UTHSCSA DENTAL SCHOOL
EVIDENCE-BASED PRACTICE CURRICULUM
Curriculum Overview: This school wide program is responsible for teaching the critical thinking and lifelong learning skills necessary to establish Evidence-Based Practice. A sequence of courses, labs, OSCEs, Selectives and Rotations are provided for both the predoctoral and advanced education students. The principles are reinforced in clinical dental courses and integrated into the General Practice Groups. The program includes a faculty development program and is developing a continuing education component. The program addresses the new CODA competencies 2.03 and 2.04:
What we Teach: The overarching goal is to provide students with life-long learning skills that will enable them to keep up-to-date during their expected 30-40 years of practice. We use a “just-in-time learning” approach, which is used in medicine to deal with the flood of new information. This approach entails learning skills that will allow the clinician to quickly find new knowledge related to a patient’s specific problem, when needed, at the point of care. This “just-in-time learning” approach is in contrast to passively reading 3-4 journals each month, attending weekend CE courses and memorizing large quantities of information that may or may not be useful. The strategy assumes the clinician has a solid basic science and clinical foundational knowledge base with which to interpret and put into perspective the new knowledge. Students are taught four evidence-based practice skills enabling them to:
(1) Ask focused questions (in a PICO format),
(2) Use a systematic search strategy to find the highest level of evidence,
(3) Critically evaluate the evidence and
(4) Make clinical judgments about the applicability of the evidence for their patients.
These skills are taught in the context of having students prepare Critically Appraised Topics (CATs) that are one-page summaries of the four step process mentioned above.
The four evidence-based practice skills are introduced in the freshman year in parallel with foundational basic science and preclinical courses. An 16-hour sophomore course in the fall semester focuses specifically on the four EBP skills. Each student must then demonstrate the EBP/CAT skills in the spring of the sophomore year by writing a CAT on a focused clinical question under the guidance of a faculty mentor. The student and faculty mentor edit and ultimately publish the completed CAT on the Dental School’s online searchable CAT Library. A PubMed learning lab rotation in the junior year requires the student to demonstrate correct PubMed search strategies for six focused clinical questions. The skills are reinforced in the context of formal clinically relevant case presentations required of each student in the spring of the junior year.
The same EBP/CAT skills are taught in seven of the school’s residency programs during a 30-hour research methods course. The residents then apply the EBP/CAT skill, in the Interdisciplinary Biomedical Core Course. This course provides a foundation in the principles of basic sciences for the clinical disciplines. To satisfy the criteria for completion of the course, each resident is required to write a CAT. The CAT is focused on the broad area of dental basic science, pertaining to a clinical question, or disease mechanism. The CAT is reviewed by a member of the Biomedical Core Course faculty and published in the Dental School CATs Library.
The Evidence-Based Practice Program is also responsible for providing the Research Methodology Course (INTD 5090) to the advanced education residents. This 30-hour course prepares residents in Prosthodontics, Endodontics, Radiology, Orthodontics and Periodontics for their master’s research and critical literature reviews. It also provides 6 hours of instruction in Evidence-Based Practice concepts.
CAT Library: The EBP Program includes an online searchable, over 600 Critically Appraised Topics (CATs) Library that provides evidence-based answers to common clinical problems. A component of the student’s education is writing and updating the online Critically Appraised Topics. This online evidence-based resource is open to the public and for practitioner continuing education credit.
Facilities: The program offices and PubMed Learning Lab are located in Rooms 4.280R & 4.278R of the Dental School. The new PubMed Learning Lab is supported by our NIH R-25 Education Research Grant and the Dental Dean’s Critical Needs Fund.
Funding and Resources: The EBP teaching program is state supported; however, a 4-year $648,000 NIH R-25 Education Research Grant supports the evaluation component of the program.