Presented in part at the annual meeting of the Society of General Internal Medicine, San Francisco, Calif, April 30, 1999.
Teaching Residents Evidence-based Medicine Skills
A Controlled Trial of Effectiveness and Assessment of Durability
Article first published online: 9 OCT 2008
by the Society of General Internal Medicine
Journal of General Internal Medicine
Volume 15, Issue 10, pages 710–715, October 2000
How to Cite
Smith, C. A., Ganschow, P. S., Reilly, B. M., Evans, A. T., McNutt, R. A., Osei, A., Saquib, M., Surabhi, S. and Yadav, S. (2000), Teaching Residents Evidence-based Medicine Skills. Journal of General Internal Medicine, 15: 710–715. doi: 10.1046/j.1525-1497.2000.91026.x
- Issue published online: 9 OCT 2008
- Article first published online: 9 OCT 2008
- Cited By
- evidence-based medicine;
- clinical trial;
- graduate medical education;
- internship and residency
OBJECTIVES: To measure the effectiveness of an educational intervention designed to teach residents four essential evidence-based medicine (EBM) skills: question formulation, literature searching, understanding quantitative outcomes, and critical appraisal.
DESIGN: Firm-based, controlled trial.
SETTING: Urban public hospital.
PARTICIPANTS: Fifty-five first-year internal medicine residents: 18 in the experimental group and 37 in the control group.
INTERVENTION: An EBM course, taught 2 hours per week for 7 consecutive weeks by senior faculty and chief residents focusing on the four essential EBM skills.
MEASUREMENTS AND MAIN RESULTS: The main outcome measure was performance on an EBM skills test that was administered four times over 11 months: at baseline and at three time points postcourse. Postcourse test 1 assessed the effectiveness of the intervention in the experimental group (primary outcome); postcourse test 2 assessed the control group after it crossed over to receive the intervention; and postcourse test 3 assessed durability. Baseline EBM skills were similar in the two groups. After receiving the EBM course, the experimental group achieved significantly higher postcourse test scores (adjusted mean difference, 21%; 95% confidence interval, 13% to 28%; P < .001). Postcourse improvements were noted in three of the four EBM skill domains (formulating questions, searching, and quantitative understanding [P < .005 for all], but not in critical appraisal skills [P = .4]). After crossing over to receive the educational intervention, the control group achieved similar improvements. Both groups sustained these improvements over 6 to 9 months of follow-up.
CONCLUSIONS: A brief structured educational intervention produced substantial and durable improvements in residents' cognitive and technical EBM skills.