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What is the evidence that postgraduate teaching in evidence based medicine changes anything? A systematic review
Arri Coomarasamy1, Khalid S Khan
1Education Resource Centre, Birmingham Women's Hospital, Birmingham, B15 2TG. arricoomar@blueyonder.co.uk
Objective:
To evaluate the effects of standalone versus clinically integrated teaching in evidence based medicine on various outcomes in postgraduates.
Design:
Systematic review of randomised and non-randomised controlled trials and before and after comparison studies.
Data Sources:
Medline, Embase, ERIC, Cochrane Library, DARE, HTA database, Best Evidence, BEME, and SCI.
Study Selection:
23 studies: four randomised trials, seven non-randomised controlled studies, and 12 before and after comparison studies. 18 studies (including two randomised trials) evaluated a standalone teaching method, and five studies (including two randomised trials) evaluated a clinically integrated teaching method.
Main Outcome Measures:
Knowledge, critical appraisal skills, attitudes, and behaviour.
Results:
Standalone teaching improved knowledge but not skills, attitudes, or behaviour. Clinically integrated teaching improved knowledge, skills, attitudes, and behaviour.
Conclusion:
Teaching of evidence based medicine should be moved from classrooms to clinical practice to achieve improvements in substantial outcomes.
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