Evidence Based Medicine
Journal club is obsolete. Why waste an hour pouring over an article which will rarely affect your practice, just because it happens to have been published within the past month? Instead, our EBM curriculum is determined by our patients, and founded on the goal of empowering our residents to be experts in identifying and applying best evidence to every clinical encounter for the duration of their careers. How is this operationalized? The answer lies in our innovative curriculum:
At NYP, we are lucky enough to have several EBM experts as part of our faculty, with whom each one of our residents are paired to navigate a unique practice based learning and implementation project. Everything begins at the bedside, where the resident identifies an interesting clinical dilemma during the course of patient care. As their project unfolds, the resident is exposed to and gains expertise in the core principals of EBM, including structuring their clinical question, finding and appraising the best evidence, and, finally, applying that evidence to patient care.
At the end of their PGY-2 year, each resident presents their PBLI project to the entire residency. The projects are voted on for impact on clinical practice by residents and faculty, and the winner is used as the foundation for the creation of an ED clinical pathway.
Research Methodology and Biostatistics
The PBLI project is supplemented with formal teaching of research methodology and fundamentals of biostatistics during conference time by our residency's very own non-clinical Research Coordinator, Sunday Clark, Sc.D. Dr. Clark's didactic series uses current and landmark EM literature to illustrate critical concepts related to study design and interpretation of results with a focus on applicability to the care of our own patients.
A monthly shift incorporated into the PGY-4 schedule, during which senior residents are given an opportunity to not only practice their EBM skills, but simultaneously affect patient care in real time. During their "E-Shifts", the PGY-4 resident rounds with the ED team in the morning, and, as the day unfolds, fields clinical questions from those engaged in active patient care. Using a combination of the EBM expertise they have achieved over the preceding three years, together with our unique, online platform, our senior residents investigate clinical questions, appraise the literature, and report their findings so the results can be applied to the very patient who was the source of the original question. Their conclusions are additionally disseminated via our internal residency-wide blog which fosters ongoing dialogue among our residents and faculty regarding clinical controversies and best practice.
Inspired by our EBM teaching process, many of our senior residents have pursued more formal EBM training through residency-sponsored participation in the annual Teaching Evidence Assimilation for Collaborative Healthcare (TEACH) workshop at the New York Academy of Medicine, where several of our own EBM faculty regularly teach, and which affords them the opportunity to learn more about EBM nuance, as well as network with the internationally renown EBM experts who attend this workshop each year.