Foundations of Evidence-Based Practice

Course Organiser: Dr Mary Fortune mdf34@medschl.cam.ac.uk

The Foundations of Evidence-Based Practice (FEBP) course is a 2nd MB/2nd Vet MB subject taken by medical and veterinary students in their first year. It serves as an introduction to the core sciences underlying much of modern clinical practice – epidemiology and biostatistics. These are areas of knowledge and skills required for the informed reading of research evidence and its translation into best clinical practice.

We will be introducing you to the key concepts that shape good research design and analysis, and giving examples of these ideas in both research and clinical practice.

The assessment is a 45 minute, multiple choice question paper sat at the end of the Lent term.

The course comprises ten large group sessions on Wednesdays at 12.00 in the Michaelmas and Lent terms. Each student will also have four seminars, two per term, during which the concepts taught during the large group teaching will be applied through discussion of published research.

Aim:

• To produce informed consumers of research who are equipped with an understanding of the fundamental principles underlying epidemiological and clinical research methods.

Objectives:

• To provide an understanding of the role of research methods in generating clinical knowledge;
• To enable students to understand and critique the design and analysis of a range of research literature, and appropriately apply research findings to clinical practice;
• To equip students with insight into the research process and encourage their engagement with research during their clinical training.

Learning outcomes:

• Describe at least one system for defining a focused clinical research question, e.g. PICO

• Generate a focused clinical research question

• Discuss a range of research methods and assess their suitability for addressing a given research question

• Describe approaches to sampling and discuss the benefits and limitations of these

• Describe a process for searching the literature for evidence relating to a research question

• List the range of observational and interventional study designs and discuss the key features, strengths and limitations of each

• Describe the rationale for and critique the use of statistics and statistical tests in research, including descriptive statistics, p values and confidence intervals

• Construct a 2x2 table from data provided, calculate an OR and / or RR as appropriate, and interpret this finding

• Define and discuss concepts of chance, bias, confounding and causality

• Identify suitable statistical tests for hypothesis testing (one and two samples), explain the rationale for the choice and identify assumptions

• Discuss the rationale for screening tests and describe the potential benefits and harms of screening

• Define and interpret screening test characteristics such as sensitivity, specificity, predictive value and discuss their relevance to practice

• Discuss the use of evidence in clinical practice including consideration of the benefits and limitations of this approach

• Describe typical academic outputs and identify opportunities for their own research activity over their entire course

The lectures are as follows: