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July 8, 2009

Clinical Practice Guidelines and Scientific Evidence

JAMA. 2009;302(2):142-147. doi:10.1001/jama.2009.916

To the Editor: In addition to the issues regarding clinical practice guidelines raised in the Editorial by Drs Shaneyfelt and Centor,1 another unintended consequence of the use of guidelines is the potential adverse effect on medical education. It may be standard rhetoric to state that guidelines are just guides, and physicians must use their discretion in clinical decision making. However, bombarding students with guidelines for all scenarios in seminars, textbooks, and journals is like providing them with the printout of the destination without showing the road map. It may seem more efficient in the short-term but does little to enhance discriminatory skills and numbs the facility for critical thinking.