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SUMMARY There is a need to move from opinion-based education to evidence-based education. Best evidence medical education (BEME) is the implementation, by teachers in. their practice, of methods and approaches to education based on the best evidence available. It involves a professional judgement by the teacher about his/her teaching taking into account a number of factors-the QUESTS dimensions. The Quality of the research evidence available-how reliable is the evidence? the Utility of the evidence-can the methods be transferred and adopted without modification, the Extent of the evidence, the Strength of the evidence, the Target or outcomes measured-how valid is the evidence? and the Setting or context-how relevant is the evidence? The evidence available can be graded on each of the six dimensions. In the ideal situation the evidence is high on all six dimensions, but this is rarely found. Usually the evidence may be good in some respects, but poor in others. The teacher has to balance the different dimensions and come to a decision on a course of action based on his or her professional judgement. The QUESTS dimensions highlight a number of tensions with regard to the evidence in medical education: quality vs. relevance; quality vs. validity; and utility vs. the setting or context. The different dimensions reflect the nature of research and innovation. Best Evidence Medical Education encourages a culture or ethos in which decision making takes place in this context.
The need for evidence-based teaching
There can be few subjects, if any, where there is as great a degree of internal dissension as education (Squires, 1999). There are tensions as to what is taught and how it is taught, with the curriculum destined, many would argue, to remain an area of conflict. In medical education, change is very much on the political, professional and public agenda. Reports from bodies such as the General Medical Council (1993) in the UK, the World Federation for Medical Education (Walton, 1993), and the Association of American Medical Colleges (1994, 1998,- Anderson & Swanson, 1993) in the USA argue powerfully for revisions to the medical curriculum and for changes in teaching practices. Individual teachers engaged in undergraduate, postgraduate and continuing education are caught up and struggle with this movement for change. Will a new approach...