Evidence-based medicine in pediatric residency programs: where are we now?

Evidence-based medicine (EBM) integrates the best research evidence with clinical expertise and patient values to optimize clinical outcomes for our patients.

To examine incorporation of EBM into journal club (JC) and other venues within pediatric residency programs.

A 30-question confidential survey was designed to determine how residents are taught and practice EBM. The survey was sent to the chief resident (CR) at all North American pediatric residency programs (N = 192). Nonrespondents were sent surveys 4 and 8 weeks later.

The response rate was 80% (n = 153). Pediatric residency programs varied in size from 12 to 132 residents from responses in 39 states. Most programs (97%, confidence interval [CI], 92-99) used EBM. JC (89%, CI, 83-93), noontime lectures (62%, CI, 54-70), and morning report (61%, CI, 53-69) were the most common venues used to teach EBM. JC (58%, CI, 50-66), morning report (11%, CI, 6-17), and resident workshop (11%, CI, 6-17) were the most effective venues to teach EBM, although resident workshops were as effective as JC to teach EBM in programs offering workshops (38% each, CI, 21-56). Most CRs felt confident in their ability to practice EBM (56%, CI, 48-64), but few CRs felt that their program could teach EBM (7%) or evaluate EBM effectiveness (20%).

EBM is common throughout pediatric residencies. JC was the most effective venue in which to teach EBM, unless a workshop was offered. Most CRs thought it was important to teach EBM, but did not feel confident in their program's ability to teach EBM.