include the Cochrane Collaboration (http://hiru.mcmaster.ca/COCHRANE); the Centre for Evidence-Based Medicine (http://cebm.jr2.ox.ac.uk); and the Agency for Healthcare Research and Quality Clinical Practice Guidelines (http://www.ahrq.gov/query/query.htm).

As evidence of the recent interest and rapid growth in evidence-based practice, a search of the National Library of Medicine, using the term evidence-based medicine either as a medical subject heading (MeSH ) or as a text word, revealed no citations from 1966 through 1991, 33 from 1992 through 1996, and 3,328 from 1997 through the first quarter of 2000. The increased interest in evidence-based practice has been worldwide (Dickson et al., 1998; Garner et al., 1998). In the United States, the Agency for Healthcare Research and Quality has created evidence-based practice centers across the country, sponsored guideline development, and established a guideline clearinghouse (Geyman, 1998). The Centers for Disease Control and Prevention has established a task force to develop evidence-based recommendations for the practice of public health (Pappaioanou and Evans, 1998; Task Force on Community Preventive Services, 2000).

Evidence-Based Practice in Health Professional Education

With the major new focus in the literature on rules of evidence, experts agree that evidence-based practice is an increasingly important concept in continuing medical education and medical school curricula (Michaud et al., 1996; Geyman, 1998; Estabrooks, 1998). It is a focused approach to interpretation and clinical translation of research findings that provides a valuable tool for managing the knowledge base of medicine by synthesizing and compressing the explosion in available information—over 1 million journal publications a year (Berg et al., 1997; Culpepper and Gilbert, 1999). Straus and Sackett (1998) suggest that using evidence-based practice and other summary sources could cut the clinical literature reading burden by 98 percent.

Furthermore, research demonstrates that textbooks are sometimes systematically biased, often inaccurate, and always outdated (Antman et al., 1992). These findings provide additional impetus for incorporating evidence-based practice into teaching curricula.

Evidence-based practice is beginning to influence medical school curricula and graduate student medical education in a wide range of teaching hospitals, practice settings, and geographic areas of the United States and Canada (Barnett et al., 1999; Chessare, 1998; Green and Ellis, 1997; Grimes, 1995; Grimes, et al., 1998; Hudak et al., 1997; McCarthy and Zubialde, 1997; Neal et al., 1999; Norman and Shannon, 1998; Poses, 1999; Reilly and Lemon, 1997; Sackett and Straus, 1998; Wadland et al., 1999). Effects on the curricula for other health professionals include reports of its development and use for public health (Brownson et al., 1999), nursing (French, 1999), behavioral scientists (medical



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