Answers 1 Possible essay plan: See table below.


Introduction


introduce the topic area give the outline of the essay


Examples of ideas importance of evidence-based medicine in providing high-quality patient care


In this essay, I will outline the issues related to introducing evidence-based medicine in a clinical setting. I will illustrate/describe … (examples) I will consider … (solutions) Finally, I will suggest … (best solution)


Body


Para 1: situation/problems (general)


Para 2: problems (specific examples)


Para 3: solutions


difficulties in introducing evidence-based guidelines into clinical practice: 1) providing timely, high-quality evidence on best practice in relation to treatments 2) ensuring evidence-based clinical guidelines are accepted by clinical staff 3) providing access to evidence at the point of decision-making


systematic reviews very time consuming: only 5,000 by 2007 University Hospital Swendon, only 30% of staff following guidelines


use of clinical evidence to provide up to date information on research implications  two


possibilities: 1) giving clinical staff responsibility for creating guidelines 2) implementing guidelines agreed by small group of representatives and ensuring wider involvement in subsequent amending by staff integration of evidence into computerized patient support systems


Para 4: evaluations of solutions


Conclusion


Evidence suggests clinicians will use guidelines where they have been involved in drawing them up. However, this can be time-consuming and complicated. Integration into computerized support systems is useful, but systems take time to be introduced.


From the evidence we can suggest/conclude … Firstly … Secondly … Thirdly …


2 Possible topic sentences: Para 1


Para 2 Para 3 Para 4 Closure


There are a number of barriers to the introduction of evidence-based medicine in the clinical setting.


There are a number of examples of specific areas where the introduction of evidence- based guidelines has proven problematic.


There are a number of solutions to the issues outlined in the previous paragraph.


There needs to be a balance between the enthusiasm of doctors for creating their own guidelines and the complexity and delay of doing this.


3 Students’ own concluding paragraphs.


Language note Although ‘situation–problem–solution–evaluation of solution’ is often said to be an organizing principle in writing, in practice it is sometimes difficult to distinguish between the situation and the problem: they may sometimes seem to be the same thing. The important thing is to be clear about the main focus of the essay – that is, the answer to the question What am I writing about? – and to structure the essay around this.


174


Use Resource 10C, which can be used as a photocopied handout. The idea is to provide a journal club-type exercise. Journal clubs are informal discussions, which are routinely used in clinical practice to allow professionals to discuss the importance of new papers to their practice. A paper is chosen and is discussed in terms of the strength of the evidence it contains and the implications that it could have on the practice if the evidence can be shown to be reliable.


Put students in groups of four. Within each group, students work in pairs. Initially the students should read the article individually. In groups of two they should identify words or phrases which could be changed or substituted in order to make the article more academic. They could also decide if any elements of the sentences can be left out, without losing essential information.


The article should then be discussed in groups of four. They should consider how important they think the article is with reference to the strength of the evidence, what the implications are and what other research might be suggested from the results. They may wish to consider the use of randomization and blinding when discussing the strength of the evidence. Feed back with the whole class.


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