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EBM975: From PubMed to Point-of-Care

2014/2015
Instructor Information
Instructor Email Office Location & Hours

Course Information
Course Description
This 16-week course will help 3
rd
& 4
th
year medical students and residents understand what evidence-based medicine
is, how to evaluate biomedical literature for research and clinical use, how to develop a clinical question, and how to
integrate EBM into clinical practice. The course will also demonstrate effective ways to stay current with research and
clinical guidelines found in the biomedical literature. Upon completion of this course, you will receive a certificate of
completion and one (1) CME credit.
Course Objectives
By the end of the course students should be able to:
Explain what evidence-based medicine is and how it can be applied to clinical practice
Differentiate between the types of resources available and the hierarchy of research
Utilize scientific and biomedical databases in an advanced way
Construct a search string, clinical question, and RSS feed
Identify mobile applications and web tools that will help them stay current
Course Expectations
Students are expected to read the assigned readings each week, listen to the podcast lectures and complete
assignments on time (see Course Policies, p #). The course is fast-paced, but organized in such a way that readings and
quizzes can be completed in the allotted time. All students are expected to participate in the online discussions, and
be respectful of their fellow classmates. Lecture attendance is optional, as these will be podcasted and available in the
online modules. Weeks 6 (Library appointment) and 13 (Presentation) do require you to be on campus.
Course Materials
Required Text
The required text schedule can be found in the Readings Schedule (page 3).
Greenhalgh, T. (2014). How to Read a Paper: The Basics of Evidence-Based Medicine (5 edition.).
Chichester, West Sussex: BMJ Books.

University, M. (2014). Users Guides to the Medical Literature: A Manual for Evidence-Based Clinical Practice,
3E (3 edition.). New York: McGraw-Hill Professional.
Supplemental Readings
Supplemental readings will be available through the shared Zotero library (see page 3), and will be located in folders
dedicated to each week of the course. The schedule can be found in the Readings Schedule section of the syllabus
(page 3).
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Course Schedule
Heavy Reading
Quiz Week
Week Topic Reading/Podcast Assignment/Discussion
1 Course Intro
What is EBM?
Zotero Week 1
Podcast #1 (15 min)
Make Library appt (for week 6)
Discussion #1
2 EBM & Controversy
EBM Hierarchy of Research
Zotero Week 2
Podcast #2 (15 min)
Discussion #2
EBM Hierarchy Assignment
Quiz 1: What is EBM? (15 pts)
3 Selecting and evaluating resources
What makes a good journal? article?
Zotero Week 3
Podcast #3 (30 min)
CRAAP Test Assignment
(opt) Favorite Journal Discussion
4 Biomedical/Scientific Database Overview
Getting started with research
Zotero Week 4
Podcast #4 (45 min)
Discussion #3 (Assigned database)
Research Map: Section 1
Quiz 2: Selecting and Evaluating
Resources (15 pts)
5 Biomedical/Scientific Database Overview cont Zotero Week 5 Database analysis paper
6 How Librarians Can Help
How to Search: Boolean, Advanced Databases
Zotero Week 6
Podcast #5 (20 min)
Appointment with Librarian
Research Map: Section 2-3
Quiz 3: How to Search (15 pts)
7 Developing a Clinical Question Zotero Week 7
Podcast #6 (35 min)
Discussion #4 (Assigned case)
Search String Assignment
8 How to Read for: Diagnosis Zotero Week 8
Podcast #7 (20 min)
Discussion #5
Worksheet #1
9 How to Read for: Therapy and Prognosis Zotero Week 9
Podcast #8 (20 min)
Discussion #6
Worksheet #2, Worksheet #3
10 Applying EBM to the Research Process
What are YOU interested in researching?
Zotero Week 10
Podcast #9 (15 min)
Discussion #7
Topic Abstract w/ sources
11 Integrating EBM into Clinical Practice
Mobile Apps for EBM
Zotero Week 11
Podcast #10 & 11 (15 min, 10
min)
Discussion #8 (Assigned case)
Mobile Apps Chosen
Quiz 4: Developing a Clinical Question (15
pts)
12 Integrating EBM at Point-of-care Zotero Week 12
Podcast #12 (15 min)
Discussion #9 (Assigned case)
(opt) Favorite Article Discussion
13 Staying Current: RSS, listservs, journal clubs Podcast #13 (10 min) Mobile App Presentation
14 PubMed Can Help!: MY NCBI Podcast #14 (15 min) PubMed Tutorial Overview
15 Review Week NONE Discussion #10 (Reflection)
16 Putting it all Together NONE (opt) Moving Forward Discussion
Course Evaluations Due
Final Quiz: EBM Essay (40 pts)
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Readings Schedule
Highlighted weeks are heavy reading, plan accordingly
Week Required Text Readings Supplemental Articles/Sites Zotero Folder*
1 University: Chapters 1-2 Sackett et al; Belsey; PLoS Med Ed
Greenhalgh: Chapter 1 Canadian Institute of Health Research
Week 1

2 University: Chapter 5 Darlenski et al; Yamey; Harrison;
Greenhalgh: Chapter 2 Rahman and Applebaum
Week 2

3 University: Chapter 4 du Prel et al; University College London
Greenhalgh: Chapter 3-4 Institute of Child Health Library
Week 3

4 University: Chapter 3 Masic & Milinovic; Lu, Z.;
Greenhalgh: Chapter 5 Browse: OWL, Conducting Research
Week 4

5 University: Chapters 6-8 Browse: KUMC Databases list Week 5
6 University: Chapters 9-9.6 Gardois et al; Aitken et al;
Complete: PubMed Tutorial
Week 6

7 University: Chapters 12-13.1 Burns, PB & Chung, KC; Burns et al;
Complete: Forming a Clinical Question
Week 7

8 University: Chapters 14-17 Zakowski et al; Greenhalgh; Fritz, J. &
Wainner, R.; McQueen, M; Price, C.
Week 8

9 University: Chapters 10-10.5 FOCUS ON REQUIRED CHAPTERS
Greenhalgh: Chapter 6-14
Week 9

10 University: Chapters 18-20.4 Faulkner, A; Thomas, D; Giacomini, M;
Paul, R & Clay, A; Sayer, A
Week 10

11 University: Chapters 11-11.5 Straus, SE & Sackett, DL; Straus et al;
Greenhalgh: Chapter 15 Glasziou et al
Week 11
12 University: Chapters 21-22.2 Banzi et al; Bjerre et al; McCord et al;
Van Dijk et al
Week 12

13 (opt) University: Chapters 22.3-22.7 (opt) Bergl, P. NONE
14 NONE (Catch up week) (opt) MyNCBI tutorials NONE
15 NONE (Catch up week) NONE NONE
16 NONE (Final Essay week) NONE NONE

*The link to the course Zotero folder will be emailed to the classalong with access instructionsa week before the
course opens. While supplemental readings are not required, they will greatly enhance class discussions and provide
you with valuable insight into the practice of evidence-based medicine. They will also help you complete the final
essay, which will require at least five (5) citations.


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Quizzes and Assignments

Quizzes
Quizzes will contain only the information found in the lectures (podcasts) and will be a mixture of 10,
multiple-choice, true/false and one short essay question (11 questions total). Each quiz will open at the start
of the week it is assigned (Monday) and will remain open until 5 p.m. the following Friday. The one
exception is the Final Quiz in week 16, which will open on Monday, but remain open until 11:59 pm the
following Sunday. This gives students the week to prepare for the essay (1500 word max.) and the weekend to
write the essay.
Quizzes will be worth 15 points each. Ten for correct multiple choice and true/false answers, and up to 5
points for the short essay (200 word max.) The quizzes will be available for retake the Saturday after the quiz
has closed. Students may use the quizzes to help them study, but the quizzes will no longer be for points. The
quizzes will remain open until the end of the course.
The final quiz question(s) will be posted at the end of Week 15. There will be four essay questions, and
students may choose to write about one. The final essay will be worth 40 points.

Assignments

EBM Hierarchy Assignment (5 pts)
Based on the levels of evidence discussed in class, students will find a primary resource that represents each level, and
write a short description of each resource found. The assignment should be uploaded to Blackboard no later than Saturday
at 5:00 pm of the week assigned.

CRAAP Test Assignment (5 pts)
Utilizing the CRAAP test, students will evaluate a print resource (can be an electronic periodical) and a web source (blog,
trade publication website etc). An example of the CRAAP Test table will be uploaded to the module. The assignment
should be uploaded to Blackboard no later than Saturday at 5:00 pm of the week assigned.

Research Map (10 pts)
Students will complete the research map over the duration of the course. The Map will be due during the Review Week of
the course, but students can upload the Map at any point before the Review Week if they feel they have adequately
completed the assignment.

Database Analysis Paper (10 pts)
Databases will be assigned during Week 4 of the course. Students will write a 2-3 page analysis/usability review on their
assigned database. The assignment will be due Saturday at 5:00 pm the following week (Week 5).

Consultation with a Librarian (10 pts)
Each student will need to schedule a consultation with one of the biomedical librarians on campus sometime between
Weeks 1-6. You CANNOT schedule the consultation after Week 6. You will bring your Research Map with you to the
consultation, and fill out a 10-question survey after the consultation.

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Search String Assignment (5 pts)
After your library consultation, students will create a search string in PubMed. The search string should utilize ONE
advanced Boolean strategy and TWO filters. The assignment should be uploaded to Blackboard no later than Saturday at
5:00 pm of the week assigned.

Worksheets (#1-3) (5 pts ea.)
eWorksheets will be assigned during Weeks 8 & 9, and will need to be completed no later than Sunday at 11:59 pm the
weeks they are assigned. You can also print the worksheets for use further on in the course and turn in up to THREE for
extra credit (1 point each) at the end of the course.

Topic Abstract w/ Sources (10 pts)
Students will choose a research topic during their librarian consultation and then develop a research proposal abstract (1
page or less). They will also need to include at least five resources in the form of a bibliography (AMA or APA format). The
assignment should be uploaded to Blackboard no later than Saturday at 5:00 pm of the week assigned.

Mobile App Presentation (20 points)
Students will choose a mobile application from the list provided in the Week 11 module. They will test the app over the
next two weeks and create a presentation TO BE GIVEN IN CLASS during Week 13. The presentation should be between 10-
15 minutes in length.

Class Participation and Discussion (10 pts)
Students are expected to participate in all required class discussions. There are 10 required discussions, which will open at
the beginning of the week they are assigned and be available until Sunday at 11:59 pm of the week they are assigned.
There are three optional discussions that students can participate in for extra credit.
Discussion 1: Introductions
Discussion 2: What is Evidence-based Medicine?
Discussion 3: (Assigned database) Database Overview
Discussion 4: (Assigned case) Developing a Clinical Question
Discussion 5: What is the most difficult aspect of reading for diagnosis?
Discussion 6: How can you read for therapy effectively? OR What was difficult about defining prognosis?
Discussion 7: Individual Research Discussion
Discussion 8: What technologies do you (or would you) use at point-of-care?
Discussion 9: How can evidence-based medicine enhance the patient point-of-care experience?
Discussion 10: Course Takeaways

Extra Credit (6 pts)
There are three optional discussions (Week 3, Week 12, Week 16) that students may choose to participate in for extra
credit. These discussions will help students tie the subject matter in the course back to real-life examples. There are
also three worksheets (1 pt).
Optional Discussion: What journal(s) do you subscribe to? Read often? Are relevant to your field?
Optional Discussion: What required reading for this course did you enjoy? Dislike?
Optional Discussion: How will you apply what you learned in this course to your practice of medicine?



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Grades
Grading Scale








Policies and Services
Grading Policy
As indicated in the Academic Catalog, the basic system is an A, B, C, D, F system, where A, designates above-average
graduate work; B, average graduate work; C, passing but not average graduate work; D and F, failing graduate work. D
and F work does not count toward a degree.
The letter P is used in this system only to indicate participation in thesis, dissertation and research enrollments (related to
thesis or dissertation), and in the first semester enrollment of a two-semester sequence course. Upon completion of
thesis/dissertation or research hours leading to a masters or doctoral degree, the P remains on the final transcript except
for the last semester of enrollment. A letter grade (A, B, C, D, or F) is assigned in the last semester of enrollment to
characterize the quality of the final product. The I grade is not appropriate for enrollment in thesis, dissertation, or
research, and is not accepted.
For enrollments other than thesis, dissertation or research, the letter I is used to indicate course work that has been of
passing quality, some part of which is, for good reason, unfinished (incomplete). A student who has an I posted for a
course must make up the work by the date determined by the instructor, in consultation with the student, which may not
exceed one calendar year, or the last day of the term of graduation, whichever comes first. An I not removed according to
this rule shall automatically convert to a grade of F or U, or the lapse grade assigned by the course instructor, and shall be
indicated on the students record.
The grades of S and U may be used to designate satisfactory and unsatisfactory performance, respectively, in continuing
education, workshop and institute courses upon the recommendation of the department offering the course. No more than
six hours total of graduate courses graded S are permitted to count toward a degree.
In courses numbered 800 or above for which specific authorization has been given, the instructor may report a grade of S
for students who have satisfactorily attended the course but for whom it has not been possible to evaluate the quality of
performance.
Once the S grade for a particular course (or a particular faculty members section of a multi-section course) has been
recommended by the department and approved by the Office of Graduate Studies, it must be applied to the entire
student enrollment in the course or section. This applies to those 800- or 900-level courses eligible for the S grade (or its
alternative of F) as well as to Continuing Education, institute, and workshop courses.
The Credit/No Credit option is not authorized for graduate students enrollments, including, but not limited to, courses
taken to fulfill the research skills requirements, undergraduate deficiencies, etc.
Points Grade
106-90 Superior
80-87 High Satisfactory
70-79 Satisfactory
<69 Unsatisfactory*
*Students who receive a grade of Unsatisfactory
will need to complete a quality improvement
remediation project under the direction of a
faculty advisor.
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All masters and doctoral students must maintain a B average to retain good academic standing. Courses graded less than
C may not be counted for graduate credit.
Performance is graded Honors, Satisfactory, or Unsatisfactory for the following examinations:
1. The general examination for the masters degree.
2. The general examination for the degree of Specialist in Education.
3. The comprehensive oral examination for the doctorate.
4. The final examination for the doctorate.
Students who would like a review of their course grades can contact the course coordinator for the course in question, and
the coordinator will begin the appeals process if it is determined that the grade received is insufficient.
Grades are not final until a week after the end of the course.

Other Policies
KU SoM Absence Policy
The School of Medicine attendance policy allows a student to miss up to 2 days of a clerkship - if the time is
approved and excused by Dr. Mark Meyer. A student may be given some leeway for brief absences for illness or absences
that are due to other medical school activities (e.g. meeting presentations, shelf exam retakes). Absences for personal
reasons (skiing holiday, vacations, tennis tournaments, routine doctor appointments, graduations, etc.) will not be
granted. Unexcused absences from clinical duties can result in required remediation, and would most likely be adversely
reflected in your final grade. If additional time off beyond 2 days is required for extreme circumstances, the clerkship
director can work with you to set up time to remediate. No more than 2 days of a 4-week clinical/fourth year experience
may be excused.
Academic Dishonesty
At this University, academic dishonesty is a basis for disciplinary action. Academic dishonesty includes but is not limited to
activities such as cheating and plagiarism (presenting as one's own the intellectual or creative accomplishments of another
without giving credit to the source or sources.)

The faculty member in whose course or under whose tutelage an act of academic dishonesty occurs has the option of
failing the student for the academic hours in question and may refer the case to other academic personnel for further
action. The University may impose penalties for academic dishonesty up to and including expulsion from the university.

Counseling Services
We provide comprehensive educational support, writing, psychological, and psychiatric services to students, medical
residents, and medical fellows as they pursue their professional goals. Our approach to excellence in service is proactive,
collaborative, confidential, and respectful. Services are available at Student Counseling & Educational Support Services by
calling 913-588-6580 or visiting G116 Student Center.

Disability Services
Access to education is one key to opening the doors of mainstream society to people with disabilities. The University of
Kansas Medical Center is committed to helping all admitted students reach their academic goals. Academic
Accommodations for students with disabilities is a program within the Division of Student Services in coordination with
Human Resources and the Student Affairs offices of the Schools of Health Professions, Medicine, and Nursing. Students
may contact Connie Hesler, chesler@kumc.edu, or 913-945-7035 to discuss accommodations.
The Americans with Disabilities Act (ADA) was enacted in 1990. In general, the ADA requires that people with disabilities
have an equal opportunity to benefit from or participate in services. A disability is defined as a physical or mental
impairment that substantially limits one or more major life activities and/or bodily functions.