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Incorporating Evidence Based Medicine into the PA Curriculum

July 30, 2015

Everything happens for a reason.  Adrian Banning, MMS, an assistant clinical professor in the Physician Assistant (PA) Department, was appointed the co-director of the Epidemiology for Practice and Prevention Course in late 2008.  Prior to her appointment, she had not been interested in statistics or analyzing research, and admits she didn’t have much of an understanding for the underpinnings of using evidence-based medicine (EBM) effectively. 

After receiving an email about an evidence-based medicine conference in Massachusetts, Banning decided spur of the moment to attend.  The conference was organized by two thought leaders in the field, David Slawson, MD, of the University of Virginia, and Allen F. Shaughnessy, PharmD of Tufts University.  “I just sat with them and their colleagues for three days discussing why you need to know how to calculate positive and negative predictive value, why are they important, how you relay all these types of things that you’ve heard about but maybe haven’t thought about in a while, and how to transfer that to the education of a medical student, meaning nursing, physician, pharmacy, et cetera,” said Banning. “After three days of that, I came back and said we can do this so much better and apply these concepts right at the point of care with a patient.”

Banning brought all of these new concepts and ideas back to her mentor, Charles Stream, MPH, director of the epidemiology course, who in a very short turnaround time helped Banning incorporate them into the curriculum.  They also brought in Gary Childs, liaison librarian, Nursing and Health Professions.  “We talk about intercollaborative efforts between PAs, physicians, nurses, and pharmacists, but we forget to use our information experts as well.  Gary had a role in the class helping us understand what resources we have, the quality of them, and how to best utilize them.  He not only has a knack for understanding and teaching the resources, but also knowing when to suggest a resource or when you might not be ready for it,” said Banning.

The new curriculum aimed to incorporate as many of the thought masters as they could in 10 weeks and to merge the progressive ideas in EBM with what they were already doing to optimize how students can actually apply the concepts and make good decisions at the point of care.  “That’s when you really start revolutionizing or at least improving patient care, using evidence with the person sitting in front of you,” said Banning.

Following the course, Banning and Stream created presentations for the Physician Assistant Education Association (PAEA) about how the curricular changes affected outcomes for the students.  The presentations touched upon how they tweaked what they were already doing as well as how they revised their curriculum, the resources they used, and how to use those resources.  The presentations were well-received, and they have been invited back several times, in both webinar and in-person, to present at PAEA conferences across the country and internationally. 

Said Banning, “So if you would have asked me 10 years ago, do you think EBM, epidemiology, statistics or public health are going to hold your interest, that you’ll be perusing amazon for books on how to read a paper, that you’ll be following these people on twitter… no, I wouldn’t have said that.  But it’s because I got assigned to this class and wanted to do a better job, and encountered some people who are really thinking about these things and making a lot of good sense.”