Best evidence medical education (BEME): a plan for action

Evidence, which has been de® ned in the American Heritage Dictionary of the English Language as a a thing or things helpful in forming a conclusion or judgmento , is such a simple word.Yet, for many in the health professions, when it is used in the context of `evidence-based medicine’ (EBM), it carries a pejorative signi® cance, as if any medical diagnostic or management decision not meeting rigid criteria de® ned by a critical appraisal process is not up to acceptable standards. This is a misconception which has led to polarization on the topic of EBM within the medical community and no doubt slowed its acceptance by many in the academic community and by medical practitioners in general. It is a misconception: Sackett et al. (1996) have de® ned EBM as a the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patientso . This misconceived controversy and its adverse effects on enthusiasm for the adoption of EBM by the medical community has probably slowed the movement on the part of those involved in the medical education community towards an inclusive, more formal and structured evidencebased approach to medical education decision making. Despite calls for a move in this direction, there has been no consensus on what is required to promote such an approach and to provide an infrastructure to allow it to happen. The patent lack of movement in the general education community, and in some cases antipathy (Larabee, 1998) in that community to the idea that useful evidence can be accumulated as to the generalizability of most educational interventions has also probably deterred movement to an evidence-based culture in the ® eld of medical education. With few good models from general and higher education to go on, establishing a foundation for such a culture in medical education would have to be de novo. Stimulated by comments at the 1998 AMEE Annual Conference in Prague that the ® eld of medical education was too `soft’ to lend itself to a more rigorous evidencebased approach, the term best evidence medical education (BEME) was coined and the decision taken to make this issue a major one at the 1999 AMEE Conference in LinkoÈ ping (Harden, 1998).This report describes a plan for action formulated at that meeting.