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Validation of an Evidence-Based Medicine Critically Appraised Topic Presentation Evaluation Tool (EBM C-PET).

ABSTRACT: BACKGROUND: Competence in evidence-based medicine (EBM) is an important clinical skill. Pediatrics residents are expected to acquire competence in EBM during their education, yet few validated tools exist to assess residents' EBM skills. OBJECTIVE: We sought to develop a reliable tool to evaluate residents' EBM skills in the critical appraisal of a research article, the development of a written EBM critically appraised topic (CAT) synopsis, and a presentation of the findings to colleagues. METHODS: Instrument development used a modified Delphi technique. We defined the skills to be assessed while reviewing (1) a written CAT synopsis and (2) a resident's EBM presentation. We defined skill levels for each item using the Dreyfus and Dreyfus model of skill development and created behavioral anchors using a frame-of-reference training technique to describe performance for each skill level. We evaluated the assessment instrument's psychometric properties, including internal consistency and interrater reliability. RESULTS: The EBM Critically Appraised Topic Presentation Evaluation Tool (EBM C-PET) is composed of 14 items that assess residents' EBM and global presentation skills. Resident presentations (N = 27) and the corresponding written CAT synopses were evaluated using the EBM C-PET. The EBM C-PET had excellent internal consistency (Cronbach α = 0.94). Intraclass correlation coefficients were used to assess interrater reliability. Intraclass correlation coefficients for individual items ranged from 0.31 to 0.74; the average intraclass correlation coefficients for the 14 items was 0.67. CONCLUSIONS: We identified essential components of an assessment tool for an EBM CAT synopsis and presentation with excellent internal consistency and a good level of interrater reliability across 3 different institutions. The EBM C-PET is a reliable tool to document resident competence in higher-level EBM skills.

SUBMITTER: Kersten HB

PROVIDER: S-EPMC3693689 | biostudies-other | 2013 Jun

REPOSITORIES: biostudies-other

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Project description:BACKGROUND:Dogs with year-round atopic dermatitis are often sensitized to Dermatophagoides house dust mites (HDM). Storage mites (SM) are known to grow on cereal-rich foods. Tyrophagus SM can exacerbate clinical signs of allergy in laboratory dogs sensitized to HDM. Consequently, atopic dogs with high-levels of HDM-specific IgE are likely to have a flare of signs after eating a food contaminated with SM; the development of such flares would lead to a false positive diagnosis of food allergy. Herein, we reviewed the published evidence about the growth of SM on commercial dry pet foods. RESULTS:We searched two databases on January 25, 2019 for articles providing original information on the growth of SM on commercial dog foods. We found ten articles, five reporting results of laboratory experiments and five from field studies. Storage mites, especially Tyrophagus putrescentiae, can multiply on protein- and fat-rich dog foods. The population growth is higher when the initial mite density is high and when kibbles are crushed. When storage conditions lead to the overgrowth of molds on the kibbles, the mite proliferation is higher. Storage mites do not bore holes in food packages but invade bags via defective seals. In the field, SM contamination usually is undetectable in newly-opened commercial dog foods, and, if present, their number is low. When newly-purchased bags are stored in temperate conditions indoors, little overgrowth-if any-of SM occurs. However, when kept in environmental conditions with higher temperature and humidity, Tyrophagus mites will enter and proliferate in sealed food packages. CONCLUSIONS:Commercial dry pet foods should be kept indoors and sealed to decrease the risk of contamination with SM. When performing dietary restriction (elimination) and provocation trials for the diagnosis of food allergies in dogs, it seems preferable to choose newly-purchased bags-of both original and testing diets-to reduce the probability of their contamination with SM, especially Tyrophagus putrescentiae. In case of doubt about the presence of SM in any of these foods, one should perform food challenges with single home-cooked ingredients. Storage mite contamination might lead to an erroneous diagnosis of food allergy in HDM-sensitized dogs.

Project description:BackgroundEvidence-based medicine (EBM) is an important element of medical education. However, limited information is available on effective curricula.ObjectiveTo evaluate a longitudinal medical school EBM curriculum using validated instruments.Design, participants, measurementsWe evaluated EBM attitudes and knowledge of medical students as they progressed through an EBM curriculum. The first component of the curriculum was an EBM "short course" with didactic and small-group sessions occurring at the end of the second year. The second component integrated EBM assignments with third-year clinical rotations. The 15-point Berlin Questionnaire was administered before the course in 2006 and 2007, after the short course, and at the end of the third year. The 212-point Fresno Test was administered before the course in 2007 and 2008, after the short course, and at the end of the third year. Self-reported knowledge and attitudes were also assessed in all three classes of medical students.ResultsEBM knowledge scores on the 15-point Berlin Questionnaire increased from baseline by 3.0 points (20.0%) at the end of the second year portion of the course (p < 001) and by 3.4 points (22.7%) at the end of the third year (p < 001). EBM knowledge scores on the 212-point Fresno Test increased from baseline by 39.7 points (18.7%) at the end of the second year portion of the course (p < 001) and by 54.6 points (25.8%) at the end of the third year (p < 001). On a 5-point scale, self-rated EBM knowledge increased from baseline by 1.0 and 1.4 points, respectively (both p < 001). EBM was felt to be of high importance for medical education and clinical practice at all time points, with increases noted after both components of the curriculum.ConclusionsA longitudinal medical school EBM was associated with markedly increased EBM knowledge on two validated instruments. Both components of the curriculum were associated with gains in knowledge. The curriculum was also associated with increased perceptions of the importance of EBM for medical education and clinical practice.

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Validation of an Evidence-Based Medicine Critically Appraised Topic Presentation Evaluation Tool (EBM C-PET).

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