The fifth step in practising EBM is self-evaluation and we've suggested some approaches for doing this in the lists that follow.
Self-evaluation in asking answerable questions
- Am I asking any clinical questions at all?
- Am I asking well-formulated (3-part) questions?
- Am I using a "map" to locate my knowledge gaps and articulate questions?
- Can I get myself unstuck when asking questions?
- Do I have a working method to save my questions for later answering?
- Is my success rate of asking answerable questions rising?
- Am I modeling the asking of answerable questions for my learners?
- Am I writing any educational prescriptions in my teaching? Are they being filled?
- Are we incorporating question asking and answering into everyday activities?
- How well am I guiding my learners in their question asking?
- Are my learners writing educational prescriptions for me?
Self-evaluation in finding the best external evidence
- Am I searching at all?
- Do I know the best sources of current evidence for my clinical discipline?
- Have I achieved immediate access to searching hardware, software and the best evidence for my clinical discipline?
- Am I finding useful external evidence from a widening array of sources?
- Am I becoming more efficient in my searching?
- Am I using MeSH headings, thesaurus, limiters, and intelligent, free text when searching MEDLINE?
- How do my searches compare with those of research librarians or other respected colleagues who have a passion for providing best current patient care?
Self-evaluation in critically appraising the evidence for its validity and potential usefulness
- Am I critically appraising external evidence at all?
- Are the critical appraisal guides becoming easier for me to apply?
- Am I becoming more accurate and efficient in applying some of the critical appraisal measures? (such as likelihood ratios, and NNTs)
- Am I creating any CATs?
Self-evaluation in integrating the critical appraisal with clinical expertise and applying the result in clinical practice
- Am I integrating my critical appraisals into my practice at all?
- Am I becoming more accurate and efficient in adjusting some of the critical appraisal measures to fit my individual patients? (such as pretest probabilities, NNTs etc)
- Can I explain (and resolve) disagreements about management decisions in terms of this integration?
- Have I conducted any clinical decision analyses?
- Have I carried out any audits of my diagnostic, therapeutic or other EBM performance?
Self-evaluation in teaching EBM
- When did I last issue an educational prescription?
- Am I helping my trainees learn how to ask answerable questions?
- Am I teaching and modeling searching skills?
- Am I teaching and modeling critical appraisal skills?
- Am I teaching and modeling the generation of CATs?
- Am I teaching and modeling the integration of best evidence with my clinical expertise and my patients' preferences?
- Am I developing new ways of evaluating the effectiveness of my teaching?
Am I developing new EBM educational material?
**if so, please share them with others and add them to the bank of resources available on this site**
Self-evaluation of continuing professional development
- Am I a member of an EBM-style journal club?
- Have I participated in or tutored at one of the workshops on how to practice or teach EBM?
- Have I joined the evidence-based health e-mail discussion group?
- Have I established links with other practitioners or teachers of EBM?