Concept note on EBES

The knowledge and skills obtained during the training in a medical college, during undergraduate and post graduate courses are insufficient to carry on lifelong successful clinical practice. To make clinical decisions, the practicing physician, even today is largely dependent on his obsolete knowledge and expertise derived from unsystematic observations made during his training, which can be as old as his medical course itself.
Evidence based medicine (EBM) simply means the need for judicious use of current, objective information in making decisions about the care of individual patients. The term was coined to encourage proficiency in judgments by individual clinicians based not only on “experience” but also on experience informed by results acquired in systematic approach. In other words, it is nothing but more scientific and sophisticated version of “Biostatistics and Epidemiology” of recent past. Thus the EBM is known to all professionals in medical fraternity. But the typical Indian medical education system has still not adopted the concept in teaching. The Evidence based education system (EBES) is the system of teaching evidence based stream to students. In this system students are learning the various aspect of current available information and critically evaluate the use of this information for practical implementation. EBES is the optimal integration of best research evidence with clinical expertise and patient values. The essential feature is that the practitioners, when faced with any problem/dilemma in the clinical context of a patient, should be able to: perform a literature search; identify the evidence available pertaining to the clinical condition; critically evaluate it; and determine the “Best Evidence” to diagnose/treat/manage the patient. The key element in this cycle is the ability of the clinician to search and retrieve the literature in the shortest possible time in an efficient manner. The adoption of EBM is all the more imperative since the ‘Internet Revolution’ has provided access to medical literature, not only to the medical world but also to the common man as well. The time-honored undergraduate and postgraduate curricula need to be revamped to train the graduate as a lifelong, self-directed learner by imparting the skills required for practice of EBM.