Practical evidence-based medicine skills

These skills are directly transferrable to ‘digital readiness‘. First, we suggest ‘actively reading papers’ using frameworks such as the CONSORT reporting checklist for randomised controlled trials, which enables learning about the key steps in the conduct and reporting of trials, including data validity and methodology.¹⁴ If there are no journal clubs at your hospital, we suggest asking mentors and consultant colleagues to help set one up. In addition, do not underestimate the power of learning through doing. Taking part in a systematic review and/or a meta-analysis is an important way to put words into action.

Escalation of IT concerns as opportunities to effect change

A specific example is the accelerated remote access to electronic health record platforms during the pandemic, after long periods of inertia. This happened, in a major part, due to health professionals raising concerns about what was needed to provide virtual services during COVID-19. At our own trust, many individual acts of agency resulted in system change. Beyond simple raising of concerns and being heard, leadership courses and adjunctive training initiatives such as the chief registrar scheme and the Topol digital fellowships are formal ways of promoting trainee curiosity, development and digital upskilling.¹⁵ These unique experiences receive consistently high feedback from trainees and we would encourage all trainees to explore these opportunities further, and to seek advice and support when applying to such schemes.

Real data analysis

Keep a logbook of the clinical decisions you make. Electronic health records have revolutionised the ability for clinicians to follow up their cases. Mastering how to apply Bayesian theory to decision making or how to interpret an investigation result that is out of keeping with the overall clinical picture requires experience allied with feedback from supervisors and, crucially, a personalised library of clinical cases, which can be used to self-reflect on how you were influenced or biased by patient, staff or external factors. It may additionally spark the idea of an audit or QI project that you wish to conduct which is driven by clinical need based on your experiences.