraised evidence – this was selected as it contained all the data needed to build interactive exercises and is publicly available).
3. Evidence Based Practice and Shared Decision Making [10 min presentation]: Participants were briefly introduced to evidence based practice and shared decision making, including the principles of risk communication.
4. Applicability of Research Evidence [Small-group exercise]: Participants completed a relevant practical exercise to teach these competencies.
5. Interpretation of research evidence [Pre-recorded video]: Participants watched a 7-minute video about the interpretation of research evidence (including the interpretation of measure of association and effect, statistical significance versus clinical importance, and measures of uncertainty).
6. Interpretation of research evidence [Small-group exercise]: Participants worked through several small group exercises to consolidate these competencies using examples from the pre-appraised evidence.
7. SDM role-play [Pre-recorded modelled role-play]: Participants watched a video of a patient-doctor consultation showing an example of what shared decision making might look like in clinical practice
8. SDM role-play [Small-group exercise role-play]: Participants completed a small group practical exercise to practice using shared decision making skills in a role-play patient-doctor consultation (one participant role-played a general practitioner, a trained standardised patient role-played a patient with knee osteoarthritis, and other -group members provided feedback).
9. Interpretation of levels of evidence and strength of recommendations [Pre-recorded video]: Participants watched a 7-minute video explaining the GRADE framework (The Grading of Recommendations Assessment, Development and Evaluation), different levels of quality of evidence (e.g. low, high) and strength of recommendations (e.g. strong, moderate), and its relevance to clinical decision-making.
10. Critical appraisal of a randomised controlled trial [Small-group exercise]: Participants applied these skills to critically appraise one of the primary randomised studies included in the pre-appraised evidence.
11. Interpretation of a forest plot [Small-group exercise]: Participants completed practical exercises about interpreting a forest plot.