More Internet resources for learning about evidence-based practice

AORN Journal, Oct, 2000 by Suzanne C. Beyea

The Internet and the World Wide Web have created many opportunities for clinicians and patients to learn more about evidence-based practice. A recent Internet search on the phrase "evidence-based practice" resulted in more than 10,000 hits related to this topic. Many of these sites provide users with resources to learn more about the evidence-based process and offer strategies and links to help users find evidence. Continuing with last month's theme, this column identifies and describes some of the helpful web sites that offer background information, analytical tools, glossaries, and search strategies, as well as articles, tutorials, software, discussion lists, and education related to evidence-based practice.

GETTING STARTED

One helpful place for clinicians to begin their journey to learn more about evidence-based practice is the Mt Sinai Hospital--University Health Network Centre for Evidence-Based Medicine (EBM) at www.library.utoronto.ca/ medicine/ebm/. This web site's goal is to develop, disseminate, and evaluate resources that can be used to practice and teach EBM. The intended audience includes individuals involved in undergraduate, graduate, and continuing education programs for health care professionals. Within this site, users will find a number of options to learn more about EBM. There are resources for practicing or teaching EBM, as well as a complete glossary of EBM terms and links to additional evidence resources. Also available on the site are syllabi for practicing EBM in general surgery, general practice, neonatal medicine, nursing, physiotherapy, critical care medicine, and six other specialty areas. Although this site still is under development, its resources provide extensive background and helpful clinical information. Additional tools available in the EBM "toolbox" include statistical tools, self-evaluation tools, and tips on critical appraisal of the evidence.

The National Health Service's Centre for Evidence-Based Medicine (http://cebm.jr2.ox.ac .uk) was one of the first centers in the United Kingdom to provide resources and support to clinicians practicing and teaching EBM. This site comes complete with an EBM toolbox, teaching activities and materials, and the CATbank, which allows users to create, store, and retrieve critically appraised topics (CATs). The toolbox provides a glossary, a guide for searching for the best evidence, a comparison of study designs, and information about the levels of evidence and grades of recommendation. The teaching materials include a self-contained, seven-session course in practicing EBM for clinicians, scenarios for problems-based learning, and worksheets for critical appraisals of various types of research reports.

Another useful site is the Canadian Centres for Health Evidence (www.cche.net/). According to the web site, the Centres were established to help patients, practitioners, and policy makers "know what to do, do what is known, and understand what is done."(1) Within this site, one can find a users' guide to evidence-based practice that is based on publications on the same topic previously published in JAMA (www.cche.net/ principles/content_all.asp). This online reference provides a step-by-step guide on how to get started using evidence and how to use primary studies and integrative reports. This site also provides worksheets for critiquing research reports as well as resources for educating clinicians about EBM.

USING RESOURCES FOR EVIDENCE-BASED SURGERY

Resources for evidence-based surgery can be found at www .rcseng.ac.uk/public/infores/ reso_ir.htm, a web site provided and maintained by the Royal College of Surgeons in England. It includes links to medical databases (eg, Medline), comprehensive guides to evidence-based practice, and links to surgery related clinical practice guidelines and systematic reviews. This site offers a variety of links to Internet resources, along with many e-mail discussion groups for surgeons. One helpful resource linked to this page is a listing of the Cochrane Systematic Reviews related to surgery. Organized according to one of 13 surgical specialties, these guidelines provide up-to-date integrated reviews of the pertinent research.

The Royal College of Surgeons' web site also provides links to resources that support evidence-based surgery, as well as links to medical gateways, search engines, educational resources, textbooks online, images, atlases, medical news, and reference materials. For example, the British Journal of Surgery link provides a current list of randomized trials and meta-analyses related to vascular, lower and upper gastrointestinal, and general surgery. Visitors to this site can easily access the Internet Pathology Laboratory for Medical Education (http://www-medlib.med.utah .edu/WebPath/webpath.html) to examine more than 1,900 images, along with text, tutorials, laboratory exercises, and examination items that demonstrate gross and microscopic pathologic findings.

SumSearch, available at http://sumsearch.uthscsa.edu/ searchform45.htm, provides a meta-search service that searches