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All practice eligible candidates must participate in the Pearls.ce program as part of their eligibility requirement. It is intended as a self-directed, structured learning activity designed to enhance the introduction of new knowledge into your practice rather than a pass/fail activity.

This assessment program has been certified by the College of Family Physicians of Canada for up to 20 Mainpro+ credits.

One of the major developments in postgraduate family medicine education in recent years has been an emphasis on the principles of evidence-based practice. The philosophy behind this is to ensure that graduates have a solid understanding of these principles and are able to apply them in their daily practice of family medicine. This program offers practice eligible candidates an opportunity to gain, enhance and demonstrate these skills.

Pearls.ce Fee : $1230

Pearls.ce Cancellation/Refund Policy

The portion of the Pearls.ce fee refunded will vary depending on the date of receipt of a written, signed withdrawal/refund request.
  • Candidates who withdraw from the program prior to completing exercise #1 will besubject to a penalty of $200.
  • Candidates who withdraw from the program after completing exercise #1 and before completing exercise #2 will be subject to a penalty of $300.
  • Candidates who withdraw from the program after completing exercise #2 and before completing exercise #3 will be subject to a penalty of $500.

Mainpro+ credits

  • Candidates who complete the Pearls.ce program receive 20 certified Mainpro+ credits.
  • Candidates who withdraw from the program after completing two exercises will receive 12 certified Mainpro+ credits.
  • Candidates who withdraw from the program after completing only one exercise will receive 6 certified Mainpro+ credits.
Several guiding principles were followed in developing Pearls.ce. Pearls.ce will encourage our members to challenge their practices, their knowledge and their ability to provide solid, evidenced-based care.


Pearls.ce provides an innovative alternative to traditional forms of learning where physicians are often provided with unfiltered information which may be difficult to integrate into practice.

Pearls.ce will stimulate participants to link learning to practice, incorporate evidence into clinical decision-making and reflect upon the outcomes created by this process.

Most importantly, this will be an enjoyable learning activity that members can do on their own.

For Pearls.ce you are required to complete a minimum of three exercises as follows:

  • A clinical question about therapy for which you seek the answer using a primary research article (the actual research study);
  • A clinical question about a diagnostic test also using a primary research article, and
  • A clinical question using either a systematic review article or a clinical practice guideline.

Step 1

Formulate a specific question which is clinically relevant to your practice. The range of possible questions is infinite. Your question could be related to clinical skills (e.g. How do I determine if a murmur suggestive of MVP is significant?), therapy (e.g. What is the best medication for panic disorder in young men?), a new test (e.g. Should I start using a rapid assay test for Streptococcus in my office?) or even communication skills (e.g. What is the best way to broach the subject of possible spousal abuse?)

Step 2

The next step is to seek the appropriate information to answer your practice reflection question. This exercise requires that you access the medical literature to ensure that you obtain the best published information when considering your question.

Step 3

Next, select and obtain the key article(s) from among those identified by your search. You must choose an article that reports original research data for your therapy and diagnostic test questions. Recently published systematic review articles or clinical practice guidelines that are themselves based on careful and thorough reviews of research data will be used for your third Pearls.ce exercise.

Critically appraise the article(s) as they pertain to your clinical question. Use the appropriate critical appraisal worksheet, (diagnostic test, therapy, review article and clinical practice guideline) found in the manual.

Step 4

Now that you have considered this information, answer your practice reflection question by stating a clinical question or guide that would be of benefit to your practice or patient. Often a review of the evidence leads to changes in your current practice. However, there will be times when the evidence reinforces your current practice. Another possibility is insufficient evidence is available so you might decide to revisit the issue at a later date.

Step 5

The last step is to consider the application of the evidence related to your clinical question to patients in your practice. You will be asked to describe a clinical scenario in which a patient’s personal beliefs or preferences lead them to consider a decision which differs from what your assessment of the scientific evidence would suggest. Be prepared to discuss the scenario with your tutor.

Your Tutor

You should contact your tutor as you work through each of these exercises and have them evaluate your work one exercise at a time. The purpose of this process is to allow you to have some feedback and comment so that each subsequent exercise can be improved. Your tutor may require you to complete additional exercises up to a total of five before indicating to this office that you have successfully completed the Pearls.ce program.

You are in Control

The choice of questions and the clinical decisions emanating from the literature search are up to you. You are in control of the pace of learning, the kind of information sought, and decisions about how to change your practice according to its own particular characteristics.

Support Resources

A Pearls.ce manual, containing detailed instruction on how to do a Pearls.ce exercise, will be provided to all new Pearls.ce participants. It has a series of appendices that provide additional information if you are unfamiliar with any of the steps. Other resources include:

  • A tutor to offer advice throughout the process
  • Free access to the Canadian Library of Family Medicine (CLFM) to provide advice on searching the literature, to conduct searches and to provide copies of relevant literature and articles
  • Digital access of the Users’ Guides to the Medical Literature

To assist you in the completion of these exercises you will have access to a tutor who will work with you and who will assess your completed work. These tutors are family physicians who have some expertise in critical appraisal and evidence-based family medicine. They are available by phone, fax, or email to give you any direction you might need.

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