by Margaret Dow, M.D. | April 6, 2021 Article Citation: Tonelli MR, Bluhm R. Teaching Medical Epistemology within an Evidence-Based Medicine Curriculum. Teach Learn Med. 2021; 33(1):98-105. DOI: 10.1080/10401334.2020.1835666 What is this article about? Don’t shy away from the heady title! The authors posit that epistemology, the philosophical branch dedicated to understanding knowledge itself, is an underemphasized element of medical education. They argue that our recent emphasis on evidence-based medicine (EBM) has obscured the value and necessity of integrating clinical experience and underlying knowledge of pathophysiology in making sound clinical decisions. They suggest that applying a metacognitive approach of applying EBM approaches to EBM itself may deepen learners’ understanding of the necessarily multifaceted nature of clinical medicine, as well as the potential pitfalls of using EBM as a sine qua non approach. They conclude that teaching learners to think about how they are thinking improves their reasoning and contributes to sound decision-making. Why should you read the article? This article walks through defining epistemology, clarifying its value in medical education, and then breaking down a three-tiered approach to integrating its central tenets. The authors encourage education on different types, levels, and hierarchies of evidence in the preclinical years, evolving to an understanding of how to assess evidence in undergraduate medical education, and culminating in an appreciation of integrating basic scientific knowledge, research findings, and clinical experience in graduate training and beyond. In a refreshing turn, they emphasize the importance of considering lessons learned from the clinical realm as a valid and essential element of the art of medicine. How can you use this article? While the title might be frighteningly philosophical, the take home message is to encourage a much broader education on how to think about what we do and how to incorporate the value of basic sciences, research, and clinical experience into a more comprehensive approach. They recommend utilizing case-based studies to explore these elements, and we as educators are positioned to benefit from this exercise as well. Thinking about how we think may allow us to shape learners’ development even further by meting out what parts of our own approaches stem from underlying pathophysiology, from research, and from our experience. The last of these can be difficult to identify clearly, and by doing so we model a broader, more integrated approach for the next generation to aspire to. Review Author: Margaret Dow, M.D.; Director, Ob/Gyn Clerkship; Mayo Clinic Alix School of Medicine, Rochester, MN. Organization: Association of Professors of Gynecology and ObstetricsTeaching Medical Epistemology within an Evidence-Based Medicine Curriculum