Entrustable Professional Activities

LG11: Critical appraisal of evidence

Learning Goal 11

Critical appraisal of evidence

Critical appraisal of 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’ 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
  • participate in developing institutional policy and guidelines to ensure they 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
  • be able to have evidence-based discussions with colleagues within 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:

  • interpret and discuss key findings from 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 shared decision making with patients and their families on treatment options based on the best evidence, with the ability to have detailed discussions of the available evidence if required and appropriate
  • communicate evidence in a way that is understandable for patients and their families or carers
  • communicate effectively with multidisciplinary team members, such as allied health staff, scientists, and statisticians, regarding best practice updates

direction
Requires some supervision

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

The trainee may:

  • be able to refer to the available evidence when making shared decisions with patients and their families

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 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
  • identify gaps and evidence that will lead to future research
  • prepare reviews of literature on patients' encounters to present at journal club meetings

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 timing, location, privacy, and appropriateness of sharing information with patients
  • recognise barriers to inclusion in clinical trials and the limitations of evidence due to under-representation of cultural groups

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 the ethical implications of applying evidence or research findings, especially in cases where evidence may be limited, experimental, or controversial
  • continue self-learning and sharing 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 to ensure research integrity, such as patient consent, research ethic boards, and conflicts of interest

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’ cohorts, considering factors such as age, comorbidities, and patient treatment preferences
  • consider the potential benefits and risks of implementing treatments based on research findings or evidence in clinical practice, considering the impact on patient outcome, quality of life, and potential adverse effects

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 the exchange of ideas and perspectives on new evidence
  • identify areas of improvement, and implement evidence-based changes in the practice 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