Entrustable Professional Activities

LG12: Critical appraisal of evidence

Learning Goal 12

Critical appraisal of evidence

Critically appraise evidence to provide the best cancer care, ensuring patient safety, wise allocation of resources, and advancement of research through evidence-based practice

This activity requires the ability to:

  • examine research evidence to judge its value and relevance in a clinical context
  • prepare informed decisions about cancer treatments regarding efficacy and toxicities of treatment using the best available evidence
  • identify biases and limitations in research findings to prevent adoption of ineffective, clinically insignificant, or potentially harmful treatments
  • prioritise interventions with proven efficacy to optimise resource allocations and reduce health care costs
  • facilitate shared decision making between patients and clinicians using the best available evidence
  • identify gaps in existing knowledge to improve future research and oncology studies
  • demonstrate institutional policy and guidelines are evidence-based and up to date

Professional practice framework domain

Medical expertise

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • demonstrate proficiency in evidence-based medicine
  • use research critically to provide considered expert opinions in all aspects of clinical care, including at multidisciplinary team meetings
  • demonstrate the ability to have evidence-based discussions with colleagues in and out of the specialty where a difference in opinion is observed

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • discuss key findings from landmark trials related to cancer management
  • keep up to date with the publication and presentation of practice-changing evidence with reference to clinical cases

Communication

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • facilitate informed and shared decision making with patients and their families, whānau and/or carers, including in-depth discussion of available evidence if required or appropriate
  • communicate evidence in a way that is understandable for patients
  • communicate effectively with multidisciplinary members, including allied health staff, scientists, and statisticians, regarding best practice updates
  • emphasise the use of clinically proven information to inform critical patient care decisions
  • acknowledge the significance of evidence-based clinical information in guiding patient care decisions

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • refer to the available evidence when making shared decisions with patients
  • recognise the timing, location, privacy, and appropriateness of sharing information with patients

Quality and safety

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • document the rationale behind decisions, including factors considered, evidence, and research findings and patients’ input as reference for future care

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • demonstrate awareness of updated consensus treatment guidelines and standards of care, with an ability to compare research findings with established best practices

Teaching and learning

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • contribute to teaching sessions to ensure critical appraisal skills are transferred successfully to the other members of the health care team

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • proactively seek to improve own ability for critical appraisal

Research

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • demonstrate proficiency in the principles of evidence-based medicine, such as hierarchy of evidence, systematic reviews, and critical appraisal tools, to evaluate research quality
  • appreciate and discuss the limitations of published research
  • identify gaps and evidence that will lead to future research

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • demonstrate understanding of research methodology, such as study design, statistical analysis, and data interpretation, to identify biases, flaws, and limitations in research studies

Cultural safety

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • communicate with careful consideration to health literacy, language barriers, and culture, respecting patients’ choices
  • consider gaps in evidence surrounding cultural groups, and consider ways to improve equity in clinical trial opportunities

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • recognise the barriers to inclusion in clinical trials and the limitations of evidence due to cultural groups’ underrepresentation

Ethics and professional behaviour

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • reflect on ethical implications of applying evidence or research findings, especially in cases where evidence may be limited, experimental, or controversial
  • apply self-learning and share updates on critical appraisal techniques, new evidence, and best practices to ensure own knowledge remains current

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • understand the ethical aspects of oncology research, such as patient consent, research ethic boards, and conflicts of interest, to ensure research integrity

Judgement and decision making

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • determine the applicability of research findings to patients, considering factors such as age, comorbidities, and patients’ treatment preferences
  • consider the potential benefits and risks of implementing treatments based on research findings or evidence in clinical practice, considering the impact on patients’ outcome, quality of life, and potential adverse effects
  • recognise the importance of being compassionate

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • assess the quality of research, including study design, methodology, and data analysis, to determine reliability and validity of presented evidence

Leadership, management, and teamwork

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • communicate with multidisciplinary members effectively to facilitate exchange of ideas and perspectives on new evidence
  • identify areas of improvement and implement evidence-based changes in own practice and/or institution

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • promote best practice treatment based on evidence-based findings

Health policy, systems, and advocacy

confident
Ready to perform without supervision

Expected behaviours of a trainee who can routinely perform this activity without needing supervision

The trainee will:

  • provide recommendations for local and institutional guidelines based on best available evidence
  • make effective decisions on resource allocation for treatment options with best efficacy, considering adverse effects and impact on quality of life
  • advocate for improved access to new diagnostics, treatments, and research funding

direction
Requires some supervision

Possible behaviours of a trainee who needs some supervision to perform this activity

The trainee may:

  • promote shared decision making and patient-centred care based on best clinical evidence