About Centre for Evidence-based Health Care

Evidence-based health care is the use of best evidence to inform healthcare decision-making to improve patient care. The Centre for Evidence-based Health Care develops, teaches and promotes evidence-based health care (EBHC) at undergraduate and postgraduate levels of all healthcare professionals; provides EBHC support and resources to healthcare professionals to help maintain the highest standards of healthcare practice; and enhances the use of best evidence by government, non-governmental organizations and the private sector in healthcare policy and practices. The Centre works in collaboration with a number of local and international institutions. The key principles are to encourage dialogue, enhance EBHC activities and to avoid duplication.

On the lighter side of teaching EBM

Our group dedcided to have an authentic journal club meeting in one of Oxford’s famous pubs. This was Ken’s idea – he wanted our group to record one of his Podcasts (which we later re-labelled as a Pubcast) for his series of podcasts. He picked a paper from the 2011 Christmas edition of the BMJ, titled: “Orthopaedic surgeons: As strong as an ox and almost twice as clever? Multicentre prospective comparative study” by Subramanian et al. This was great fun!

The posdcast will shortly be published on http://www.TheSGEM.com



Start Tweeting!!

On the second last day of the workshop (I cannot believe how time has flown!) we had a few presentations and many discussions around using Social Media in the context of EBHC.

On of the most interesting and I think innovative examples, was the Twitter Journal Club. This was started by two medical students from Cambridge and can be accessed by following #TwitJC. This is how it works:

The journal club is held every second Sunday, at 7pm GMT. Anybody can suggest a paper to be discussed, which, together with an introduction to the session, is posted on the website 2-3 days in advance. On the evening, anybody can participate in the discussions by tweeting comments – as for any other Tweet, one is only allowed 140 characters per Tweet. After the session, all the Tweets are collated and posted as a summary on the website (www.twitjc.com).

I think this is such an excellent example of using social media as a tool for learning and a brilliant way of bringing together people from all over the world to participate in discussions. It really has the potential to spread the principles of EBHC – I think this really convinced me (as a not very Twitter-wise person) to sign up and start tweeting! 



Live, love, laugh and LEARN

A recurrent theme at the workshop is how to energize your audience when teaching EBHC. Today we had a few excellent examples. One option is to use humour in your presentation  – this will definitly keep your audience awake. There are published papers on mud-wrestling, headbanging and parashooting – why not use these to teach critical appraisal or measures of effect? In addition, there are cartoons, real life stories that are funny etc. Although I think if this does not come naturally (as in my case), there are always alternatives. Using examples of studies currently in the news –  dark chocolate for lowering blood pressure, for example – is an excellent way to get your audience to participate in discussions. This also makes EBHC more relevant in the eyes of the learners. Lastly, telling the audience a story about yourself – how you became interested in EBHC, what you have experienced in your own practice, or while you were teaching – these personal stories make you more human in the eyes of the learners and they automatically feel more connected to you.

Another question frequently popping up, is how to emphasise the importance of EBHC. Dr Carl Henegan presented one of his ideas today – using examples where people disregarded the evidence which led to disability or even death. Stories like the ones on Thalidomide and Vioxx will grab the learners’ attention, even shock them and hopefully make them realise how crucial it is to use evidence when making decisions about health care.

In our small group session, we were asked by one of the participants, to role model freshly qualified paramedics receiving a lecture on EBHC. She asked us why we think EBHC is important in our practice. These were the group’s answers:

  • That I stay out of trouble
  • Because I lack experience, I need the evidence to inform my practice
  • To structure my problem-solving process
  • So that others can see you know what you are doing
  • So that we can better communicate what we do to our patients
  • To challenge misconceptions
  • To keep up to date with the literature
  • To know what works and what doesn’t work
  • To simplify the day-to-day life as a clinician

Why do you think EBHC is important, and how did you get interested in EBHC? The answers to these questions are all you need to engage with your learners and make EBHC more relevant, personal and interesting.

Having a free afternoon, I decided to explore Oxford a little – what an experience! I love the beautiful, old colleges!

Less is more…

… according to Amanda Burls who gave a presentation on “Stats in small doses”. Not only did she manage to keep us all awake in the session after lunch, but she demonstrated various techniques and tips on teaching complicated concepts related to statistics.

“Less is more” was a theme that emerged throughout the day. Going back to the first session of the day, Rod Jackson gave a presentation on critical appraisal. After hearing him talk about the Graphic Appraisal Tool for Epidemiological studies (GATE), I finally see how this can be useful in teaching students how to critically appraise epidemiological studies. Even though I have been teaching students to use the GATE framework in the past, this presentation was like a “light bulb” moment. Rod Jackson’s enthusiasm and interesting stories on how he developed the tool definitely contributed to my new understanding of how to use this. The goal is really to simplify critical appraisal, without missing any critical points. And once you remember the picture, the acronym and the formulae (less), you have the tools to make a judgement about the study quality, the magnitude of the effect and the precision (more). For busy clinicians wanting to appraise studies, this tool seems ideal since not all of them are going to be clinical epidemiologists.

See http://www.epig.co.nz for more information on the GATE frame and to access critical appraisal sheets for various studies.

During the morning session on the lawn – see photo in previous post – we listened to one of the group member’s (Ken) podcast on the Ottawa rule for ankle injuries. Ken is an emergency medicine physician in Canada and is aiming to produce 10 minute podcasts on best available evidence for relevant questions in the emergency department. This is part of a larger project, “The Sceptics Guide to Emergency Medicine” (www.TheSGEM.com) . It was very interesting to have discussions around socila media and the role of technology in education.  It is becoming increasingly important to include Podcasts, Facebook, blogs, Twitter and other technologies in teaching and learning – especially for the current undergraduate students (Generation Z) who do not know a life without mobile phones, who can access information by clicking one button and who are constantly connected with the people around them. Using these tools to teach EBHC can be of great value – has anybody thought about a GATE framework app yet?



What are the characteristics of a good teacher?

The first day of this workshop was anything but boring. The first thing that struck me, was that I am spending a week with people from all over the world, interested in the same thing: Teaching evidence-based health care (EBHC) – although this is quite obvious from reading the title of the workshop, it is great to be surrounded by people who know what EBHC is and who do not need to be convinced that teaching EBHC is essential!

The day started out with an introductory plenary session by Dr Carl Henegan in which he presented the five characteristics of a good teacher. To summarize, a good teacher:

1. is enthusiastic, energetic, excited (think about the best teacher you ever had – mine definitely fits this description and he was teaching Maths!)

2. is highly knowledgable in his area

3. maintains that knowledge (think: professional students)

4. is committed to life-long learning

5. is changing and influencing practice (this is probably the most difficult aspect since changing practice requires consideration of a number of other factors)

In our break-away session, we also experienced how telling a story can really grab the learners’ attention and set the scene for the lecture. This can be a personal story (which allows you to connect with the learners) a recent news paper article, or even a story about a German physician who, in the 1780’s, claimed that magnetism was the answer to ill health. (Read more about Franz Mesmer http://en.wikipedia.org/wiki/Franz_Mesmer)

A teacher should  take his knowledge, simplify it and communicate it to the learners – this in itself is a challenge. How do I explain difficult EBHC concepts to learners who know little about the field? This is only one of the questions I am hoping to have answered by the end of the week.

Luckily the wheather allowed us to spend part of the afternoon session in the lovely garden of St. Hugh’s College.

So, what do you think are other characteristics of a good teacher?