Grading Rubrics (Form A) The practice of Evidence-Based Medicine (EBM) involves some basic knowledge and skills related to searching and evaluating medical literature.

Grading Rubrics (Form A) The practice of Evidence-Based Medicine (EBM) involves some basic knowledge and skills related to searching and evaluating medical literature.

This UCSF-Fresno Medical Education tool is designed to assess the level at which you are already utilizing EBM skills. Please complete the entire test in one sitting. There are 7 short answer questions, 2 questions that require a series of mathematical calculations, and three fill-in-the-blank questions. Allow yourself at least 30 minutes to complete the test. Answer questions 1-4 based on the following clinical scenarios • You have just seen Lydia who recently delivered a healthy baby. She plans to breastfeed, but also wants to start oral contracep tion. You generally prefer to prescribe combination oral contraceptiv es (estrogen + progesterone) but you have been told that these might more negatively affect her breastmilk production than progesterone only pills. • John is an 11 year old boy who presents with primary enur esis. He has grown frustrated with the inconvenience and embarrassment of his problem. You have excluded the possibility of urinary tract anomalies and infection as possible causes. Yo u consider recommending a bedwetting alarm, but a colleague tells y ou he thinks they’re “worthless” and suggests that you treat with imiprimine or desmopressin. 1. Write a focused clinical question for each of these patient encounters that will help you organize a search of the clinical literature for an answer and choose the best article from among those you find. Scoring Rubric for breast-feeding/contraception question. (When in doubt, consider whether what is written will contribute to an optimally specific search of the clinical literature. ) Population Intervention Comparison Outcome Excellent (3 pts) Multiple relevant descriptors e.g., “post partum woman,” “breast feeding/lactating mother” or “breastfeeding mom desiring contraception,” or “breast Includes specific intervention of interest ; e.g. combined contraceptives (estrogen and Identifies specific alternative of interest since pt. wants to use oral contraception e . g . p r o g e s t e r o n e o nly c o n t r a c e p t i o n O u t c o m e t h a t i s o b j e c t i v e a n d m e a n i n g f ul t o p a t i e n t e . g . i n f a n t g r o w t h r a t e, number of lactation “dr o p o u t s,” o r m a t e r n al s a t i s f a c t i o n w i t h i n f a n t s a t i e t y o r m ilk flo w f e d n e w b o r n ” N o t e : “ b r e a s t f e e d i n g w o m a n ” i s c o n s i d e r e d t w o d e s c r i p t o r s . p r o g e s t e r o n e ), o r s p e c i f i c i n d i v i d u al components of contraception suc h a s “ e s t r o g e n ” S t r o n g ( 2 p t s ) O n e a p p r o p r i a t e d e s c r i p t o r a s a b o v e e x a m ple s e . g . “ w o m a n,” o r “ i n f a n t ” o r “ b r e a s t f e e d i n g ” M e n t i o n s c o n t r a c e p t i o n o r t y p e o f i n t e r v e n t i o n, e.g. oral contraceptive s , o r h o r m o n e s M e n t i o n s a s p e c i f i c c o m p a r i s o n g r o u p e . g . pla c e b o, o r a s p e c i f i c f o r m o f c o n t r a c e p t i o n, o r m o t h e r s n o t t a k i n g O C P’s N o n – s p e c i f i c o u t c o m e e . g . “ m ilk ” o r “ b r e a s t f e e d i n g ” OR Disease oriented outcome such as milk volume without accompanying measure of clinical relevance e.g. “milk volume” or “chemical composition of milk” or “breastmilk production” Limited (1 point) A single general descriptor unlikely to contribute to search e.g. “patient” Mentions intervention but unlikely to contribute to search e.g. “methods” “options” “treatments” Mentions comparison but unlikely to contribute to search e.g. “compared to other methods” (Note: Using a plural non-specific term, e.g. “various treatment options,” should only be counted once, in the Intervention column) Reference to outcome , but so general as to be unlikely to contribute to search e.g. “effects” “change the outcome” Not Evident (0 pts) None of the above present None of the above present None of the above present None of the above present Scoring Rubric for bedwetting question. (When in doubt, consider whether what is written will contribute to an optimally specific search of the clinical literature.) Population Intervention Comparison Outcome Excellent (3 pts) Multiple relevant descriptors e.g., “boy with primary enuresis” specific age group, gender, exclude infection or anatomic anomalies Note: “primary enuresis” is considered two descriptors. Specific intervention of interest ; e.g. bedwetting alarm Identifies specific alternative treatment of interest e.g. “desmopressin acetate” or “imipramine” or “anti-depressants” Outcome that is objective and meaningful to patient e.g. dry nights Strong (2 pts) One appropriate descriptor as above examples e.g. “enuresis” or “child” Mentions type of intervention without specifics e.g. “Behavior modification” Mentions a specific comparison group e.g. “placebo” or “medical treatment” or “no treatment”

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