- basic template for answering on ‘critically evaluate’ questions in the FCICM exam
- often this is critically evaluate the role of a therapy in a specific condition or patient group
- Rationale – e.g. why was this question important to address?
- Merits (Pros)
- Limits (Cons)
- Evidence – if none or low quality then state that
- My approach – How does all of the above influence how I manage these types of patients, or, in a specific instance, how will this information influence what I do for this particular patient? (ie Tailor to context)
TIPS AND TRAPS
- may need to include key definitions of terms used in the question
- if critically evaluating the role of a therapy (e.g. vasopressin in septic shock), integrate the pathophysiology of the disease with the pharmacology/ features of the therapy. Rationale could also include prevalence of the therapy and/or disease.
- To help generate pros and cons, think about comparisons to alternate therapies and doing nothing. e.g. for vasopressin, consider the specific benefits and adverse effects of the therapy itself, the lack of benefits of alternate therapies, avoidance of adverse effects of other therapies, and avoiding the downsides of no treatment
- There can be overlap between rationale, merits/ limits, and evidence – choose where to put information on a case-by-case basis that is logical and allows the sections to flow. Succinct linking statements may help, e.g. in Limits – “the weight of evidence suggests no benefit for this therapy (see below)” then expand on the evidence in the evidence section below
- There is often no single correct answer to the “My approach” section, however, it should be defensible, be within the range of current practice by your colleagues, and flow logically from the preceding sections