Sunday, October 31, 2010

Do you use AFP to teach evidence-based medicine?

For the past few days, I participated in the annual Northeast Region meeting of the Family Medicine Education Consortium in Hershey, Pennsylvania. In addition to presenting a well-received session on social media tools in family medicine (including the AFP Community Blog), I attended a thought-provoking seminar on "Reinventing Journal Club: Innovations in the Internet Age" led by faculty and residents from the University of Rochester. This seminar demonstrated their program's successful experience with increasing residents' use of AAFP-recommended evidence-based medicine resources such as reports from the Agency for Healthcare Research and Quality, the Cochrane Database of Systematic Reviews, and Essential Evidence Plus to answer clinical questions.

At the end of the seminar, I asked the presenters if they encouraged their residents to read American Family Physician, and what role the journal plays in their evidence-based medicine curriculum, if any. (After all, we require AFP's clinical review authors to consult the same types of EBM resources as part of their literature searches and to label key clinical recommendations using the rigorous Strength-of-Recommendation Taxonomy.) Their response was that everyone reads AFP, so they didn't necessarily see a need to promote the journal as a resource.

In a previous editorial, AFP Deputy Editor Mark Ebell, MD, MS argued that rather than focusing on the skills needed to analyze original research studies, the typical family physician should instead aim to be an "informed consumer of the secondary literature" and "an expert at assessing the quality of an information source." Since medical school and residency are the best times for family physicians to develop skills in answering clinical questions, we would like to know how teachers of family medicine are using the journal for this purpose. Are there any particular AFP features that you find especially useful for teaching EBM, or areas where you feel we could improve? We welcome your feedback and suggestions.