Use of EBM Guidelines and Point-of-Care Resources

Numerous resources are available to providers and their patients. some of which are of poor quality and questionable validity. The stated quality of evidenced based resources ranges from expert opinions to systematic reviews. It is imperative that teachers provide evidence based point-of-care (POC) resources and evidence based medicine (EBM) guidelines to both their patients and learners.

Learners of all levels use POC resources. Many learners feel that using apps and online resources are superior to books as they can be updated with more frequency. The top four resources used at POC were Wikipedia, Google, UpToDate, and WebMD.1 The following medical apps were also among the most frequently referenced: Medscape, Skyscape, Dynamed, Epocrates, VisualDx, Micromedex, and Lexicomp.1,2

Quick Tips

  • Have a discussion with your learner about what EBM guidelines are, how they are created, by whom they are created, and how they are evaluated for level of evidence
  • Discuss different levels of evidence and what they mean
  • Discuss with the learner what POC apps they have downloaded or learned about previously
  • Download at least one POC app (e.g., MedCalc, AHRQ ePSS)
  • Become familiar with at least one source of EBM guidelines (e.g., DynaMed, USPSTF, CDC, IDSA, etc.)
  • At least once per student rotation, model the use of a POC resource with your learner as a means of answering a clinical question
  • Show the student a resource where they can obtain EBM guidelines regarding a recent patient they had seen together

Author: David Rebedew, MD

References
  1. Quant, C. Altieri, L. et al. The Self-Perception and Usage of Medical Apps amongst Medical Students in the United States: A Cross-Sectional Survey. International Journal of Telemedicine and Applications. 2016. http://dx.doi.org/10.1155/2016/3929741.
  2. Koh, K. Wan, J. et al. Medical Students’ Perceptions Regarding the Impact of Mobile Medical Applications on Clinical Practice. Journal of Mobile Technology in Medicine 3:1:46-53, 2014. DOI:10.7309/jmtm3.1.7.