Assignment: Development and Implementation

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Assignment: Development and Implementation

Assignment: Development and Implementation

Disconnect between the 2 ap- proaches is also evident in, and main- tained by, the teaching provided to clinicians and students, again often reflecting the backgrounds of their teachers. Opportunities to attend EBM teaching abound with content largely

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focused on forming questions and finding and criti- cally appraising evidence.5 Learning how to apply and integrate the evidence is usually absent, or mentioned in passing without skill training.

Realizing the Connection Between EBM and SDM A logical place to start is by incorporating SDM skill train- ing into EBM training. This will help to address not only the aforementioned deficits in EBM training but also the lack of SDM training opportunities presently available. Additionally, it may facilitate the uptake of SDM and, more broadly, evidence translation. Recent calls for SDM to be routinely incorporated into medical education pre- sent an immediate opportunity to capitalize on closely aligning the approaches.

Without shared decision making, EBM can turn into evidence tyranny.

VIEWPOINT

Tammy C. Hoffmann, PhD Centre for Research in Evidence-Based Practice, Faculty of Health Sciences and Medicine, Bond University, Queensland, Australia; and University of Queensland, Brisbane, Australia.

Victor M. Montori, MD, MSc Knowledge and Evaluation Research (KER) Unit, Mayo Clinic, Rochester, Minnesota.

Chris Del Mar, MD, FRACGP Centre for Research in Evidence-Based Practice, Faculty of Health Sciences and Medicine, Bond University, Queensland, Australia.

Viewpoint page 1293

Corresponding Author: Victor M. Montori, MD, MSc, Knowledge and Evaluation Research Unit, Mayo Clinic, 200 First St SW, Plummer 3-35, Rochester, MN 55905 (montori.victor @mayo.edu).

Opinion

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Copyright 2014 American Medical Association. All rights reserved.

Another place to start to bring EBM and SDM together is the development and implementation of clinical practice guidelines. Whereas most guidelines fail to consider patients’ preferences in formulating their recommendations,6 some advise clinicians to talk with patients about the options but provide no guidance about how to do this and communicate the evidence in a way patients will understand. Shared decision making may be strongly

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