“EBM – Bench to Bedside” Resident Facilitator Guide
Preparation Timeline
➢ Scheduling – Find your assigned date and faculty session mentor.
➢ Choosing a PICO Question
o One month prior to session – Send clinical scenario & PICO question via e-mail to the PedsChiefs + your faculty mentor.
o If you’re assigned to present “EBM – Clinical Care” (faculty mentor is Dr. Rastogi, Dr. Malik, or Dr. Scharbach), please choose an outpatient clinical question.
o If you’re assigned to present “EBM – Bench to Bedside” (mentor is Dr. Goilav), please choose a question that has a significant basic science component.
➢ Literature Search – After your mentor approves your PICO question, perform a literature search & identify a journal article. Ask for help from your faculty mentor if you need it during this process.
➢ Faculty Mentorship – Send a PDF of journal article to your faculty mentor at least 3 weeks prior to your assigned date. At the same time, arrange a time to meet with your mentor – meeting should occur at least 5 days before the session. Read and critically appraise your journal article in preparation to meet with your faculty mentor. Purpose of the meeting:
o For you to ask any questions that you have.
o Discuss possibly learning objectives for the session.
Critical Appraisal – complete these steps prior to meeting with your faculty mentor.
➢ Use outlines below as guide
➢ Use a critical appraisal tool if available. Ask for help identifying one if you need it. The following link has tools.
➢ Read appropriate sections of Epidemiology, by Leon Gordis. Ask for help identifying sections to read if needed.
Facilitating Your Session
➢ Adult Education 101
o Tell them what you are going to teach, teach it, then tell them what you taught – this is part of why you are identifying learning objectives…
o Adults are active learners. You should aim to be talking less than 50% of the time. Do not use powerpoint – you are a facilitator, not a lecturer. Get them to be involved. Think about how you will handle awkward silence – stare back, reword question, call on someone, etc… Encourage participation with eye contact and questions.
➢ Intro to Session
o Review case/clinical scenario that inspired your PICO question. Get your colleagues involved at this stage – ask them to relate to your clinical scenario – discuss relevance to their present or future practice. Review your PICO question – why did you choose this question?
o Discuss literature search & article selection – why this article? How did you find it?
o Share learning objectives for the session.
➢ Summary/Closing
o Summarize applicability of your article/study to your question
o Highlight/reinforce key points mentioned during session
o Review learning objectives
o You are in charge of ending the session by 11:30am so that all residents can get to 11:45am lecture.
❧ for sessions with Dr. Rastogi, Dr. Malik or Dr. Scharbach❧
INTRO: 2-5 minutes
① Clinical scenario – get people to relate to this…
② PICO question – why this question? get people to relate…
③ Literature search – include successes & challenges
④ Article selection – why this article?
⑤ Learning objectives
CRITICAL APPRAISAL: 40 minutes
① Background
▫ Research question – compare to your PICO question
▫ Why is this important?
▫ Background information that your colleagues need to understand the article
② Methods – a large percentage of your time will be spent here…
▫ Population
▪Demographics ▪Sampling
▪Recruiting ▪Baseline characteristics
▫ Setting
▫ Study design
▫ Inclusion/exclusion criteria
▫ Follow up
▫ Exposures or interventions to be studied
▪objective vs. subjective
▪ethical?
▫ Outcome measures
▪primary vs. secondary – why is it important to have a single primary outcome?
▪objective vs. subjective
▫ Power
▫ Statistical analysis
③ Results
▫ Focus on charts & tables – what is the message in each?
▫ Clinical meaningfulness vs. statistical significance
▫ Type I error – what is the risk of making a type I error if you conclude that there is a difference?
▫ Type II error – was the study powered to make the conclusions that the authors make?
④ Discussion
▫ How does this study fit into the body of literature on this topic?
▫ Strengths & limitations
▫ Internal validity – do the results support the conclusion?
CONCLUSION: 5 minutes
① Study bias – financial disclosures, conflicts of interest
② Application of study – external validity – can you use this study to inform practice elsewhere?
▫ to clinical scenario
▫ to CHAM setting
③ Summarize what was learned (learning objectives)
❧ for sessions with Dr. Goilav❧
INTRO: 2-5 minutes
① Clinical scenario – get people to relate to this…
② PICO question – why this question? get people to relate…
③ Literature search – include successes & challenges
④ Article selection – why this article?
⑤ Learning objectives
CRITICAL APPRAISAL: 40 minutes
① Background
▫ Research question – compare to your PICO question
▫ Why is this important?
▫ Background information that your colleagues need to understand the article
② Methods – a large percentage of your time will be spent here…
▫ Experimental approach
▪ Cell culture
▪ Animal model
▪ Tissue from humans/animals
▫ Experimental intervention
▫ Why was a particular model used?
▫ Can the model used be a cause for biased results? – If yes, to the benefit or detriment of the authors?
▪ Exposures or interventions to be studied
▪ Was there a proper protocol in place?
▪ Were the studies on animal models done in compliance with the recommendations of the AAALAC (Association for Assessment and Accreditation of Laboratory Animal Care)
▫ Could this experimental approach achieve the aim of the study?
▫ Statistical analysis
③ Results
▫ Focus on charts & tables – what is the message in each?
▫ Clinical meaningfulness vs. statistical significance
▫ How does the research method change the significance of the results? – Do you need to repeat an experiment, if the method is considered gold standard?
④ Discussion
▫ How does this study fit into the body of literature on this topic?
▫ How can the results obtained in the lab be translated to the clinical setting?
▫ Strengths & limitations – Based on what you learned about the methods used, was it the best choice? Any pitfalls?
▫ Internal validity – do the results support the conclusion?
CONCLUSION: 5 minutes
① Study bias – financial disclosures, conflicts of interest – who paid for the experiments?
② Application of study – external validity – can you use this study to inform practice elsewhere?
▪ to clinical scenario
▪ to CHAM setting
③ Summarize what was learned (learning objectives)