Journal article
A real-world approach to Evidence-Based Medicine in general practice: a competency framework derived from a systematic review and Delphi process.
- Abstract:
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Background
Evidence-Based Medicine (EBM) skills have been included in general practice curricula and competency frameworks. However, GPs experience numerous barriers to developing and maintaining EBM skills, and some GPs feel the EBM movement misunderstands, and threatens their traditional role. We therefore need a new approach that acknowledges the constraints encountered in real-world general practice. The aim of this study was to synthesise from empirical research a real-world EBM competency framework for general practice, which could be applied in training, in the individual pursuit of continuing professional development, and in routine care. We sought to integrate evidence from the literature with evidence derived from the opinions of experts in the fields of general practice and EBM.
Methods
We synthesised two sets of themes describing the meaning of EBM in general practice. One set of themes was derived from a mixed-methods systematic review of the literature; the other set was derived from the further development of those themes using a Delphi process among a panel of EBM and general practice experts. From these two sets of themes we constructed a real-world EBM competency framework for general practice.
Results
A simple competency framework was constructed, that acknowledges the constraints of real-world general practice: (1) mindfulness - in one’s approach towards EBM itself, and to the influences on decision-making; (2) pragmatism – in one’s approach to finding and evaluating evidence; and (3) knowledge of the patient – as the most useful resource in effective communication of evidence. We present a clinical scenario to illustrate how a GP might demonstrate these competencies in their routine daily work.
Conclusion
We have proposed a real-world EBM competency framework for general practice, derived from empirical research, which acknowledges the constraints encountered in modern general practice. Further validation of these competencies is required, both as an educational resource and as a strategy for actual practice.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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- Files:
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(Preview, Version of record, pdf, 829.1KB, Terms of use)
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- Publisher copy:
- 10.1186/s12909-017-0916-1
Authors
- Publisher:
- BioMed Central
- Journal:
- BMC Medical Education More from this journal
- Volume:
- 17
- Issue:
- 1
- Pages:
- 78
- Publication date:
- 2017-05-01
- Acceptance date:
- 2017-04-26
- DOI:
- EISSN:
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1472-6920
- Pmid:
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28468646
- Language:
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English
- Keywords:
- Pubs id:
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pubs:693415
- UUID:
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uuid:e16de81c-0713-45f9-8f63-439ddcb938f5
- Local pid:
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pubs:693415
- Source identifiers:
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693415
- Deposit date:
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2018-01-19
Terms of use
- Copyright holder:
- Galbraith et al
- Copyright date:
- 2017
- Notes:
- © The Author(s). 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
- Licence:
- CC Attribution (CC BY)
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