So what is EBM? We cant find EBM in a book because its a process or activity.

Clinical expertise our understanding of what the right question is for our patient, values concerns, preferences, expectations. It will be different for Cambodians than French or Germans or Americans.

The first step in EBM is using your clinical evaluation and understanding of the patient to form an answerable question. Spelling is important!

Patient: 18 month old child Intervention: MMR vaccine Comparison: no MMR vaccine Outcome: autism / autistic spectrum disorder

AND/OR Boolean expressions: AND restricts, OR expands

Before, needed to use PubMed, Cochrane but now

Then you need to assess the validity of the study or information separate talk but looking for systematic reviews or well-designed trials.

Problem: newborn thrush Intervention: nystatin Comparison: fluconazole Outcome: get better

Problem: Childhood asthma Intervention:ipratropium Comparison: Outcome: benefit

3 doses helpful

Problem: Infant GERD Intervention: Cisapride/ranitidine C: Outcome: effectiveness

Sometimes doing the research makes the situation more confusing.

Then we need to add our clinical expertise and the patients values. Do I think it will help? What do the parents want to do? And that is EBM.

ideas?

Show Palm/iphone, books are still part of EBM

Highlight diff dx. On most handphones (Java, symbian, etc)

Bring articles/information to discussion, anticipate questions and prepare answers, ask students to look something up, bring answers to questions or decisions made previously

Sometimes technology is TOO MUCH. Use technology only when it helps with teaching/learning; avoid it when it distracts.