Are you an evidence based emergency physician?

Evidence based medicine (EBM) is supposed to be at the core of our clinical practice. While few can argue with the principle of bringing the best available evidence to the care of our patients, it is debatable whether many of us manage to achieve this in reality. The EMJ has promulgated an approach to EBM through BestBets, Cochrane reviews, review articles and debate, but simply publishing and reading such articles does not reflect the practice of EBM at the local level. Arguably, EBM cannot occur within the pages of any journal or text, it can only occur at the bedside.

Like me, I suspect that you do indeed consider yourself to be an evidence based emergency physician. You probably think that what you do is based on sound knowledge and experience, but are you really up to date, up to speed and dynamic in the world of emergency EBM? Perhaps you should consider taking the test below and find out more.

THE TEST

1. You are reducing a Colles fracture under haematoma block. Your colleague tells you that a Bier’s block is better. Do you:

   1. Tell him to get lost and mind his own business?

   2. Ask him why?

   3. Ask him why and to show you the evidence?

2. How often do you attend the departmental journal club?

   1. >30 times a year

   2. <30 times a year

   3. What journal club?

3. When was the last time you found a paper so valuable you went out and told a colleague about it?

   1. Within the last month

   2. Within the last year

   3. Never

4. Bias in published papers is:

   1. Usually easy to spot

   2. When a systematic flaw exists in the study that may influence the results

   3. When the conclusions don’t agree with your clinical experience

5. You are asked to help one of your F2 doctors with an audit project. She asks …