Evidence Based Practice, Critical Thinking and Research & Education

Evidence-based practice is a cornerstone of modern general practice, empowering GPs to deliver care that is informed by the best available research, tailored to patient needs, and grounded in clinical expertise. Developing critical thinking skills and an understanding of research methods is essential for GPs to evaluate new evidence, apply clinical guidelines appropriately, and contribute meaningfully to quality improvement. General practice presents unique clinical challenges-including managing undifferentiated illness, multimorbidity, and uncertainty-that require research tailored to its specific context. Active engagement with research not only enhances patient care but also fosters a reflective, self-critical professional culture. GPs contribute to evidence based medicine in many ways: from incorporating evidence into daily practice, to supervising trainees, conducting audits and quality improvement projects, and even leading studies that shape policy and service delivery. By cultivating these skills, GPs play a vital role in advancing primary care and advocating for patient-centred, evidence-informed healthcare in Ireland. Participating in research studies, and leading research studies that shape clinical practice policy and service delivery.
Education is a fundamental component of general practice, with GPs acting not only as clinicians but as lifelong learners and everyday educators of patients, trainees, peers, and multidisciplinary colleagues. The GP as educator delivers teaching that is grounded in evidence and clinical experience, and mapped to specific needs and context of each individual learner. Delivered through this evidence-informed approach, General Practice education is integral to high-quality, safe, person-centred care. 

• EB1: Appreciate the role of quality improvement, research, and audit in primary care to enhance healthcare delivery.
• EB2:Distinguish between personal experience and established research findings when providing evidence based opinions and advice.
• EB3: Demonstrate competence in applying evidence-based medicine to clinical practice by critically evaluating research using recognised critical appraisal tools, assessing its applicability, and considering the cost-benefit of interventions.
• EB4: Apply evidence-based medicine while maintaining objectivity, recognising personal biases, and considering the ethical implications of research and clinical practice.
• EB5: Outline the essential components of the research process, including identifying a gap in the evidence, developing research questions, selecting appropriate methodologies, data analysis, and disseminating findings.   
• EB6: Recognise the need to conduct research ethically, ensuring adherence to principles of informed consent, confidentiality, and obtaining necessary approvals, and adhering to general data protection regulations.
• EB7: Critically appraise the principal methodologies, including qualitative, quantitative and mixed-methods approaches, observational research and interventional study designs (including clinical  trials) and evidence reviews, to support evidence-based decision-making in primary care.
• EB8: Demonstrate competence in conducting literature searches, accessing relevant resources, and understanding the hierarchy of evidence to inform clinical decision-making.
• EB9: Evaluate the processes researchers use to identify and formulate effective research questions.
• EB10: Communicate evidence-based information to patients, fostering shared decision-making and respecting patient autonomy.
• EB11: Apply evidence-based medicine to individual patients, considering the generalisability of research findings, the unique context of each patient.
• EB12: Evaluate the effectiveness of clinical interventions, recognising the complexity of many interventions, the limitations of research conducted in secondary care settings, and the need to apply findings appropriately to primary care practice.
• EB13: Utilise available resources from the Irish College of GPs and seek appropriate support to enhance evidence-based practice.
• EB14: Develop an awareness of the importance and value of public, patient involvement in research.
• EB15: Develop the knowledge, skills, and professional behaviours required to act as effective educators, in order to support their own lifelong learning and to contribute, where appropriate, to the learning of others, including patients, peers, students, healthcare colleagues, and communities.

Wherever possible learning resources included here are peer reviewed and externally maintained. This is to ensure that trainees have access to quality assured information that is kept up to date.

Self-Directed

Blended Learning Resources (Education Platform)

Tile: Evidence at Your Fingertips: Library and Search Skills for GPs | Evidence at Your Fingertips: Library and Search Skills for GPs

Diagnostic Reasoning & Cognitive Bias

Research at the Irish College of GPs

Workplace Based Learning

In the day-to-day clinical environment, trainees can actively apply evidence to real patient scenarios, interpret new guidelines, and reflect on diagnostic or management decisions. Regular discussions with trainers and colleagues encourage the development of critical appraisal skills and foster a questioning mindset essential for lifelong learning. Observing how evidence is integrated into decision-making and participating in team-based discussions about complex cases help build confidence in navigating uncertainty.

Day Release

Day release sessions offer a valuable opportunity to strengthen evidence-based practice, critical thinking, and research skills in a collaborative learning environment. Through case-based discussions, journal clubs, literature review and structured teaching, trainees can deepen their understanding of how to critically appraise medical literature and apply research findings to everyday clinical decisions. Sharing experiences with peers from different practices encourages reflection on varied approaches to care and exposes trainees to a broader range of evidence-informed strategies. Day release also provides protected time to explore topics such as guideline implementation, audit design, and quality improvement methodologies in a supportive setting.

Registrar Tutorials

Registrar tutorials provide an ideal setting for personalised, in-depth learning around evidence-based practice, critical thinking, and research. In these one-to-one sessions, trainees can explore how to apply evidence to complex or uncertain clinical cases, with direct guidance from an experienced GP. Tutorials offer the chance to critically appraise recent research, discuss emerging guidelines, and reflect on the rationale behind clinical decisions made in practice. They also support the development of practical skills, such as designing audits or planning quality improvement projects.

Assessment – How this area of practice may be examined

Audit / QI Project / Research

https://www.irishcollegeofgps.ie/Home/Lifelong-Learning-PCS/Professional-Competence-Scheme/Frequently-Asked-Questions/Clinical-Audit/TabPath/318
https://www.irishcollegeofgps.ie/Home/Lifelong-Learning-PCS/Research/TabPath/142
https://www.icgpeducation.ie/course/view.php?id=334
https://www2.healthservice.hse.ie/organisation/qps-improvement/quality-improvement-guide-and-toolkit/
https://assets.hse.ie/media/documents/HSE_Quality_Improvement_Guide_and_Toolkit_2024.pdf

Entrustable Professional Activities (EPAs) underpin workplace-based assessment in this curriculum. Each EPA represents an integrated clinical task that General Practitioners must perform safely and independently, assessed through direct or indirect observation in real clinical settings.

The curriculum and EPA framework are closely aligned: the curriculum defines the required knowledge, skills, and professional behaviours, while EPAs assess their application in practice. Together, they create a coherent approach to developing and demonstrating readiness for independent clinical work.

The examples show how specific activities within general practice & chapters of the curriculum align with particular EPAs.

EPA 17: Manage the integration of evidence-based therapeutics into patient care and prescribe and manage medications

A patient requesting a new treatment (such as starting a novel diabetes medication) provides an opportunity to demonstrate EPA 17. In this scenario, the trainee might conduct a literature search, critically appraise the evidence using recognised tools, and discuss with their supervisor the treatment’s benefits, risks, and cost implications. A CBD tool is suitable to capture feedback after reviewing the evidence and formulating a shared decision-making plan with the patient.

A succinct case entry could read: “evaluated evidence for new diabetes medication and discussed prescribing options.” Reflection should cover appraisal of study design (e.g., whether results are generalisable to primary care), interpretation of key statistics such as relative and absolute risk reductions, and communication strategies for explaining evidence to patients in a clear, accessible way.

Core Knowledge Test (CKT)

• Common terminology used in risk communication, such as ARR, RRR, NNT and NNH, and simple calculations relevant to general practice.
• Choosing the most appropriate screening test based on sensitivity, specificity, and pre-test probability.
• Identifying the most important limitation of an observational study linking a lifestyle factor to disease. 

Clinical Competency Test (CCT)

• Explain the risks and benefits of screening to a patient.
• Counselling a patient who wishes to stop a medication that has proven benefit.
• A patient of yours has been invited to be involved in some research and would like to discuss this with you.

Disclaimer: The examples provided within this section are intended to be indicative only and are included to illustrate how elements of the curriculum may be assessed in the Clinical Competency Test (CCT).

Examination questions in the CCT test the ability of candidates to integrate knowledge, skills, and professional behaviours across multiple curriculum areas to address the challenges posed by the question.

The indicative content should therefore be used solely as a general guide as to some of the topics that may be introduced. Actual examination questions will assess a greater depth and complexity of understanding than the illustrative examples provided.

Please note that a number of CCT questions will require candidates to undertake a physical examination of the simulated patient. In some circumstances, for example in the case of an intimate examination, candidates may be required to display their examination skills through use of a manikin or other device.