Clinical Clerkships Resources: Home

Resources for UC San Diego School of Medicine's third year medical students.

Key Resources in Evidence-based Medicine

As you enter the Clerkships, your need for information-rich resources increases -- especially for ones that help give you an answer quickly.  Understanding the type of question you have can help you decide where to begin looking for information.  If your question is one that is very general and not related to a specific clinical issue you have a background question.  If your question is more specific and is more clinically or patient oriented, you have a foreground or "clinical question".  Understanding that difference can help you choose the most efficient resource. 

In your quest for information, depending upon your question(s) - background or clinial - you may need to use one or more of the following types of resources.    

  • Clinical Information Sources:  often unique tools that provide (hopefully easy) access to evidence-based or evidence-focused literature including Cochrane, Guidelines Clearinghouse, First Consult, Up-to-Date, and ACP Pier.  It may also include the good "old fashioned" databases that you have used for so long - it is best to use all the methods you know to narrow your searches.  For tips, see the database tutorials (coming soon!).
  • Background Information Sources:  this information is found in a variety of resources with textbooks being the biggest category of resource.  Our collection of online medical textbooks can be found in Access Medicine, MDConsult & StatRef.  These types of questions can also be answered by some of the "expert opinion" type resources such as UpToDate or First Consult.

Asking an Answerable and Searchable Clinical Question

A clinical question differs from a background question because you need to take into account the patient - her's or his' situation and desires about treatment or other medical issues. It is important to come up with a good clinical question because it can help identify the best terms to search with, direct you to resources, and help you decide upon an appropriate article.  A helpful mnemonic is PICO:

  • P:  Patient, problem
  • I:  Intervention
  • C:  Comparison (for the intervention)
  • O:  Outcome

For example, if you have a diabetic patient, how old are they?  What are they currently dealing with - a new diagnosis?  a new complication to the diabetes?  How do you intend to treat or diagnose the problem?  Are there 2 options and you need to find the best one?  What are you hoping to achieve or avoid with the intervention?  Not the least of these is, what does the patient want?  Having a good grasp of the background information will help with developing the clinical question, so don't be afraid to look up the background information before you develop the clinical question.  Sometimes, the last 2 items in the mnemonic are not used, but your question should include the first two criteria. 

Hierarchy of Resources

Hierarchy of Evidence

 

Always look for resources offering the highest level of evidence that is appropriate for your question.