Knowledge Translation
During residency, numerous questions arise throughout your clinical shifts. Studies have demonstrated that in such cases, asking a faculty or colleague is the most frequently accessed “database”. This is superimposed on the larger frame of physician “translation” of evidence into their practice patterns after they leave the academic center. Numerous studies have demonstrated the slow adaptation of practice patterns over time. So project ahead after graduation when most of you will find yourselves working alone. Picture a busy shift, and you encounter a novel situation (the “experience” circle of EBM practice is empty, as is your “evidence” circle for this problem). How will you assure that you settle on a medico-legally sound, evidence – based recommendation for this patient?
We developed the KT shift at IUSM EM Residency as a novel method to improve the resident’s ability to ask focused clinical questions, efficiently search the available databases for evidence, and applying that to answer your questions.
During this shift, the EMR2 focuses on generating focused clinical questions (often thrown their way by faculty and collegues) and experimenting with various databases to ascertain the "best evidence". The resident may also engage in other "knowledge exploration" activities as they deem appropriate. This can range from procedures to observing other team members (Social Work, Physical Therapy, Crisis Intervention Team) do their roles, etc. Usually, one medical student will primarily staff cases with this resident during the shift as well
