Douglas S. Bell, MD, PhD; Gregg C. Fonarow, MD; Carol M. Mangione, MD, MSPH
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Bell DS, Fonarow GC, Mangione CM. Self-Study from Web-Based and Printed Guideline Material. Ann Intern Med. 2001;134:534-535. doi: 10.7326/0003-4819-134-6-200103200-00030
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Published: Ann Intern Med. 2001;134(6):534-535.
We thank Dr. Blank for highlighting the tension in medical education between teaching simplified rules for patient care and teaching the underlying primary evidence. We agree that the latter approach should support more robust decision making, but it also generally requires more time. Our intervention was intended to facilitate learning both guideline recommendations and the evidence that underlies them, but, as we noted, few of the participants pursued the evidence in depth. The participants may have shared an attitude that was found recently among British general practitioners—they do not have time to pursue critical appraisal of the primary evidence (1). Given that all physicians face time constraints, it remains possible that generalists could best improve their practices by focusing on simple, clear messages about actions that have proven benefit. On the other hand, it is also possible that if generalists invested more time learning the primary evidence, they would remember best practices with less repetition, effectively making their initial learning more efficient. Because many physicians fail to learn and apply even simple recommendations supported by both strong evidence and expert opinion, research that addresses these questions is urgently needed.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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