Use of Wikis and Evidence-Based Medicine in Surgical Practice

2014-08-27 03:16:34 | BioPortfolio


The goal of this study is to improve surgical residents' skills in critically appraising the literature and to promote the dissemination and application of the best available evidence to surgical practice. The hypothesis is that mandatory participation, with faculty oversight, in a journal club wiki will improve the dissemination, evaluation, and application of evidence-based medicine (EBM) in a surgical residency program at University of Texas Health Science Center at Houston (UT-Houston).


The translation of evidence-based medicine (EBM) to clinical practice requires training in literature searching and critical appraisal, which is particularly lacking in surgery. The demands of surgical residency coupled with the 80-hour work week make attendance at journal clubs suboptimal. Internet technology such as wikis, which are free user-friendly collaborative websites, may be a solution to improving resident participation in journal club-related activities, but their utility is highly dependent upon resident contributions and usage. We propose a pilot randomized trial of mandatory versus voluntary participation in a general surgery journal club wiki to verify its feasibility, sustainability, and impact on resident EBM skills as measured with a validated questionnaire. Secondary outcomes will include resident self-assessment of wiki usage and comfort with EBM skills and faculty-assessed resident application of these skills in weekly morbidity and mortality conferences. If the wiki is feasible and sustainable, then the project will be expanded to include other surgical disciplines and cohorts (i.e. students, fellows, other institutions, other medical disciplines) to ensure generalizability. If beneficial, wikis could not only improve resident EBM skills, but also have a halo effect on students and faculty, and ultimately wikis could improve patient care. The assembled multi-disciplinary and multi-institutional team has significant collective expertise in evidence-based medicine, medical education, library skills, and clinical trial design and analysis which are necessary for this project.

Study Design

Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Open Label


Evidence Based Medicine


Mandatory use of surgery wiki, Voluntary use of the surgery wiki


University of Texas Health Science Center-Houston
United States




The University of Texas Health Science Center, Houston

Results (where available)

View Results


Published on BioPortfolio: 2014-08-27T03:16:34-0400

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Surgical procedures conducted with the aid of computers. This is most frequently used in orthopedic and laparoscopic surgery for implant placement and instrument guidance. Image-guided surgery interactively combines prior CT scans or MRI images with real-time video.

Surgery which could be postponed or not done at all without danger to the patient. Elective surgery includes procedures to correct non-life-threatening medical problems as well as to alleviate conditions causing psychological stress or other potential risk to patients, e.g., cosmetic or contraceptive surgery.

Surgery which could be postponed or not done at all without danger to the patient. Elective surgery includes procedures to correct non-life-threatening medical problems as well as to alleviate conditions causing psychological stress or other potential risk to patients, e.g., cosmetic or contraceptive surgery.

Endoscopic surgical procedures performed with visualization via video transmission. When real-time video is combined interactively with prior CT scans or MRI images, this is called image-guided surgery (see SURGERY, COMPUTER-ASSISTED).

Procedures that avoid use of open invasive surgery in favor of closed or local surgery. These generally involve use of laparoscopic devices and remote-control manipulation of instruments with indirect observation of the surgical field through an endoscope or similar device. With the reduced trauma associated with minimally invasive surgery, long hospital stays may be reduced with increased rates of short stay or day surgery.

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