Promote an evidence based approach to curricular renewal.

Case scenario: Knee Osteoarthritis - When I studied modalities, Ultrasound is indicated for knee OA as it helps to reduce pain and improves healing, TENS is indicated for knee OA as it reduces pain, IFT is indicated for knee OA as it helps to reduce pain, and so on for other modalities too. But the evidences don't support the use of modalities while managing knee OA. There is a strong evidence for not to use categories of modalities in knee OA (eg: TENS as suggested by ACR guidelines). Even if some modalities are indicated they are used as a second line, adjunct treatment.

As per the "Twelve tips for curriculum renewal" on the tips of 'Promote an evidence based approach to curricular renewal' we should focus on four components. (I want to address the curriculum renewal in this format)

1) Curriculum content: Core treatment of the OA should be on focus which consists of patient education, exercise, weight management and self management strategies. This type of content changes the focus from theoretical modalities perspective to the best evidence based management strategies.

2) Learning approaches: It should include the non-contact and contact hours. In non-contact hours we can ask the students to read recent available evidences on OA management in the Nepalese Scenario. They can write it on the padlet activity. In contact hours, we can compare and contract it with the guidelines based management. This will shift the locus of control towards the guidelines based management of the condition. Once an author said "If we don't teach guidelines based approach and application in clinics, we are making handicapped clinicians".

3) Assessment practices: We should make a checklist of the treatment for knee OA and should assess if students have incorporated the core treatment for all the patients with knee OA during their clinical placement. This should be in a written form and there should be a scheduled assessment by the clinic educator.

4) Evaluation practices: Does the implemented guideline based management addresses the patient problem and improved their performances? Does the student applied the core treatment properly? By this was we can evaluate the patient progression evaluation and student's ability to use guideline based treatment.

By this way we can incorporate the evidence based content in the real case scenario.

And hence bridging the literature and clinical practice gap!