EBN.
Introduction to TAMU 1-day EBP Workshop
Texas A&M University
OCTOBER
2024
Introduction to TAMU 1-day EBP workshop
EXPECTED DATE: OCTOBER 2024 (EXACT DATE TBD)
What is this workshop about?
Evidence-Based Practice (EBP) posits that health care providers should use the best available evidence, ideally from up-to-date, high-quality systematic reviews or guidelines, together with clinical or real-world experience, to help patients and members of the public prevent, resolve, or cope with problems related to their health, according to their values and preferences.
EBP involves the following steps, referred to as the ‘4A model’:
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Defining clinical questions in a way that allows clear answers (Ask)
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Efficient searching for the best information to answer the question (Acquire)
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Appraising the evidence (i.e. study methods/risk of bias and magnitude of effects) to determine its strength (Appraise)
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Applying that information to ones’ patients or population based on their health-related values and preferences, including weighing benefits, harms, inconveniences (e.g. cost, ease of adherence) in the context of patient/population values and preferences (Apply)
The 1-day EBP workshop will emphasize these steps through self-directed, problem-based, interactive learning based on large group lectures and small group breakout sessions. This approach focuses on presenting key background materials in large group sessions (e.g., lower vs higher quality systematic reviews and practice guidelines, risk of bias assessment, interpreting the importance of study results), and constructing one’s own learning in small groups, ultimately arriving at a solution to a problem or knowledge need through small group presentations and discussions.
Why should you attend this workshop?
Currently, we perceive a need for methodologically sound EBP skills training, particularly for healthcare providers and trainees that haven’t been extensively exposed to evidence-based practice training. This skills training workshop in EBP is targeted towards faculty who teach evidence-based practice curricula. On special request, health professionals in clinical practice, and clinicians in training may also be admitted.
What to expect at this workshop?
Overall, the large and small group sessions from the Workshop will emphasize the acquisition of knowledge from large group presentations, literature readings, and for some brave volunteers, the visceral experience of teaching your peers self-selected EBP concepts. For instance, volunteer participants will be asked to identify and choose core EBP concepts (e.g., relative versus absolute treatment effects, how to interpret a confidence interval based on the minimal important difference) from healthcare domains related to therapy or prevention relevant to their teaching interests or clinical practice. After each presentation there will be both self-reflective and small-group feedback on teaching on EBP concepts.
Learning Objectives
Participants can choose one of two EBP streams (Teaching or Practicing)
1. Teaching Objectives
An overarching objective of the workshop is to renew and enhance participants’ enthusiasm about teaching EBP, and to kindle their imagination about ways to improve their teaching. After participation in the Evidence-Based Practice workshop, the learner will develop the knowledge base and/or skill set to:
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Describe approaches for effective teaching of evidence-based clinical practice in different educational settings (on the wards, in out-patient clinics, tutorials, journal clubs, and large group sessions).
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Understand and describe the process of incorporating evidence-based care into clinical practice.
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Advance their evidence-based clinical practice skills
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Describe effective and interactive means of teaching in small and large groups settings.
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Identify high-quality evidence-based resources for the purpose of patient care, teaching, and continuing education through independent learning
2. Practicing Objectives
An overarching objective of the workshop is to renew and enhance participants’ enthusiasm about learning EBP, and to kindle their imagination about ways to improve their learning and incorporation of the concepts into clinical practice. After participation in the Evidence-Based Practice workshop, the learner will develop the knowledge base and/or skill set to:
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Advance their evidence-based clinical practice skills
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Understand and describe the process of incorporating Evidence-Based Practice into clinical practice
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Apply evidence-based clinical practice skills to real-world clinical problems
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Demonstrate ability to solve clinically oriented problems in an interactive problem-based small group learning format
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Identify high-quality evidence-based resources for the purpose of patient care and continuing education through independent learning
Examples content/EBP concepts covered in workshops:
1. Systematic error vs random error
2. Study designs (experimental versus observational)
Therapy or prevention
1. Evaluating risk of bias
a. Sampling and selection bias
b. Randomization
c. Allocation concealment
d. Prognostic balance
e. Blinding
f. Completeness of follow-up and missing outcome data
g. Intention-to-treat analysis
h. Per-protocol analysis
i. Complete case analysis
j. As treated analysis
k. Stopping trials early
2. Interpreting study results
i. Measures of effect
a. 2x2 tables
b. Relative Risk
c. Relative Risk Reduction
d. Absolute Risk Reduction
e. Number Needed to Treat (benefit and harm)
f. Odds Ratios
g. Mean Difference
ii. Statistical significance
iii. Precision of estimate of treatment effect
a. Confidence intervals
b. Number of events or observations
iii. Magnitude of treatment effect
a. Minimal Important Difference (MID)
b. Decision thresholds
3. Applying the results to patient care or policy
a. Study patients’/environment vs. clinical patient/environment
b. Balance of all important outcomes addressed (e.g., patient-reported outcomes)
c. Trading off desirable vs. undesirable health outcomes
d. Sufficient duration of follow-up
e. Interventional harms and costs
f. Values, preferences, beliefs and attitudes in decision-making
Summarizing the evidence
a. Review types
i. Narrative review
ii. Systematic review
iii. Systematic review and meta-analysis
iv. Systematic review and network meta-analysis
v. Systematic review and individual patient data meta-analysis
b. Summary estimate or pooled estimate of effect
i. Relative Risk
ii. Odds Ratios
iii. Hazard Ratios
iv. Absolute Difference
v. Mean Difference
vi. Standardized Mean Difference units
vii. Ratio of Means
viii. Minimal Important Difference (MID) units
c. Forest Plots
i. weighting
ii. fixed and random effect models including DerSimonian-Laird, Peto, Hartung-Knapp models; frequentist vs Bayesian
d. Heterogeneity (visual inspection, statistical inspection including I2 and p-value and determining credibility of observed subgroup effects)
e. Reporting bias (e.g., outcome reporting and publication bias, funnel plots)
f. Moving from evidence to recommendations
i. Certainty of evidence (e.g., Grading of Recommendations, Assessment, Development, and Evaluation (GRADE)
ii. Evidence to decision frameworks (e.g., magnitude of effect, certainty of evidence, and values and preferences, as well as cost considerations, equity, acceptability, and feasibility)
Tuition
OCTOBER 2024
Tuition
Minimal, pay on site
Location
Texas A&M University, College Station Campus
Date
October 2024, to be confirmed
The Venue
THE CENTER FOR TEACHING EXCELLENCE
TAMU
TEXAS A&M UNIVERSITY
COLLEGE STATION CAMPUS
400 BIZZELL STREET
COLLEGE STATION, TX 77843