Last month I gave my final lecture of the year on EBM. I talked about diagnostic testing but used a new format. Well it isnt really a new format as we do this in another setting but it was new for EBM lectures. I presented a case, actually a few cases, to a colleague of mine and we discussed the approach to diagnosing these cases and sprinkled in the EBM topics along the way. The process is labelled “clinical problem solving” at UAB. Basically a presenter gives snippets of information to a discussant. The discussant walks the audience through his or her thoughts after each snippet of information is given.

I did the same thing but applied to teaching EBM principles of diagnostic testing. I gave information and asked the discussant what he thought the patient’s pretest probability was. I gave more information and we discussed testing and treatment thresholds. I gave more info and we discussed how to get to posttest probability. We covered sensitivity, specificity, LRs, choosing tests, determining posttest probability. I had quite a few questions for the audience (using our ARS) and they could compare their answers to that of my discussant.

I only changed up the format because I was bored giving the same lectures year after year. I was amazed at the evaluations of the discussion. I didnt get across all the info I normally would have but it didnt matter. We engaged the audience and demonstrated EBM in action. We demonstrated clinical reasoning (using EBM). I look forward to doing this more in the future.