Evidence-Based Medicine (EBM)

“With Light, Katz, and Atkinson we would expect that EBM perpetuates a dogmatic, control-centered form of medicine in residents’ daily clinical practice, validating the power of medicine while accentuating the strengths and weaknesses of its scientific basis. . . . The residents we interviewed, however, noted that the most immediate effect of the increased reliance on guidelines and medical literature was a new source of uncertainty to be managed. Residents not only need to know how to diagnose and treat patients but how to acquire epidemiological research skills as well. . . . First, some residents felt uncomfortable about their ability to search for primary or review articles. . . . Second, residents expressed their discomfort in evaluating the quality of primary articles. . . . Third, residents questioned the rationale behind conducting studies and expressed suspicion about the effects of economical incentives on the quality of medical knowledge. . . . The new research-based uncertainty leads to new forms of managing the uncertainty. . . . Learning how to deal with the specific uncertainty of research led, thus, to a new kind of research-infused skill, an additional dimension of learning to doctor” (Timmermans & Berg, 152,153).