Abstract
BackgroundEvidence-based medicine (EBM) is a core skillset for enhancing the quality and safety of patients’ care. Online EBM education could improve clinicians’ skills in EBM, particularly when it is conducted during vocational training. There are limited studies on the impact of online EBM training on clinical practice among general practitioner (GP) registrars (trainees in specialist general practice). We aimed to describe and evaluate the acceptability, utility, satisfaction and applicability of the GP registrars experience with the online course. The course was developed by content-matter experts with educational designers to encompass effective teaching methods (e.g. it was interactive and used multiple teaching methods).MethodsMixed-method data collection was conducted after individual registrars’ completion of the course. The course comprised six modules that aimed to increase knowledge of research methods and application of EBM skills to everyday practice. GP registrars who completed the online course during 2016–2020 were invited to complete an online survey about their experience and satisfaction with the course. Those who completed the course within the six months prior to data collection were invited to participate in semi-structured phone interviews about their experience with the course and the impact of the course on clinical practice. A thematic analysis approach was used to analyse the data from qualitative interviews.ResultsThe data showed the registrars were generally positive towards the course and the concept of EBM. They stated that the course improved their confidence, knowledge, and skills and consequently impacted their practice. The students perceived the course increased their understanding of EBM with a Cohen’s d of 1.6. Registrars identified factors that influenced the impact of the course. Of those, some were GP-related including their perception of EBM, and being comfortable with what they already learnt; some were work-place related such as time, the influence of supervisors, access to resources; and one was related to patient preferences.ConclusionsThis study showed that GP registrars who attended the online course reported that it improved their knowledge, confidence, skill and practice of EBM over the period of three months. The study highlights the supervisor’s role on GP registrars’ ability in translating the EBM skills learnt in to practice and suggests exploring the effect of EBM training for supervisors.
Highlights
Evidence-based medicine (EBM) is the integration of best available clinical evidence with clinical expertise and patient values to inform a clinical decision [1]
This study showed that general practitioner (GP) registrars who attended the online course reported that it improved their knowledge, confidence, skill and practice of EBM over the period of three months
It is recognised as a core skillset for improving the quality and safety of health care [2]. This is acknowledged by the inclusion of EBM competencies in the curriculum for general practice education throughout the training continuum - from undergraduate learners to continuing professional development programs for established general practitioners (GPs) [3, 4]
Summary
Evidence-based medicine (EBM) is the integration of best available clinical evidence with clinical expertise and patient values to inform a clinical decision [1] It is recognised as a core skillset for improving the quality and safety of health care [2]. This is acknowledged by the inclusion of EBM competencies in the curriculum for general practice education throughout the training continuum - from undergraduate learners to continuing professional development programs for established general practitioners (GPs) [3, 4]. There are some specific barriers related to GP registrars, for example, GP registrars often seek answers for their clinical questions, especially for more complex ones, [16] by consulting supervisors and colleagues [17] This could be a barrier or facilitator to the practice of EBM, depending upon the supervisor [18, 19], Some studies reported that the atmosphere established by supervisors (authoritarian vs collaborative) could be a barrier for GP registrars [20]. The course was developed by content-matter experts with educational designers to encompass effective teaching methods (e.g. it was interactive and used multiple teaching methods)
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