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Graduate Course Proposal Form Submission Detail - PAS6013

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Current Status: Approved by SCNS - 2013-04-22
Campus: Tampa
Submission Type: New
Course Change Information (for course changes only):
Comments: to GC 1/14/13. for MA in P.A.; GC approved 1/28/13. to USF Sys 1/28/13; to SCNS 2/5/13. Approved eff 4/1/13


  1. Department and Contact Information

    Tracking Number Date & Time Submitted
    3019 2012-11-26
     
    Department College Budget Account Number
    Graduate School MD HSC-10009-611600-000000-0000000
     
    Contact Person Phone Email
    Larry Collins 813-396-9424 lcollins@health.usf.edu

  2. Course Information

    Prefix Number Full Title
    PAS 6013 Evidence-Based Medicine

    Is the course title variable? N
    Is a permit required for registration? N
    Are the credit hours variable? N
    Is this course repeatable?
    If repeatable, how many times? 0

    Credit Hours Section Type Grading Option
    1 C - Class Lecture (Primarily) -
     
    Abbreviated Title (30 characters maximum)
    EVIDENCE-BASED MEDICINE
     
    Course Online? Percentage Online
    C - Face-to-face (0% online) 100

    Prerequisites

    N/A

    Corequisites

    N/A

    Course Description

    This course will establish the basic principles of utilizing evidence-based medicine in clinical practice. Efficient strategies for tracking and appraising evidence and examining available evidence-based journals will be developed.


  3. Justification

    A. Please briefly explain why it is necessary and/or desirable to add this course.

    Needed for new program/concentration/certificate

    B. What is the need or demand for this course? (Indicate if this course is part of a required sequence in the major.) What other programs would this course service?

    Consistent with other Physician Assistant Degree Programs

    C. Has this course been offered as Selected Topics/Experimental Topics course? If yes, how many times?

    No

    D. What qualifications for training and/or experience are necessary to teach this course? (List minimum qualifications for the instructor.)

    PA, MD, PhD, ARNP, MSW


  4. Other Course Information

    A. Objectives

    • Developing a systematic and rigorous approach towards the search for scientific biomedical literature and evidence, aimed at summarizing a topic, answering clinical questions and/or making clinical decisions.

    • Developing a systematic and critical approach towards clinical research evidence and its use for making clinical decisions.

    • Describing the steps for using EBM.

    • Enumerating the different purposes for searching the scientific biomedical literature.

    • Describing the difference between background and foreground questions

    • Defining the elements of a well formulated clinical question.

    • Describing the main terminology used in searching for clinical evidence: key words, MeSH terms, Boolean operators, limits.

    • Describing the principles for reading critically the most common types of clinical research papers:

    o Interventions

    o Diagnostic tests

    o Systematic reviews

    • Clinical practice guidelines

    • Describing the principles to establish whether a given piece of evidence is applicable to individual patients.

    • Correctly asking clinical questions from patients’ problems.

    • Conducting efficient searches of clinical evidence in databases available through the Internet.

    • Selecting, from a research or clinical question, the most appropriate terms for conducting a literature search.

    • Identify the most appropriate databases for searching for evidence, in accordance with the type of evidence of interest:

    o For original studies: PubMed, the Cochrane Library (CENTRAL)

    o For syntheses: the Cochrane Library Database of Systematic Reviews

    o For systems: the National Guideline Clearinghouse

    • Planning and conducting efficient searches in the clinical databases mentioned above.

    • Using MeSH terms, Boolean operators, limits, and Clinical Queries for conducting searches in PubMed.

    • Saving and retrieving the full text of materials found.

    • Critically appraising the most common types of clinical research papers (interventions, diagnostic tests, systematic reviews and clinical practice guidelines).

    • Applying the evidence obtained from the clinical research literature to individual patients.

    B. Learning Outcomes

    Upon completion of the course, students will be able to:

    1. Define evidence-based medicine, and describe the EBM process.

    2. Demonstrate the skills needed for critically assessing evidence and practice guidelines

    3. Compare the major internet sources for locating practice and policy relevant evidence in the U.S. as well as in other countries

    4. Demonstrate the skills for developing and evaluating personalized practice guidelines

    5. Critically evaluate new knowledge and to determine its relevance to the clinical problems and challenges presented by the individual patient.

    6. Demonstrate the ability to interpret, assess, integrate, and apply data and information from diagnostic tests in the process of clinical problem solving, reasoning, and decision making

    7. Value evidence in making medical decisions over opinion and the practice of life-long learning.

    8. Distinguish between different scales of measurement; define mean, median, mode, variance, range, and probability.

    9. Define epidemiologic concepts of incidence, prevalence, and rates including fatality rates.

    10. Define criteria for inferring causality from statistical associations including the Surgeon General and Hill criteria.

    11. Recognize differences in study design for both observational and experimental studies including randomized controlled trials, community intervention trials, cohort studies, case-control, cross-sectional, case series, community surveys, systematic reviews, and meta-analyses.

    12. Discuss the strengths and weaknesses of each and the application of appropriate statistics for each study type.

    13. Recognize the value of a literature search strategy and define MeSH. Translate strategy into a MEDLINE search of moderate complexity using MeSH and limits appropriately.

    14. Define principles of statistics used in cohort and case-control studies including odds ratio, relative risk, and absolute risk. Define and recognize types of bias found in these studies.

    15. Explain the difference between statistical significance and clinical significance, type I and type II error, and define power.

    16. Understand the use of and define markers to evaluate the strength of evidence, including absolute and relative risk reduction, number needed to treat, and confidence intervals. Differentiate between disease and patient oriented evidence. Use the above concepts in critically evaluating information from drug representatives.

    17. Define concepts relating to diagnostic tests including sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV), ROC curves, and likelihood ratios; calculate sensitivity, specificity, PPV, NPV.

    18. Discuss characteristics of a good screening test and explain features of diseases amenable to screening.

    19. Explain common biases that occur in trials about screening.

    20. Understand the application of statistical and study-design concepts in evaluating clinical trials.

    21. Describe and define characteristics of randomized controlled trials such as randomization, blinding, concealed allocation, intention-to-treat analysis and explain how these characteristics reduce bias.

    22. Recognize appropriate statistical methods for categorical and continuous data, including Chi-squared, survival analysis, linear regression, logistic regression, and ANOVA. Recognize appropriate parametric and non-parametric tests for continuous data.

    23. Define public health and explain the ten essential services of public health. Compare and contrast public health to medical care and describe a range of possible public health, medical, and policy interventions for a given health issue.

    24. Describe barriers for patients to understand evidence and explain several techniques for communicating information and numeric information to patients.

    25. Understand how cohort, case control, and ecological studies give evidence for environmental impacts on health.

    26. Explain the toxicologic paradigm and understand toxicologic risk assessment.

    27. Describe how the EBM process is used and applied in a medical setting. Distinguish between narrative review articles, systematic reviews, and meta-analysis and understand issues in using them such as publication bias, forest plots, and heterogeneity.

    C. Major Topics

    • Introduction to Evidence-based Medicine

    • PubMed

    • Cochrane Library (CENTRAL)

    • Cochrane Library Database of Systematic Reviews

    • National Guideline Clearinghouse

    • How to search the clinical evidence (key words, MeSH terms, Boolean operators, limits)

    • Posing questions and running searches

    • How to appraise evidence on:

    o interventions

    o diagnostic tests

    o systematic reviews

    o clinical practice guidelines

    D. Textbooks

    Mayer, Dan. Essential Evidence-based Medicine. Cambridge: Cambridge UP, 2010.

    E. Course Readings, Online Resources, and Other Purchases

    PubMed; Cochrane Library (CENTRAL); Cochrane Library Database of Systematic Reviews; National Guideline Clearinghouse

    F. Student Expectations/Requirements and Grading Policy

    Expectations of Students

    You are part of a community of learners that includes students, faculty and support personnel. As part of that community, we all have the responsibility to actively contribute to the educational process. Your responsibilities include:

    • Attendance

    o As a professional in the field, you should make a conscientious effort to attend each session and to be on time. History and experience show that students who attend classes regularly do much better work and earn better grades. Attendance in lectures is strongly encouraged.

    o Student attendance and active participation in small groups will be mandatory. Attendance records will be kept to aid in tracking student participation. Your presence is required for effective team function, and you will be graded on team participation as a measure of your professional competence.

    • Adequate preparation for class

    o This is particularly important in the small group sessions where students are expected to read the article and answer the worksheet questions in advance.

    • Active participation

    o You are expected to take an active role in your own education by participating actively in the small group discussion. Every student has some knowledge and experience to contribute.

    o Being able to make a cogent and thoughtful argument are skills worth developing early in your training as you will be called upon to do this repeatedly in your clinical years and beyond.

    • Independent and group study

    o Another way to enhance your learning is to participate in a study group. You will get as much out of your education as you put into it. The more independent work you do – additional readings, practicing skills – the better prepared you will be. Interacting with your classmates in active discussions of the material is a terrific way to test your assumptions.

    o PLEASE NOTE – If you participate in a study group to prepare, you should not divide the questions among the group, unless specifically instructed to do so by your instructor. It is fine to discuss the questions on the worksheets and the articles, but the answers you bring to small group must be your own.

    • Technology

    o You must be competent in the use of email and the E*Value/Blackboard (Bb) course management system. Information and grades will be disseminated via E*Value/Bb.

    o Assignments will be submitted electronically to the course site. It is your responsibility to understand this technology.

    • Strive for excellence - Do not be satisfied with minimal contributions and performance.

    G. Assignments, Exams and Tests

    Grading

    3 quizzes – 30% (10% each)

    Mid term – 30%

    Final – 40%

    H. Attendance Policy

    Course Attendance at First Class Meeting – Policy for Graduate Students: For structured courses, 6000 and above, the College/Campus Dean will set the first-day class attendance requirement. Check with the College for specific information. This policy is not applicable to courses in the following categories: Educational Outreach, Open University (TV), FEEDS Program, Community Experiential Learning (CEL), Cooperative Education Training, and courses that do not have regularly scheduled meeting days/times (such as, directed reading/research or study, individual research, thesis, dissertation, internship, practica, etc.). Students are responsible for dropping undesired courses in these categories by the 5th day of classes to avoid fee liability and academic penalty. (See USF Regulation – Registration - 4.0101,

    http://usfweb2.usf.edu/usfgc/ogc%20web/currentreg.htm)

    Attendance Policy for the Observance of Religious Days by Students: In accordance with Sections 1006.53 and 1001.74(10)(g) Florida Statutes and Board of Governors Regulation 6C-6.0115, the University of South Florida (University/USF) has established the following policy regarding religious observances: (http://usfweb2.usf.edu/usfgc/gc_pp/acadaf/gc10-045.htm)

    In the event of an emergency, it may be necessary for USF to suspend normal operations. During this time, USF may opt to continue delivery of instruction through methods that include but are not limited to: Blackboard, Elluminate, Skype, and email messaging and/or an alternate schedule. It’s the responsibility of the student to monitor Blackboard site for each class for course specific communication, and the main USF, College, and department websites, emails, and MoBull messages for important general information.

    I. Policy on Make-up Work

    Didactic Attendance Policies

    Students are encouraged to attend all scheduled hours of instruction. Mandatory sessions and participation requirements are listed on the final page of this syllabus. Recognizing that situations arise which require students to miss time from course responsibilities, the procedures presented below will be followed when absence is necessary.

    1. Religious Observances

    All students, faculty and staff at the University of South Florida have a right to expect that the University will reasonably accommodate their religious observances, practices and beliefs. Students are expected to attend classes and take examinations as determined by the University. The University will attempt, at the beginning of each academic term, to provide written notice of the class schedule and formal examination periods. The University, through its faculty, will make every attempt to schedule required classes and examinations in view of customarily observed religious holidays of those religious groups or communities comprising the University’s constituency. Any student who believes that he/she has been treated unfairly with regard to the above should contact the Office of Student Affairs.

    2. Lectures

    a. Emergencies for Personal Illness, Family Illness, etc.

    The student must contact both the Course Directors by e-mail or telephone and Student Affairs by e-mail or telephone to report his/her absenteeism on the first day of being absent. He/she should indicate the nature of the emergency or unexpected illness. The student must also complete and submit the Absence Report Form. Specifics on planned and unplanned absences, as well as unexcused absences, are listed below.

    b. Exam Attendance Procedures

    Students are expected to attend all scheduled hours of instruction. However, attendance at all examinations is mandatory, and all students should take the examinations on the day and time scheduled.

    Planned Absence

    Absence for attendance at a professional meeting or other educational or research related activity should be submitted for approval to the Course Directors at least 6 weeks prior to the event. Each request for absence will be considered on a case-by-case basis. Personal travel plans should not be considered valid excuses for missing an exam.

    To receive an excused, planned absence, the student must submit a completed Exam Absence Request form to the Course Directors. A copy of the written request must also be submitted to the Office of Student Affairs as soon as possible before the exam occurs. The Course Directors or designee will make the final determination to grant or deny the request and will inform the Office of Student Affairs of the decision. The Office of Student Affairs will subsequently notify the student and the Office of Educational Affairs.

    Unplanned Absence

    If the student has an unanticipated, unplanned absence on the day of an exam, he/she must contact Student Affairs by 8:30 a.m. on the day of the exam. When the student returns to school he/she must fill out and sign the Absence Report form. Documentation for the absence to be excused (e.g. physician’s note, accident report, etc.) will be at the discretion of the OSA.

    Students who miss an examination for any reason are required to contact the Office of Educational Affairs (974-2435) prior to returning to class to determine the date and time of the make-up examination. Dates and times of make-up examinations are determined by the Program Director in consultation with Course Directors.

    In general, make-up examinations must be taken within 48 hours of the original examination date. If a student’s absence from an examination is unexcused, the grade recorded for the exam will be the student’s actual score or 69, whichever is lower, and will not include a group score. A second unexcused absence will result in a grade of “0” and action taken by the Academic Performance Review Committee (APRC) regarding professionalism.

    3. Mandatory Course-Specific Events

    In addition to examinations, the following are all considered mandatory events:

    a. Laboratories

    b. Small group conferences

    c. Problem-solving sessions

    d. Team Based Learning sessions

    e. Large group/Active Learning sessions

    Planned Absence

    In general, in order to be excused from one of these events, the same procedure for examinations is followed. The student must first directly contact the Course Directors with a copy of the request to Student Affairs. The Absence Request form should be completed and given to the Course Directors as soon as possible for planned absences. The Course Directors will make the determination to grant or deny a request in addition to any required remediation.

    Unplanned Absence

    An unanticipated absence on the day of an event requires notification of the Course Directors and Student Affairs. Upon returning to campus, the Absence Report form should be completed and given to the Course Directors. The Course Directors will make the determination to grant or deny the absence in addition to any required remediation.

    Students who miss course-specific mandatory events are expected to acquire the same level of competency as other students involved in the course. Therefore, students with an excused absence may be assigned work to complete by the Course Directors in order to remediate. In the case of an unexcused absence the Course Directors may assign a “0” or no credit for the missed work and/or require other remediation at their discretion. Multiple absences, or a prolonged absence, could result in failure of the course or a grade of “Incomplete”, at the discretion of the Course Directors. In any event all absences for course-specific mandatory events and the outcome should be reported to the OSA by the Course Directors.

    Sign-in sheets will be used for laboratories, case studies and group discussion conferences to determine attendance (Sign-in sheets WILL NOT be used for lectures). Signing an attendance roster when you didn’t attend or arrive late to a lab, or signing the roster for another student is considered an unprofessional act and a violation of the honor code.

    J. Program This Course Supports

    Physician Assistant


  5. Course Concurrence Information

    n/a



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