Teaching evidence-based medicine skills: an exploratory study of residency graduates' practice habits

The long-term effect of teaching critical appraisal (CA) and evidence-based medicine (EBM) skills is unknown. This study explores long-term behaviors and learner satisfaction after a 3-year longitudinal CA/EBM curriculum.

Telephone interviews were conducted with 1996-1998 graduates of an academic family medicine residency program with an established CA/EBM curriculum. The graduates were all in clinical practice.

Ten of 17 graduates met inclusion criteria and consented to be interviewed. Their age range was 31-58, and all had been in practice 3 to 5 years. Six were female. Most participants did not regularly practice CA or use EBM skills. Instead, colleagues were the most commonly used information source. Time constraints and clinical production pressure were the primary barriers to practicing EBM. Despite not practicing CA and EBM, participants generally were satisfied with their training in these skills. Respondents said they used continuing education meetings and reading journals to keep current.

In this study, residents instructed in CA and EBM skills did not regularly practice these skills. Time and workload pressures appear to be major barriers to these behaviors. Those training residents to integrate EBM into clinical practice should evaluate short- and long-term clinically oriented behaviors to assure educational effectiveness.