Teaching Emergency Medicine Residents Evidence-Based Critical Appraisal Skills: A Controlled Trial

Abstract

Study Objectives: To compare the performance of an evidence-based medicine (EBM) approach and a traditional approach to teaching critical appraisal skills to emergency medicine residents. Methods: This was a prospective, case-controlled trial of 32 emergency medicine residents (16 control and 16 intervention). Intervention residents were exposed to a monthly, 1-hour journal club using an EBM approach to critical appraisal over the course of 1 year. Control residents were exposed to a traditional, unstructured journal club, also monthly. Both groups were given a factitious article to evaluate in an essay format before and after the 12-month study period. The Wilcoxon rank sum test was used to compare mean improvement in test scores for each group. Results: The mean improvement in test scores was 1.80 for the control group and 1.53 for the intervention group; these values were not significantly different ( P =.90). The difference in mean change in test score between the 2 groups was .27 points. Conclusion: Compared with a traditional approach, an EBM approach to teaching critical appraisal did not appear to improve the critical appraisal skills of emergency medicine residents. However, because of the small number of subjects studied, small differences in critical appraisal skill improvement cannot be ruled out. [Bazarian JJ, Davis CO, Spillane LL, Blumstein H, Schneider SM: Teaching emergency medicine residents evidence-based critical appraisal skills: A controlled trial. Ann Emerg Med August 1999;34:148-154.]