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Towards an evidence based culture

Dr. Soltani is an assistant professor of endocrinology and internal medicine in Tehran University of Medical Sciences and founder of Evidence Based Medicine Working Team (EBMWT) at the Shariati hospital. His main academic interests are dissemination and culturalization for evidence based medicine among medical students and practitioners and ultimately to generalize this concept among Iranian population. EBMWT has conducted a series of weekly classes on the topics such as health research methodology, sources of errors, critical appraisal, and probabilistic reasoning and this group is entering to new horizons for culturalization of evidence based thinking.

As the members of EBMWT we have noticed that conventional methods almost always prescribe the use of mathematical thinking (namely, pathophysiologic reasoning in clinical medicine) to solve any kind of problems afflicting today progressing world, whether they are national issues as great as drug trafficking or simple issues like traffic congestion! Our experience has also showed that very few people really seek knowledge in this world. On the contrary, they try to wring from the unknown the answers they have already shaped in their own minds. This experience has led us to this hypothesis that a number of human problems can be handled better by evidence based thinking (critical thinking) rather than mathematical thinking, although this needs testing and confirmation.

Evidently, like other behaviours, mathematical thinking takes shape during childhood. Our children are typically taught to think about and rationalize daily events rather than asking the reasons and seeking sensible evidences about them. We can also see the affect of this method in our medicine in Iran. While many of our scientists in subjects like mathematics and theoretical physics are among the high-ranking positions in the world, our medicine is dramatically far from international standards of evidence based practice.

Besides, with the huge amount of information available to the general population nowadays, people should be aware of principles of critical appraisal, which enables them to distinguish valuable or valid from invalid or useless information. It seems essential for everybody to know how to appraise general sources of information like newspapers, TV, magazines, web pages, books, and political or social lectures. For this purpose, it is critical to have information about (or at least awareness of the presence of) common biases, random errors, fallacies, confounders, measurement errors, causality, levels of evidence, and principles of probabilistic reasoning.

The experts say critical thinking is fundamental to, if not essential for, a rational society. Induction of these changes in a developing country like Iran compels a great project of culturalization. In doing so, Dr. Soltani has suggested teaching principles of critical appraisal and evidence based thinking to children at schools. The future now belongs to societies that organize themselves for learning. Nations must develop policies that emphasize the acquisition of knowledge and skills of critical thinking by everyone, not just a selected few. The vital question now is that in Iranian general population, will incorporating principles of critical appraisal and evidence based thinking into school textbooks compared with the traditional teaching methods influence the way of thinking and performance in day-to-day events.

Thus, our ultimate purpose is to grow critical thinkers who are habitually inquisitive, well-informed, trustful of reason, open-minded, flexible, fair-minded in evaluation, honest in facing personal biases, prudent in making judgements, willing to reconsider, clear about issues, orderly in complex matters, diligent in seeking relevant information, reasonable in the selection of the criteria, focused in inquiry, and persistent in seeking results which are as precise as the subject and the circumstances of inquiry permit.

Please visit Dr Soltani's CV for detailed contact information.

 
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