Teaching Evidence Based Practice in Pharmacy

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Teaching Evidence Based Practice in Pharmacy

• Kirstie Galbraith
• Clinical Senior Lecturer, Victorian College of
  Pharmacy, Monash University
• Senior Pharmacist, Research Education, RMH

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EBP teaching in pharmacy

• Undergraduate
• Professional development
• Postgraduate

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Undergraduate EBP teaching (4 year course)

• Fairly new to curriculum
• Increasing every year
• First year
• 6 lectures epidemiology biostatistics
• Third year
• 7 lectures EBP health economics
• Sackett approach
• Assessment includes
• Clinical scenario, development of PICO
• Critical appraisal of RCT using CEBM template
• Needs more!

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Professional development RMH

• CE
• Didactic sessions each year on EBP approach
• Help with searching from DI pharmacist
• Regular JClub
• Pharmacy residents program
• More focused on EBP
• Regular Jclub using CEBM templates
• Research project after identifying a knowledge gap

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Professional development PSA

• Day long workshops in EBP
• Clinical scenario involving patient enquiring
  about a CAM (saw palmetto for BPH)
• PICO
• Searching (theory)
• Appraising (practice)
• Applying
• Resources
• Keepads to gauge audience experience

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Professional development SHPA

• National conference 2007
• 1.5 hours interactive workshop on appraising the
  evidence
• Family request for a drug with information found
  on internet (Piracetam for stroke)
• Keepads to answer CEBM validity questions
• National conference 2006
• 2 hour presentation Putting evidence into
  practice
• Overview of EBP process then examples from
  pharmacists regarding how they apply evidence in
  their day-to-day practice

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Postgraduate EBP teaching

• Semester long postgraduate unit in EBP offered by
  Monash uni
• Generic content following Sackett approach
• Suitable for range of health professionals
• So far pharmacists (6 RMH), nurses, podiatrists
• Modules
• Introduction
• Research methods epidemiology
• Asking answerable questions
• Searching the literature
• Critical appraisal of the literature
• Putting evidence into practice

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Postgraduate EBP teaching

• Currently available as
• Stand alone unit (with university credit)
• Credit towards
• MClinPharm (compulsory)
• Grad Cert Pharmacy Practice (will be compulsory)
• Post graduate course in wound care (compulsory at
  Grad Dip level)
• All completed on line
• Moderator has experience with Cochrane
  collaboration ( is not a pharmacist)

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Postgraduate EBP teaching assessment

• PICO question based on knowledge gap from
  students own practice
• Literature search strategy (for PICO)
• Answer to PICO question
• Critical appraisal (JClub presentation)
• Online tasks set each week, including evaluating
  different sources of evidence considering
  strengths weaknesses etc

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• With my new ability to write an answerable
  question my efficiency and effectiveness has
  improve ten fold to seeking out answers to
  clinical questions. In my role I provide a
  consultancy service to other practitioners with
  complex wounds. I like to back my suggestions
  with evidence to increase the other practitions
  knowledge base. I am finding by doing this it is
  encouraging these staff to start to seek answers
  themselves. Unfortunately I do not have time to
  go through the process with them however they are
  learning. I have also started a journal club at
  our monthly meeting. Within this forum the
  articles are not only be discussed in the context
  of outcome they are also critically appraised
  (never been done before). From a client
  perspective my confidence in the best treatment
  will benefit the clients ensuring optimal
  outcomes

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• this unit has encouraged me to be much more
  succinct in structuring and answering the
  questions that arise in my daily practice. Having
  mainly worked in outpatients the last few months,
  I used to refer most clinical questions from
  other health professionals directly through to
  our Drug Information Department. I now have much
  more confidence to find the best resources to
  answer these questions myself, and if I cannot
  find the answer in the available time, I have
  vastly improved in my ability to phrase these
  problems for Drug Information to follow up. I
  have also found myself being more proactive in
  keeping up to date with the current literature to
  pre-empt the questions that tend to appear in my
  practice. I will also be taking advantage of the
  BMJ updates feature to make this process a little
  less labour intensive

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Teaching Evidence Based Practice in Pharmacy

• Kirstie Galbraith
• Clinical Senior Lecturer, Victorian College of
  Pharmacy, Monash University
• Senior Pharmacist, Research Education, RMH