The traditional evidence-based medicine approach, although attractive to academics, has not been widely embraced by clinicians because it focuses on identifying and validating information communicated by the written word, making it unrealistic and too time consuming for most clinicians. This approach of rigor over relevance is rooted deep in the foundation of pedagogy,9 but is less valid when applied to adult learners.
Two specific tools are needed to help physicians efficiently identify information that is highly relevant and valid. Clinicians need a first-alert method—a POEM bulletin board—for relevant new information as it becomes available. Resources—newsletters, Web sites, continuing education, and others—used by clinicians to update their knowledge should carefully filter out preliminary or unverified information so that this keeping-up process is efficient.
Clinicians also need a way of rapidly retrieving the information to which they have been alerted but that has not yet been cemented into their minds. Computer-based resources (especially handheld portable devices) are available that can provide information in less than 30 seconds. To be lifelong learners, physicians have to use tools that help them to hunt and forage through the jungle of information.
Irrelevant information, even if highly valid, is not useful in the scope of a busy daily practice. Sifting through valid, but irrelevant, information wastes valuable information-gathering time. To be relevant and complete, a comprehensive foraging source for new information must contain specialty-specific POEMs (a POEM alert system). The one-stop shopping approach of information for all specialties offered by Best Evidence does not meet this need.