* By Juliana Gomes
Historically, medicine has always been evidence-based. Over the course of medical evolution, however, this evidence has been improved and reached higher levels, becoming even more essential in the clinical decision support . The big challenge, in this sense, is the sensitivity of being able to instill in medical students the applicability of criteria for analyzing the levels of this evidence, especially at this time when remote classes have become inevitable and the transformation to online teaching has happened in a way. abrupt.
In this sense, from the initial moments at the university, it is imperative to teach and apply basic notions of biostatistics, so that the concept of Evidence-Based Medicine (MBE) is perpetuated as a reality for students. And that they are able to assess the level of certain evidence, without biases and without distortions, so that clinical decision-making and medical conduct are not affected.
In recent years, we have observed that some professionals have reduced the focus of applying statistics in the process of critically judging clinical evidence levels, opting to follow the medical approach as indicated in articles, often with incipient discoveries by the pharmaceutical industry or in accordance with with the culture of everyday practice, without a consistent comparison and a critical look at what already existed by consensus or new studies that could bring an effective impact with scientific support. This type of behavior increases the risk of failure, which directly impacts the quality of health management as a whole.
Knowing how to differentiate what interferes consistently or not in the conducts and knowing how to stratify this, based on studies, is the main key to ensure that Evidence-Based Medicine becomes a rule and not an exception within the medical culture. And, for this process to happen efficiently, it is necessary that the preparation of this knowledge and skills base starts in the university classrooms.
Evidence-Based Medicine at Universities
As seen above, one of the main obstacles of Evidence-Based Medicine in the academic world is making it applicable for the student. In general, the arrival of the pandemic brought several challenges for students in this context, from the basic cycle to internship, since the teaching of MBE must be applied throughout the learning process, starting in the theoretical cycle and spreading in the mandatory curricular internship, or medical internship.
The first step in implementing this culture is the application of methods that enable the theoretical learning of this concept at the beginning of the course, to ensure that the student understands how the evidence is stratified and on what it is based. In this way, it is possible to develop critical reasoning that supports the decision-making of future professionals, whether for individual application to a patient, or in the clinical setting in a general context.
At the same time, scientific initiation projects, coordinated by a professor, are essential to help establish and build an information base for the student, since knowledge is based on practical processes. That is, it happens from the creation of environments of integrative activities and problem situations, in which students need to focus their reasoning on the union and relationship of this knowledge.
With the onset of the pandemic and the transformation of the teaching routine, universities had to adapt to new tools to ensure that this process continued. The suspension of classes and the care provided by the inmates interrupted this process just as the concept's applicability came into play, since, in the internship, study designs and conduct discussions are introduced in clinical practice. Faced with this scenario, universities bet on online platforms and resources to reinforce the reasoning process and applicability of Evidence-Based Medicine.
The role of technology in supporting Evidence-Based Medicine
We live in a time when there has never been so much talk about evidence-based medicine. The transformations resulting from COVID-19 went far beyond universities. The routine of medical care in hospital institutions was changed as a whole. At first, the lack of information had a direct impact on the clinical approach, as the little existing information was not supported by quality evidence to justify certain approaches. In a second moment, the excess of information made it difficult for the professional to analyze the best evidence to be followed.
In this sense, technologies have become strong allies, both for students and for front-line professionals. In other words, with regard to the search for and choice of the best evidence, aligning the critical reasoning developed at the university with the use of technological resources ensures more agility and preparation throughout the decision-making process.
In the academic context, universities have adopted virtual platforms for realistic discussion, aiming to reinforce this reasoning process, as well as the applicability of Evidence-Based Medicine. Thus, from the point of view of student education, there are powerful instruments for them to develop a culture that culminates in the ability to correctly use information involving Evidence-Based Medicine, without, of course, exempting the student's responsibility to know how to analyze and apply this information in the most appropriate way, based on the learning acquired in classrooms and curricular internships.
From the professional's point of view, the situation is the same. The clinical decision support platforms are the main responsible for streamlining the process of medical conduct, signaling the evidence, with a high level of quality and that should be the guide for support in more assertive decision-making.
*Juliana Gomes is new business and project leader at Wolters Kluwer, Health in Brazil.
Notice: The opinion presented in this article is the responsibility of its author and not of ABES - Brazilian Association of Software Companies
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