Specific Aims: The specific aims of this grant have not been modified.

The Evidence-based Medicine Resource Center, a joint project of the New York Academy of Medicine and the New York Chapter of the American College of Physicians moved solidly into its second year of funding. The project continued with a third Teaching Evidence-based Medicine course, follow-up continuing education sessions, committee meetings and enhanced use of technology for communication including the web site and the listserv. In addition, the project expanded to include a retreat to evaluate the impact of the EBM Course and establish an evaluation research model for the future.

The year began with an EBM Resource Center sponsored retreat on the Evaluation and Assessment of the Impact of the EBM Course on June 4, 2000. During this day long event four educational and sociology consultants, Dr. Ian Hart (Dalhousie University), Dr. Michael Green (Yale), Dr. Geoffrey R. Norman (McMaster University) and Dr. Cheryl Walters (Columbia University) were brought in to assist EBM Committee members in evaluating educational interventions. The issues the group focused on were documenting frequency of important teaching behavior, efficacy of teaching, and linking outcomes to learners.

In October 1999 the third Teaching Evidence-based Medicine course was held. As in previous years the course had a waiting list from the summer on with inquiries from as far afield as the Mayo Clinic and the University of Illinois at Chicago. While enfolding 16 emergency medicine physicians within the course, the targeted population of internal medicine faculty and librarians composed the bulk of the participants. In 1999 there were 80 physicians and 10 librarian participants. Participants were divided into small groups both to enhance learning and to introduce teaching concepts in the dynamics of small group processes. Each group had two tutors and two co-tutors one of whom as a degreed librarian. With 20 tutors and co-tutors the teacher to student ratio was 2 to 1. The number of participants trained through the three Teaching Evidence based Medicine courses currently total 219 physicians and librarians from 34 academic health centers. Fifteen programs sent (>3) participants.

The EBM Committee held continuing education sessions every other month after the course. The sessions were designed to enhance the learning that had taken place during the course and to delve into details on specific topics. The continuing education sessions usually draw about 30-40 attendees who hear talk such as, "Seven Year Odyssey: Creating and Teaching a Longitudinal EBM Course for Medical Students" and "Undecided about Decision Analysis? A Beginner's Approach to Using Decision Analysis in Education." The EBM Committee, composed of physicians and librarians, also meets every other month to set the agenda for the direction of the project and to provide feedback on the project’s activities. In winter 1999 the EBM Committee created seven subcommittees to expand the scope of its work: Web, Evaluation, Geriatrics, Medical School Curriculum, Continuing Education, Librarians and Palm Pilot Users.

The EBM Committee continues to use technology in communicating with each other and with course participants and alumni. The web site is actively used [statistics here]. The semi-annual newsletter and listserv have expanded in terms of subscribers and use.

The EBM Resource Center has been established both in reality and virtually. Our dissemination model for teaching EBM to NYS house staff, primarily in internal medicine, is based on training trainers and providing support to help participants overcome barriers to practicing and teaching EBM that others have had upon returning to their home institutions after similar courses. These supports include the "buy-in" of the departmental chair or program director through their role in nominating participants and guaranteeing course time; giving preferential selection to programs with >2 nominees; training librarians whenever possible from the same institutions; and providing post-course support in person, by email, and by newsletter. The virtual EBM resource center, accessed through the web site, is an important feature as it promotes the use of resources to individuals who are not physically on-site at the New York Academy of Medicine.

Thus far our three courses have trained faculty from 219 physicians and librarians from 34 academic health centers. Fifteen programs sent (>3) participants. Additional faculty and librarians attend our continuing education programs, receive our newsletter, and access our web site. Two physicians and 6 librarians have advanced from course participant to co-tutor or from co-tutor to tutor, creating a strong and synergistic group of teacher-practitioners in the New York metropolitan area. There is a high level of interest in this course.

Plans: The 4th Teaching EBM course will be offered in October 2000. The EBM Committee of the New York Chapter of the American College of Physicians meets bimonthly to assist in the development of the group. The EBM committee has expanded its charge to act as an Advisory Committee for the EBM Resource Center.

Publications: Dunn K, Wallace, EZ, Leipzig, RM. A Dissemination Model for Teaching Evidence-based Medicine. Academic Medicine May 2000 In press.

Project-generated resources:.