Pearls Resources and Submission Forms
Use these resources, forms, and worksheets to help you get the most out of each Pearls™ exercise.
Before you get started...
The first thing you should do is review the information on this page – it will help you to understand how Pearls™ works. The resources, worksheets and tools provided here will assist you in completing your Pearls exercises – and all are available for free to CFPC members
Ready to go paperless? If you would prefer to complete Pearls online, then ePearls™ is the program for you.
Learn more about ePearls and try a free no-risk trial today!
Need assistance with literature searches or accessing articles? As a member of the CFPC, you have access to the Canadian Library of Family Medicine including:
- Five free literature searches per year
- 25 free articles per year
- Personal online literature search assistance
Learn more about the Canadian Library of Family Medicine .
Pearls™ Submission Forms (mandatory)
Step-by-Step Instructions for Completing a Pearls™ Exercise
There is no right or wrong way to do any of these steps. The question, the articles, the decision and the reflective period – they all are under your control. The most important aspect is to ensure that the question is relevant to you and your practice.
Step 1: Formulate your question
The first step is to formulate a specific clinical question that is relevant to your practice. Your question might be related to:
- Clinical skills (e.g. How do I determine if a murmur suggestive of MVP is significant?)
- Therapeutic options (e.g. What is the most appropriate option for treating erectile dysfunction in young men?)
- New diagnostic tools/test (e.g. Should I start using a rapid assay test for Streptococcus in my office?)
- Communication skills (e.g. What is the best way to broach the subject of possible spousal abuse?)
- Or anything else that relates to your practice
Questions may arise from interactions with patients, from review of recently published studies, from discussions with colleagues or reading a recently published clinical practice guidelines (CPGs).Remember, the choice of clinical question is entirely up to you.
Access a list of recently published Canadian clinical practice guidelines
Step 2: Seek the appropriate information
The next step is to seek the appropriate information to answer your clinical question. This step of the exercise requires that you complete a literature search. A literature search can be accomplished in a number of ways.
Not familiar with literature searches? Learn more about accessing quality clinical information
Many local hospital and medical school libraries have searching capabilities and experienced librarians who are willing to help physicians learn how to perform a literature search. Canadian Library of Family Medicine (CLFM) provides a literature searching service for College members. All members are entitled to five free literature searches each year and others can be requested for a nominal fee. Learn more about the Canadian Library of Family Medicine .
The number of articles that your search yields will depend upon the specificity of your question and/or the search criteria used. A question such as "should I give my elderly patients the Pneumococcal vaccine?" is more easily addressed than "how can I improve preventive measures and screening in my practice?" Be sure to record the MeSH (Medical Subject Headings) terms or key words used in your final search strategy, and the total number of articles identified from your search; you will be asked to report this information on the Pearls exercise submission form.
Looking for answers to your clinical questions? Access an up-to-date list of databases, clinical practice guideline collections, textbooks (print and electronic textbooks), re-filtered evidence repositories, and websites or portals containing evidence-based resources.
Step 3: Evaluate the information
The third step is to select the key article(s) from among those identified by your search. Ideally, you should select articles that:
- Report original research data, and/or;
- Report recently published systematic review articles, and/or;
- Focus on clinical practice guidelines (if based on careful, thorough reviews of research data).
Critically appraise each article as it pertains to your stated clinical question. Are the results and/or recommendations valid? Can the results and/or recommendations be applied to your practice?
If you have not had training in critical appraisal of literature, there are many resources that can guide you through this process. Many of these resources are available locally or through the CLFM.
As well, the CFPC has developed four critical appraisal worksheets that you can use to assist you in this step of the Pearls™ exercise (optional). Each worksheet is geared toward a specific type of article:
These are derived from articles in the very successful Users’ Guides to the Medical Literature published in JAMA from 1993 to 1997 by The Evidence-Based Medicine Working Group at McMaster University. Those with limited experience in critical appraisal should find these worksheets helpful. Their use is optional and they are not to be submitted with the submission form. These worksheets are located at the bottom of this page.
Step 4: Make a practice decision
Now that you have analyzed the best available information/data, it is time to answer your clinical question and determine how best to integrate this new knowledge into your practice in a meaningful way.
Often a review of the evidence will lead to changes in your current practice. However, there will be times when the evidence reinforces your current practice – helping to validate your current approach. If insufficient evidence is available to answer your clinical question, you might decide to revisit the issue at a later date and make no changes to your practice at this time.
There may also be barriers (human resources, financial, time, policy, etc.) that prevent you from successful introducing new practices or guidelines. For example, a decision to introduce a new recall system for a disease prevention intervention may have implications for your office staffing. Developing strategies to address these issues may be crucial to the success of implementing new knowledge into your practice.
Once you have completed Step 4 of the Pearls submission form:
- Record the date (see space provided).
- Indicate the approximate number of hours spent to date on the exercise.
- Place the form in a safe place.
It is now time to apply the clinical decision recorded in Step 4. You must allow a sufficient period of time to elapse between Steps 4 and 5 to allow for you to assess the impact of your clinical decision.
Once you feel that asufficient amount of time has elapsed to allow you to assess the implementation of your clinical decision from Step 4 (total time will vary based on your level of expertise and/or comfort with the topic/issue, the number of opportunities you have to apply/test your clinical decision, etc.)you may complete Step 5 of the Pearls exercise.
Step 5: Evaluate the impact of your decision
The final step of the Pearls exercise asks you to reflect on your experiences in applying your clinical decision (from Step 4). In evaluating the impact of your decision, you might ask yourself the following:
- How successful have I been in implementing the stated decision (Step 4) into my practice?
- Was my assessment of the literature appropriate in terms of applicability to my practice?
- Have I encountered new information or evidence that might further impact my stated decision?
- Am I/will I do anything differently as a result of completing this Pearls exercise?
Once you have completed Step 5, you are finished. All that is left to do is to:
- Sign and date the completed submission form on the bottom of the second page.
- Return the form to the CFPC by fax, mail or email.
- Confirmation of receipt and credits will be sent to you by email or mail.
Remember that there will be no judgment made about the value of your question, decision or experience. We will only review the form to verify that you have completed each of the five steps. This is not a pass-fail exercise.