Scholarly Activities Core Curriculum Examination Committee Reference List

The resources listed below will help the reader to address the content specifications for the scholarly activities section of the content outline. These resources vary in detail, and some are quite comprehensive. Most of the content specifications will be covered by several of the listed resources, so readers will want to review the style and depth of these resources to determine which will be most useful for their level of background and experience.

EPIDEMIOLOGY AND BIOSTATISTICS Streiner DL, Norman GR: PDQ Epidemiology, ed 2. Hamilton, Ontario. BD Decker, 1996 Streiner DL, Norman GR. PDQ Statistics, ed 3. Hamilton, Ontario. BD Decker, 2003

These two short books provide a quick overview of the basic concepts of epidemiology and biostatistics applied to clinical research. Each short chapter reviews one concept using a single (usually amusing) example. Each chapter ends with a description of misuses of the covered concepts that commonly lead to flaws in research design and analysis.

Gordis L: Epidemiology, ed 3. Philadelphia, PA. Elsevier Saunders, 2004

This textbook provides a concise and accessible introduction to epidemiology and the epidemiologic approach to the study of health and disease. It successfully describes the basic principles and methods of epidemiology. It is well written and uses data-based examples and illustrations to improve understanding of the main points. The book’s 20 chapters are divided into three sections: the epidemiologic approach to disease and intervention, using epidemiology to identify the causes of disease, and applying epidemiology to evaluation and policy. Recommended audiences include graduate students in public health, nursing, medicine, and veterinary medicine.

Haynes RB, Sackett DL, Guyatt GH, et al: Clinical Epidemiology: How To Do Clinical Practice Research, ed 3. Lippincott Williams & Wilkins, 2006

This entertaining and highly readable book covers many of the principles of epidemiology and study design in a practical and accessible way. It is filled with realistic examples that will resonate with readers. The book highlights the application of epidemiologic and biostatistical principles to the practice of medicine.

Hennekens CH, Buring, JE: Epidemiology in Medicine. New York, NY. Little Brown and Company, 1987

This comprehensive and readable compendium of epidemiologic techniques used in medicine provides practical examples and details discussions of basic and advanced concepts. It is useful for individuals with all levels of expertise.

Hulley SB, Cummings SR, Browner WS, Grady D, Hearst N, Newman TB: Designing Clinical Research. An Epidemiologic Approach, ed 2. Philadelphia, PA. Lippincott Williams & Wilkins, 2001

This easily accessible and readable book covers a broad array of clinical research designs and methodologies. It is a detailed and step-by-step approach to conceiving of research questions and designing and implementing strategies to address them. It is practical and comprehensive, and strongly recommended for anyone considering conducting clinical research.

Kane RL: Understanding Health Care Outcomes Research, ed 2. Sudbury, MA. Jones and Bartlett Publishers, 2006

This well-written text provides an overview and discussion of approaches used in conducting health outcomes research, and examines the scope and complexity of issues related to this topic. The book focuses on study design, measurement of outcomes, risk adjustment, and treatment. Its 10 chapters highlight key concepts in outcomes research, including demographic and psychosocial factors, patient satisfaction, comorbidity, and practical advice. Through an emphasis on providing practical ideas and insights, the book offers guidance for researchers seeking to improve their study methods and to obtain more informative data on health outcomes. Recommended audiences include clinicians and researchers.

Koepsell TD, Weiss NS: Epidemiologic Methods: Studying the Occurrence of Illness. Oxford, UK. Oxford University Press, 2003

This introductory text is written by two professors who have more than 50 years of teaching experience. It is filled with excellent examples of applied principles. The book is organized around three main themes: general methods of epidemiology, major study designs, and special applications (eg, screening). These topics form the core of graduate-level courses but are covered in sufficient detail to be of use to a broad audience. The book is lucid and easy to read.

Shi L: Health Services Research Methods. Albany, NY. Delmar Publishers, 1997

This textbook provides a comprehensive discussion of the field of health services research, focusing particularly on research design and research methods. It is practical and well organized, and uses relevant examples to clarify main points. The book successfully relates elements of research design to corresponding basic statistical techniques. Individual chapters are devoted to specific types of research, including qualitative, experimental, survey, and evaluative. It identifies relates resources about research methods, including journals, professional associations, and funding sources. Recommended audiences include graduate students in health services administration, health services practitioners, and researchers.

EVIDENCE-BASED MEDICINE Greenhalgh T: How to Read a Paper. The Basics of Evidence Based Medicine, ed 2. London, UK. BMJ Books, 2001

The author of this short book uses every-day examples from her career as a British general practitioner to illustrate, in a conversational tone, the basics of evidence-based medicine. The chapter on searching is now outdated, but the chapters on research designs and appraisal are clear and concise. The content of this book is similar to others on this list, but the extremely practical approach taken by this author may be especially useful to those with little prior exposure to epidemiology or evidence-based medicine.

Moyer VA, editor: Evidence-based Pediatrics and Child Health, ed 2. London, UK. BMJ Books, 2004

This text is ideal for the practicing pediatrician. It begins with an introductory approach to the evidence-based medicine (EBM) process. Following that, each chapter addresses common problems in pediatrics using the EBM framework. It is practical and easy to read, and is useful for those getting started with EBM. It can also provide new teachers of EBM with some straightforward sample cases.

Riegelman RK: Studying a Study and Testing a Test. How to Read the Medical Evidence, ed 5. Philadelphia, PA. Lippincott Williams & Wilkins, 2005

This textbook addresses basic principles of reading and interpreting the literature. It is aimed at the beginning learner (medical students and residents) and addresses related to study design and other epidemiologic principles. It is less focused on evidence-based medicine than other texts on this list, however. It has an accompanying Web site, www.studyingastudy.com, which includes teacher handouts and guides for teaching this information.

Strauss SE, Richardson WS, Glasziou P, Rennie D: Evidence-based Medicine. How To Practice and Teach EBM. Edinburgh, UK. Elsevier Churchill Livingstone, 2005

This is the original handbook on evidence-based medicine. It is well written and well edited, and comes with a CD that includes the entire contents of the book, and with laminated, color-coded cards that just fit in the pocket of a white coat. The practical application of epidemiologic principles is demonstrated, including many of the relevant calculations such as number needed to treat and likelihood ratios. The book includes a concise section on teaching evidence-based medicine, and the CD includes presentations that can be used to develop personalized learning packages. This book is geared primarily to North American readers.

The Evidence-based Medicine Working Group, Guyatt G, Rennie D, editors: Users’ Guide to the Medical Literature. A Manual for Evidence-Based Clinical Practice. Chicago, IL. AMA Press, 2002

This text is a compilation and extension of the series of articles about evidence-based medicine (EBM) that originally appeared in JAMA. The first half of the book focuses on using the literature, ie, practicing EBM; the second half focuses on using and teaching the principles of EBM. In addition, the second half goes beyond the usual “how to” to delve into theory and more advanced applied epidemiology than many of the shorter handbooks on the list. This book is very detailed and will have considerable crossover with more traditional textbooks of epidemiology and statistics. An abbreviated version of the first half of the book is available as a pocket-sized handbook.

http://www.cebm.net

This Web site of the UK Center for Evidence Based Medicine has teaching materials, online calculators, and links to other evidence-based medicine resources.

http://www.jr2.ox.ac.uk.bandolier/

Bandolier is an online journal about evidence-based medicine, with an extensive collection of teaching materials found on the link labeled “Learning Zone.”

http://www.shef.ac.uk/scharr/ir/netting/

This is probably the single best set of links to evidence-based medicine resources on the Internet.

http/www.nlm.gov/bsd/pubmed_tutorial/m1001.html

The searching tutorial from the National Library of Medicine, which takes 1 to 2 hours to complete, is an excellent introduction to the finer points of searching Medline.

TEACHING AND LEARNING

Ambulatory Pediatric Association: Educational Guidelines for Pediatric Residency, found at www.ambpeds.org/egwebnew)

These online guidelines present a compilation of goals, objectives, and competencies for each subspecialty that help with “what to teach.” The reader can click on eight tutorials to download short sections about medical education (available in MSWord or PowerPoint). The modules range from planning to evaluation, of which the following four are most likely to be useful: a. Module 1: What is a Planned Curriculum?

The principles of a structured curriculum stated in this module also apply to individual learning experiences.

b. Module 4: Planning Learning Experiences

This module contains more detail than Module 1 about the specifics of planning.

c. Module 5: Resident Evaluation and Feedback

The “competencies” are addressed.

d. Medical Education Terms and Concepts

Brief definitions are provided to educate the reader about the language and concepts used in medical education.

ABC of Learning and Teaching in Medicine series. BMJ, 2003

This series of 14 very brief, readable, accessible articles covers the basics of teaching, of which the following seven modules are likely to be the most helpful. Kauffman D: Applying educational theory in Practice. BMJ 2003;326:213-216

Succinctly states the principles of adult learning theory, self-directed learning, self-efficacy, and reflective practice, with examples of application.

Cantillon P: Teaching large groups. BMJ 2003;326:436-440

This article focuses on how to engage your audience and how to maximize learning from a lecture.

Farrow R: Creating teaching materials. BMJ 2003;326:921-923

This short article adds a few useful tips to the information found in the preceding citation.

Jacques D: Teaching small groups. BMJ 2003;326:492-494

This author identifies techniques to facilitate effectively and multiple ways to structure a group of learners.

Gordon J: One to one teaching and feedback. BMJ 2003;326:543-545

Gordon identifies “do” and “don’t” bullet points for teaching, but more detailed information is available from Feedback in medical education by Ende J (see below).

Norcini J: Work based assessment. BMJ 2003;326:753-755

This author depicts Miller’s pyramid: “Knows,” “Knows how,” “Shows how,” and “Does.”

Hutchinson L: Educational environment. BMJ 2003;326:810-812

This short article presents useful considerations about the physical environment and the psychological/educational environment.

Ende J: Feedback in medical education. JAMA 1983;250:777-781

Included in this frequently quoted article are guidelines for providing feedback and information about the dangers of not providing feedback.

Ende J, Pomerantz A, Erickson F: Preceptors’ strategies for correcting residents in an ambulatory care medicine setting: A qualitative analysis. Acad Med 1995;70:224-229

The authors provide examples of the counterproductive techniques commonly used by preceptors. They also particularly note that, when preceptors correct residents’ errors, they may try so hard to avoid bruising residents’ egos that the residents do not recognize that they made an error.

Neher J, Gordon K, Meyer B, et al: A five-step “microskills” model of clinical teaching. J Am Board Fam Pract 1992;5:419-424

Neher et al lists steps to use for efficient precepting: get a commitment, probe for supporting evidence, teach general rules, reinforce what was done right, and correct mistakes.

RESEARCH ETHICS Caldwell PH, Murphy SB, Butow PN, et al: Clinical trials in children. Lancet 2004;364:803-811

This thoughtful review article articulates the complex scientific and ethical issues triggered by randomized clinical trials in pediatric populations, which are necessary to establish a standard of care that addresses the needs of children and adolescents. Public policy toward these trials has evolved and is presently more encouraging than in the past, yet this very fact places greater burdens on the Institutional Review Boards and independent review boards to provide greater scrutiny for the science and for the review process. Studies document that parents fail to grasp the notion of randomized clinical trials and, therefore, may make less informed choices.

Institute of Medicine: Ethical Conduct of Clinical Research Involving Children. Washington, DC. National Academies Press, 2004

This comprehensive discussion of clinical research with children grapples with the dilemma that children can most often not provide legally and ethically adequate consent to research, and yet research with children is essential to future improvements in children’s health and health care. It assesses the appropriateness of the regulations (45 CFR 46: 401-409: Subpart D – Additional Protections for Children Involved as Subjects in Research), interprets the key concept of “minimal risk,” reviews the expectations of parents and children involved in research, and examines the processes for enrolling children and the propriety of paying them and their parents. It is an essential grounding for evaluating research in the present social, ethical, and economic climate.

Kopelman LM, Murphy TF: Ethical concerns about Federal approval of risky pediatric studies. Pediatrics 2004;113:1783-1789

This timely and informative article addresses the growing practice of applying to the Office for Human Research Protections (OHRP) for approval for studies that cannot be approved by individual Institutional Review Boards without consultation with the OHRP and without convening an “Expert Panel” under section 45 CFR 46:407; such studies are not acceptable under the usual risk-benefit calculus of the regulations. The article raises ethical concerns about the expertise of panelists, the scope of information shared on the

OHRP Web site, whether there is an upper limit to risk, and how the regulatory section adheres to or violates a pediatric “best practice” standard.

Murphy DJ: Presumed consent in emergency neonatal research. J Med Ethics 2000:26;249-253

Manning raises issues related to informed consent for emergency research on neonates. The article explores whether a practice of “presumed consent” would reduce parental stress and diminish the risk of over-representing vulnerable and disadvantaged families in the enrollees. It also raises issues about the nature of the setting and the nature of consent in the neonatal intensive care unit.

Santelli JS, Smith RA, Rosenfeld WD, for the Society for Adolescent Medicine: Guidelines for adolescent health research. A position paper of the Society for Adolescent Medicine. J Adolesc Health 2003;33:396-409

Santelli et al present an excellent review of the ethical and legal context of research with children, especially adolescents. The authors focus on adolescent development and the moral capacity of adolescents to consider whether to participate in research. The article surveys the types of research that need to involve adolescents, reviews the stake holders in this process, and considers how their interests are either aligned or in possible conflict. Finally, it suggests situations in which the waiver of parental permission might be appropriate in specific research contexts.

Shah S, Whittle A, Wilfond B, et al: How do Institutional Review Boards apply the Federal Risk and Benefit Standards for pediatric research? JAMA 2004;291:476-482

This article explores the variety of conflicting positions taken by Institutional Review Boards (IRB) in reviewing the possible risks and benefits in pediatric research and in categorizing protocols as either “minimal risk” or some higher level of exposure. It underscores how disparate these decisions are and how guidance is needed for pediatric researchers and for the IRBs.