Consensus on evidence-based medicine curriculum contents for healthcare schools in Brazil.

OBJECTIVES: Healthcare professionals need to take into account their knowledge, skills and attitudes to develop a focused clinical question, perform an effective search of the literature, critically appraise the evidence, and apply to the clinical context and evaluate the effectiveness of the process. To date, there is a lack of consensus on evidence-based medicine (EBM) curriculum for undergraduate healthcare students in Brazil. The aim of this study was to develop a consensus on EBM curriculum contents for healthcare schools in Brazil considering expert opinion. DESIGN: Modified three-round Delphi methodology. SETTING: Online survey. PARTICIPANTS: The expert panel was composed of 40 healthcare professionals from different specialties. Most of the participants (n=24; 60%) were female with the age between 30 and 44 years. Participants were also experts in the field of epidemiology, biostatistics or public health. The mean experience of experts in teaching EBM was 9.5 years. MAIN OUTCOME MEASURES: An online questionnaire consisting of 89 items related to EBM was sent to the experts. The experts ranked each item of EBM curriculum considering the importance of each item as omitted, mentioned, explained or practised. The last section of the questionnaire was composed of 'additional content' where the experts evaluated only if an item should be included or not, the form of offering the EBM contents and the total workload (in hours/semester). Open-ended questions were present in each section to give the opportunity to experts to insert suggestions. Items that reached values greater than or equal to 70% of agreement among experts was considered definitive for the curriculum. Items between 51% and 69% of agreement were included for the next round and those items with less than or equal to 50% of agreement were considered unnecessary and were excluded. In the third round, the EBM contents were classified according to the degree of consensus as follow: strong (≥70% of agreement), moderate (51%-69% of agreement) and weak (50% of agreement) based on the maximum consensus reached. RESULTS: Of the 89 initial contents, 32 (35.9%) reached a strong degree of consensus, 23 (25.8%) moderate degree of consensus, two (2.2%) weak degree of consensus and 35 items were not recommended (≤50% of agreement). The workload suggested by experts should be between 61 and 90 hour/semester and an EBM curriculum should be offered with epidemiology and biostatistics as prerequisites. Regarding the importance of each item, 29 (72.5%) should be explained and 25 (27.5%) should be practised with exercises. CONCLUSIONS: The consensus on an EBM curriculum for Brazilian healthcare schools consists of 54 items. This EBM curriculum also presents the degree of consensus (strong, moderate and weak), the importance of each item (mentioned, explained and practised with exercises). A total workload of between 60 and 90 hours per semester was suggested and the EBM curriculum should be offered with epidemiology and biostatistics as prerequisites, but also EBM contents should be included within other disciplines throughout the entire undergraduate course.

Avaliação e categorização das publicações científicas sobre covid-19 para a prática da fisioterapia baseada em evidências

A fisioterapia como estratégia de combate aos sintomas respiratórios da COVID-19 ganhou destaque no ano de 2020. Mas ainda é escasso o conhecimento sobre os tratamentos, sua eficácia e nível de evidência, bem como sua procura e disseminação pelos profissionais fisioterapeutas no âmbito da saúde no Brasil. A disponibilidade de estudos sobre tratamentos fisioterapêuticos contra a COVID-19 é de suma importância para o manejo correto no tratamento dessa doença. Este projeto visa conhecer, avaliar e classificar a literatura científica para sistematizar tratamentos fisioterapêuticos e sua aplicabilidade na tomada de decisão clínica baseada em evidências para o Fisioterapeuta em relação a COVID-19. O estudo irá identificar as publicações desde o começo da pandemia sobre tratamentos/práticas fisioterapêuticas para a COVID-19 nas bases de dados, classificar e categorizar os níveis de evidência dos estudos, avaliando a curva crescente de publicações voltadas ao tratamento da COVID-19. A evidência científica de alta qualidade nas publicações sobre tratamentos se faz imprescindível nestas circunstâncias para que o manejo da condição desse paciente seja correto, evitando um tratamento ineficaz, colocando em risco a vida do paciente.