Abstract

BackgroundEvidence-based medicine (EBM) has been widely integrated into residency curricula, although results of randomized controlled trials and long term outcomes of EBM educational interventions are lacking. We sought to determine if an EBM workshop improved internal medicine residents' EBM knowledge and skills and use of secondary evidence resources.MethodsThis randomized controlled trial included 48 internal medicine residents at an academic medical center. Twenty-three residents were randomized to attend a 4-hour interactive workshop in their PGY-2 year. All residents completed a 25-item EBM knowledge and skills test and a self-reported survey of literature searching and resource usage in their PGY-1, PGY-2, and PGY-3 years.ResultsThere was no difference in mean EBM test scores between the workshop and control groups at PGY-2 or PGY-3. However, mean EBM test scores significantly increased over time for both groups in PGY-2 and PGY-3. Literature searches, and resource usage also increased significantly in both groups after the PGY-1 year.ConclusionsWe were unable to detect a difference in EBM knowledge between residents who did and did not participate in our workshop. Significant improvement over time in EBM scores, however, suggests EBM skills were learned during residency. Future rigorous studies should determine the best methods for improving residents' EBM skills as well as their ability to apply evidence during clinical practice.

Highlights

  • Evidence-based medicine (EBM) has been widely integrated into residency curricula, results of randomized controlled trials and long term outcomes of EBM educational interventions are lacking

  • This paper reports results from a longterm, randomized controlled trial designed to test the hypothesis that participation in a brief interactive EBM workshop leads to increases in residents’ EBM knowledge, literature searching, and self-reported use of evidence-based resources

  • After using Analysis of covariance (ANCOVA) models to adjust for baseline (PGY-1) scores, the differences between the workshop and control groups remained small at both time points

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Summary

Introduction

Evidence-based medicine (EBM) has been widely integrated into residency curricula, results of randomized controlled trials and long term outcomes of EBM educational interventions are lacking. We sought to determine if an EBM workshop improved internal medicine residents’ EBM knowledge and skills and use of secondary evidence resources. Determination of the best methods for teaching clinical decision-making has been made difficult by the lack of well-validated evaluation tools and the absence of randomized controlled trials evaluating the impact of EBM educational interventions [10,11]. This paper reports results from a longterm, randomized controlled trial designed to test the hypothesis that participation in a brief interactive EBM workshop leads to increases in residents’ EBM knowledge, literature searching, and self-reported use of evidence-based resources. Improvements in EBM competency are assessed across residency training in an effort to elucidate how best to prepare residents for effective clinical decision-making

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