Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Email this article to a Colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My Articles & Searches Download to citation manager Citing Articles via HighWire Citing Articles via Google Scholar Articles by Mascola, A. J. Search for Related Content PubMed Citation Articles by Mascola, A. J. Education, Psychiatrists

Guided Mentorship in Evidence-Based Medicine for Psychiatry: A Pilot Cohort Study Supporting a Promising Method of Real-Time Clinical Instruction

Received March 20, 2007; revised July 17, 2007; accepted July 25, 2007. Dr. Mascola is affiliated with the Department of Psychiatry and Behavioral Sciences at Stanford University in Stanford, Calif. Address correspondence to Anthony Joseph Mascola, M.D., Stanford University, Psychiatry and Behavioral Sciences, 401 Quarry Rd., Mail Code 5722, Stanford, CA 94305-5722; amascola{at}stanford.edu (e-mail).

OBJECTIVE: Evidence-based medicine has been promoted to enhance clinical decision making and outcomes in psychiatry. Residency training programs do not routinely provide instruction in evidence-based medicine. Where instruction exists, it tends to occur in classroom settings divorced from the clinical decision-making process and is focused narrowly on appraisal of evidence quality. The goal of this pilot study was to develop and evaluate the promise of a method of "hands-on" instruction in evidence-based medicine done in real clinical time. METHODS: A modularized curriculum to promote decisionmaking strategies using evidence-based medicine during the course of actual patient care was delivered by an attending physician mentoring a small team on the inpatient and consultation-liaison psychiatry services at Stanford. A staggered cohort of 24 consecutive trainees was followed between August and January 2007. Measures of trainees’ skills in evidence-based medicine were assessed before and after mentoring. A blinded grader scored each inventory according to an explicit, predefined rubric. Demonstrated proficiency in delivery in each of the core skills of evidence-based medicine was assessed as a secondary outcome measure via the attending physician’s unblinded subjective evaluation of trainee performance. Subjective descriptions of the experience were obtained via review of trainees’ evaluations. RESULTS: Postmeasures of knowledge and skills in evidence-based medicine increased significantly relative to baseline. The Cohen’s d effect size was large and clinically meaningful. The majority of trainees were able to demonstrate adequate proficiency of skills by attending subjective evaluation. Trainees’ subjective experiences overall were positive. CONCLUSION: Guided mentoring in evidence-based medicine appears promising for further study.

This article has been cited by other articles:

				J. H. Coverdale, L. Weiss Roberts, and A. K. Louie Teaching Evidence-Based Psychiatry to Residents and Fellows: Developing the Curriculum Acad Psychiatry, November 1, 2008; 32(6): 453 - 457. [Full Text] [PDF]

Get information about faster international access.

Privacy Policy

Copyright © 2008 Academic Psychiatry. All rights reserved.

Home | Search | Current Issue | Past Issues | Subscribe | All APPI Journals | Help | Contact Us