Evidence-based Medicine Course Research Articles

Measurement of perceptions of educational environment in evidence-based medicine

In recent years, there has been a renewed interest in measuring perceptions regarding different aspects of the medical educational environment. A reliable tool was developed for measuring perceptions of the...

Familiarity of Physicians, Translational Researchers, Nurses, and Other Health Professionals with Evidence-Based Medicine Terms and Resources

Evidence-based medicine (EBM) is a central theme in health practice and training. The understanding of EBM technical terms and the familiarity with EBM resources were surveyed in four different health professional categories. A self-administered questionnaire on the familiarity with EBM terminology and resources was proposed to 218 health professionals (physicians, translational researchers, nurses, and others) working in the oncology field. Relationships between variable and familiarity were examined: Pearson χ(2) or exact Fisher test was used for the categorical variables and one-way ANOVA for the continuous ones. The odds of familiarity for subjects, who had followed or not at least one EBM course, were estimated fitting a multiple logistic regression model adjusted for age, gender, and profession. All subjects completed the questionnaire. The majority of health personnel seemed to lack a sound knowledge of key EBM terms and sources. Physicians showed the highest knowledge of terms, nurses the lowest. Physicians also declared the largest familiarity with the widest variety of resources, followed by others and the researchers. The most popular resource was PLNG, the Italian Guideline System. People who attended at least one EBM course showed consistently higher percentages of knowledge, but the association was irrelevant for nurses. The main perceived barrier to implement EBM in practice was a lack of personal time. Familiarity of health professionals with EBM terminology and resources is still limited to the medical field and needs to be improved. Increasing education may be pivotal, even if different approaches should be developed for different professional categories.

Reflections From a Resident's Immersion in the World of Mass Media

Reflections From a Resident's Immersion in the World of Mass Media

Methods of teaching medical trainees evidence-based medicine: a systematic review

The principles of evidence-based medicine (EBM) provide clinicians with the ability to identify, source, appraise and integrate research evidence into medical decision making. Despite the mantra of EBM encouraging the use of evidence to inform practice, there appears little evidence available on how best to teach EBM to medical trainees. A systematic review was performed to identify what type of educational method is most effective at increasing medical trainees' competency in EBM. A systematic review of randomised controlled trials (RCTs) was performed. Electronic searches were performed across three databases. Two reviewers independently searched, extracted and reviewed the articles. The quality of each study was assessed using the Cochrane Collaboration's risk of bias assessment tool. In total, 177 citations were returned, from which 14 studies were RCTs and examined for full text. Nine of the studies met the inclusion criteria and were included in this review. Learner competency in EBM increased post-intervention across all studies. However, no difference in learner outcomes was identified across a variety of educational modes, including lecture versus online, direct versus self-directed, multidisciplinary versus discipline-specific groups, lecture versus active small group facilitated learning. The body of evidence available to guide educators on how to teach EBM to medical trainees is small, albeit of a good quality. The major limitation in assessing risk of bias was the inability to blind participants to an educational intervention and lack of clarity regarding certain aspects within studies. Further evidence, and transparency in design, is required to guide the development and implementation of educational strategies in EBM, including modes of teaching and the timing of delivering EBM content within the broader medical curriculum. Further research is required to determine the effects of timing, content and length of EBM courses and teaching methods.

An exploratory analysis of research directors in US physician assistant programs.

The purpose of this study was to investigate the current and anticipated utilization of research directors in physician assistant (PA) programs in the United States. The study employed a descriptive, cross-sectional design. Research directors and/or PA program directors responded to a web-based survey assessing the characteristics and responsibilities of current and anticipated faculty or staff responsible for performing research and/or evaluation activities. Descriptive analyses were performed using SPSS 21.0. Ninety respondents (53.8%) from 167 PA programs participated in the survey. The majority of programs (70%) employed a designated individual responsible for research and/or evaluation within the program. Nearly 37% of respondents affirmed that they specifically employed (n = 26) or planned to hire (n = 7) a "research director." Some of the major duties of research directors were coordinating research activities, assisting with the program's annual report and accreditation documents, teaching research and/or evidence-based medicine courses, and assisting and mentoring faculty in research. The majority of research directors (61.5%) were doctorally prepared. This study provides a better understanding of the roles, responsibilities, and educational backgrounds of research directors within the PA educational community. Research directors are a viable option to help meet the growing expectation of faculty to produce research and other scholarly work. The research director's role may vary from program to program based on its unique needs and level of research experience.

Survey on knowledge, attitudes, and training needs of Italian residents on genetic tests for hereditary breast and colorectal cancer.

Objectives. The aim of the study was to assess knowledge and attitudes of medical residents working in Università Cattolica del Sacro Cuore, Rome, Italy, on genetic tests for breast and colorectal cancer. Methods. We distributed self-administered questionnaire to the residents. Logistic regression models were used to evaluate the determinants of knowledge and attitudes towards the tests. Results. Of 754 residents, 364 filled in questionnaire. Around 70% and 20% answered correctly >80% of questions on breast and colorectal cancer tests, respectively. Knowledge on tests for breast cancer was higher among residents who attended course on cancer genetic testing during graduate training (odds ratio (OR): 1.72; 95% confidence interval (CI): 1.05–2.82) and inversely associated with male gender (OR: 0.55; 95% CI: 0.35–0.87). As for colorectal cancer, residents were more knowledgeable if they attended courses on cancer genetic testing (OR: 2.08; 95% CI: 1.07–4.03) or postgraduate training courses in epidemiology and evidence-based medicine (OR: 1.95; 95% CI: 1.03–3.69). More than 70% asked for the additional training on the genetic tests for cancer during the specialization school. Conclusion. The knowledge of Italian residents on genetic tests for colorectal cancer appears to be insufficient. There is a need for additional training in this field.

Adopting a blended learning approach to teaching evidence based medicine: a mixed methods study.

BackgroundEvidence Based Medicine (EBM) is a core unit delivered across many medical schools. Few studies have investigated the most effective method of teaching a course in EBM to medical students. The objective of this study was to identify whether a blended-learning approach to teaching EBM is more effective a didactic-based approach at increasing medical student competency in EBM.MethodsA mixed-methods study was conducted consisting of a controlled trial and focus groups with second year graduate medical students. Students received the EBM course delivered using either a didactic approach (DID) to learning EBM or a blended-learning approach (BL). Student competency in EBM was assessed using the Berlin tool and a criterion-based assessment task, with student perceptions on the interventions assessed qualitatively.ResultsA total of 61 students (85.9%) participated in the study. Competency in EBM did not differ between the groups when assessed using the Berlin tool (p = 0.29). Students using the BL approach performed significantly better in one of the criterion-based assessment tasks (p = 0.01) and reported significantly higher self-perceived competence in critical appraisal skills. Qualitative analysis identified that students had a preference for the EBM course to be delivered using the BL approach.ConclusionsImplementing a blended-learning approach to EBM teaching promotes greater student appreciation of EBM principles within the clinical setting. Integrating a variety of teaching modalities and approaches can increase student self-confidence and assist in bridging the gap between the theory and practice of EBM.

Building Capacity Through a Social Network for African Researchers: Piloting two eLearning Courses on Evidence Based Medicine and Research within the AFRICA BUILD Project

Background and Purpose: Practicing Evidence-Based Medicine (EBM) means integrating the best available external clinical evidence from research into clinical care and new research. Certain skills, often involving Information Technology, such as searching scientific literature databases, appraising or grading evidence, are essential to apply the latest evidence for a health care intervention or to identify gaps in clinical research. The target population for learning these skills, health care workers willing to do clinical research or deciding on policies, often lack time to enrol in full time face-to-face training in EBM and clinical research. Therefore part-time, flexible and modular distance-learning courses have a larger potential to learn EBM and research techniques. As part of the AFRICA BUILD project, a Coordination Action to improve capacity in health research and education through ICT, we designed a pilot course on EBM and clinical research, which was offered through an on-line educational platform, embedding several features similar to a social network, to African researchers. The objective of this pilot course was to identify factors contributing to success and/or failure of an on-line education programme through such social network. Methods: Different lecturers from partner institutions in Mali, Cameroon and Belgium recorded short presentations using DUDAL software (developed by the RAFT Network, University of Geneva) on the topics of EBM and clinical research. Theory from those sessions could then be applied in on-line assignments and in a group exercise. Experts from Mali and Cameroon facilitated those group exercises and discussions between participants. Seminars, exercises, group discussions and a virtual community were integrated in the eLearning platform designed for this purpose, allowing participants to connect with experts and fellow students. The pilot course was evaluated using both quantitative and qualitative methods, such as: attendance statistics from Google Analytics, results of pre- and post-course tests, users’ satisfaction surveys and participants’ focus group discussions. Results: 33 out of 38 participants starting the course completed a final test and the course evaluation. For 24 out of those 33 (73%), the Internet connectivity remained the main barrier for attending the course. Although the on-line webinars required limited bandwidth, only 23% of participants has not had any problem when watching on-line sessions. Despite these problems, hardly any participants would have preferred to be approached by a different learning method. 82% valued applying theory in a group exercise as essential component of this on-line course. The application of the main principles of EBM and research were tested through a few practical examples before and after the course. Participants would be most eager to continue taking on-line courses if these covered statistical analysis within clinical research and methods on how to write scientific papers. They named a lacking “research culture” and difficult access to scientific journals as main barriers to start mastering research. Their main motivation to engage in research was a possible future academic career, i.e. teaching at the Faculty of Medicine. Conclusions: A potential to let many students successfully complete a course in EBM and clinical research is there, but it requires engaging participants in an active exchange with fellow participants and experts involved in the on-line course development or at the Faculty. The impact and benefits of linking even more peers and experts in the field should be investigated in a second pilot phase of this EBM and clinical research course. Keywords: Education, Distance, Research ,Evidence-Based Medicine

Short Course in Evidence-Based Medicine Improves Knowledge and Skills of Undergraduate Medical Students: A Before-and-After Study

Background: Providing evidence-based care is recognized as a key skill for health care workers from diverse professions and cultures. Purpose: We aimed to assess the effectiveness of a short course in evidence-based medicine (EBM) to change the knowledge and skills of undergraduate medical students and point to possible incorporation of EBM in their curriculum. Methods: This is a before-and-after study that was evaluated by the Fresno questionnaire. A 2-week short course of lectures, seminars, online search, and answering worksheets was conducted on 54 fifth-year medical students rotating through the family medicine department at Jordan University Hospital from September 1 until mid-December 2011. Results: The students achieved a mean score of 26.7 out of 200 in the pretest and 119.5 in the posttest. The mean difference between the pre- and posttests was 92.8, a statistically significant result with a 95% confidence interval of 84.7, 101.0 (p < .0001) with an effect size of 4.2 standard deviation units. Conclusions: A short course in EBM will significantly improve the skills and knowledge of undergraduate medical students.

Using the ADDIE Model in Designing Library Instruction

Librarians are increasingly placed in the role of instructor and are required to design and deliver effective instruction. This article highlights ADDIE, an instructional design model that librarians at Weill Cornell Medical College used to redesign an evidence-based medicine course taken by first-year medical students. The ADDIE model incorporates the five phases of analysis, design, development, implementation, and evaluation. It was found that the application of ADDIE can result in instruction that focuses on learning outcomes relevant to students, meets students' needs, and facilitates active learning.

Evaluating factors affecting the implementation of evidence based medicine in primary healthcare centers in Dubai

ObjectivesTo assess the current evidence based medicine (EBM) knowledge, attitude and perceptions of physicians at Dubai Primary Health Care Sector (PHCS). Further to evaluate barrier and facilitator factors toward implementing the EBM practice. MethodologyA cross-sectional study, at Dubai PHCS, UAE between June and August 2010. The survey was composed of two phases. The first phase was a self administrated questionnaire employed for data collection and the second phase was qualitative method, which was in the form of individual interviews. Statistical Package for Social Sciences (SPSS) was used for data analysis. ResultsIn total 48 participants responded to the survey questionnaire and 13 responded to individual interviews. The response rate was 70.0%. Mean age was 42.18 (SD 10.46). The majority were females (64.6%). The physicians who attended EBM courses reported 70.30% using EBM and showed statistical significance (p=0.002) from those who did not attend the EBM courses. 65.0% believe that 50–75% of the patients are capable of participating in clinical decision while 71.8% disagreed that the concept of EBM is not applicable to their culture. In addition they showed significance (p=0.03) between physician beliefs with regard to patient capacity to take decision. About 67.0% of the family physicians were knowledgeable and followed systematic review as the strongest evidence. They had no access to the EBM resources (37.0%) and had no time to practice the EBM (38.0%). Nearly 40.0% interviewees reported lack of encouragement to attend EBM courses. EBM activities (22.0%) and active audit (18.0%) were top rated facilitating factors. ConclusionsEBM is not fully utilized by indefinite physicians in the Dubai PHC sector. Factors associated with non-utilization of EBM in the PHCS are lack of encouragement to attend EBM courses, senior physicians resist adoption of EBM, lack of time and insufficient dissemination process for implementing the clinical guideline.

Assessing the FACTTS: An Evidence-Based Medicine and Critical Appraisal Course for Medical Students

The Fourth-year Academic Clinical Training and Teaching Selective (FACTTS) is a course taught by medical and library faculty on the practice of evidence-based medicine and critical appraisal of the medical literature. This study assesses the impact of the course on students' understanding of the subject matter by examining three years of pre- and post-test data and addresses whether the number of sessions in the course affects the knowledge gained by the students. The data show an improvement in the students' understanding of course material, but no benefit was found in having two versus three sessions.

Fortbildungskurse zu Themen der Evidenzbasierten Medizin im Gemeinsamen Bundesausschuss

Since 2006 the office of the Federal Joint Committee (FJC) has been offering training courses in Evidence-based Medicine (EbM) to its delegates. The courses were initiated due to a comprehensive and far-reaching restructuring of the FJC. For example, in 2004 it was decided to involve patient representatives in the discussions. Furthermore, the enactment of the cross-sectoral Code of Procedure in 2005 led to the removal of sectoral differences in the evaluation of the benefit of diagnostic and therapeutic methods. The main aim of the training courses is to build a common understanding of EbM in the interdisciplinary boards of the FJC. From the first course in 2006 until the middle of 2012, 385 people participated in these courses. Since many of them attended more than one course, the total number of participants is 663. In 2011, the courses were certified as the "Basic EbM-Course" by the German Network for Evidence-Based Medicine. The results of the course feedback and the continuing demand for further courses confirm their successful implementation and demonstrate that teaching EbM to groups with a fairly heterogeneous academic and professional background is advantageous.

Competence training in evidence-based medicine for patients, patient counsellors, consumer representatives and health care professionals in Austria: a feasibility study

Informed and shared decision-making require competences for both partners - healthcare professionals and patients. There is a lack of training courses in evidence-based medicine for patients and counsellors. We investigated feasibility, acceptability and the potential effects of a 2x2.5 days training course on critical health competences in patients, patient counsellors, consumer representatives and healthcare professionals in Austria. We adapted a previously developed curriculum for patient and consumer representatives. The adaptation comprised the specific needs of our target group in Austria and was founded on Carl Rogers' theory of person-centred education. For the formative evaluation a questionnaire was applied to address the domains: 1) organisational conditions (time and duration of the course, location, and information given in advance, registration); 2) assistance outside the courses; 3) teaching methods (performance of lecturers, teaching materials, structure of modules and blocks) and 4) satisfaction; 5) subjective assessment of competences. Participants evaluated the course, using a 5-point Likert scale. Long-term implementation was assessed using semi-structured interviews three to six months after the course. To estimate the increase in critical health competences we used the validated Critical Health Competence Test (CHC test). Eleven training courses were conducted including 142 participants: patients (n=21); self-help group representatives (n=17); professional counsellors (n=29); healthcare professionals (n=10); psychologists (n=8); teachers (n=10) and others (n=29). 97 out of 142 (68%) participants returned the questionnaire. On average, participants strongly agreed or agreed to 1) organisational conditions: 71% / 23%; 2) assistance outside the courses: 96% / 10%; 3) teaching methods: 60% / 28%; and 4) satisfaction: 78% / 20%, respectively. Interviews showed that the training course raised awareness, activated and empowered participants. Participants passed the CHC test with mean person parameters of 463±111 (pre-test, n=120) and 547±135 (post-test, n=91). For participants who returned both tests (n=71) person parameters were comparable: pre-test 466±121 versus post-test 574±100, p<0,001. Training in evidence-based medicine for patients, patient counsellors, consumer representatives and healthcare professionals is feasible. For a broad implementation, train-the trainer courses and further research are needed.

Effectiveness of a Clinically Integrated e-Learning Course in Evidence-Based Medicine for Reproductive Health Training

For evidence-based practice to embed culturally in the workplace, teaching of evidence-based medicine (EBM) should be clinically integrated. In low-middle-income countries (LMICs) there is a scarcity of EBM-trained clinical tutors, lack of protected time for teaching EBM, and poor access to relevant databases in languages other than English. To evaluate the effects of a clinically integrated e-learning EBM course incorporating the World Health Organization (WHO) Reproductive Health Library (RHL) on knowledge, skills, and educational environment compared with traditional EBM teaching. International cluster randomized trial conducted between April 2009 and November 2010 among postgraduate trainees in obstetrics-gynecology in 7 LMICs (Argentina, Brazil, Democratic Republic of the Congo, India, Philippines, South Africa, Thailand). Each training unit was randomized to an experimental clinically integrated course consisting of e-modules using the RHL for learning activities and trainee assessments (31 clusters, 123 participants) or to a control self-directed EBM course incorporating the RHL (29 clusters, 81 participants). A facilitator with EBM teaching experience was available at all teaching units. Courses were administered for 8 weeks, with assessments at baseline and 4 weeks after course completion. The study was completed in 24 experimental clusters (98 participants) and 22 control clusters (68 participants). Primary outcomes were change in EBM knowledge (score range, 0-62) and skills (score range, 0-14). Secondary outcome was educational environment (5-point Likert scale anchored between 1 [strongly agree] and 5 [strongly disagree]). At baseline, the study groups were similar in age, year of training, and EBM-related attitudes and knowledge. After the trial, the experimental group had higher mean scores in knowledge (38.1 [95% CI, 36.7 to 39.4] in the control group vs 43.1 [95% CI, 42.0 to 44.1] in the experimental group; adjusted difference, 4.9 [95% CI, 2.9 to 6.8]; P < .001) and skills (8.3 [95% CI, 7.9 to 8.7] vs 9.1 [95% CI, 8.7 to 9.4]; adjusted difference, 0.7 [95% CI, 0.1 to 1.3]; P = .02). Although there was no difference in improvement for the overall score for educational environment (6.0 [95% CI, -0.1 to 12.0] vs 13.6 [95% CI, 8.0 to 19.2]; adjusted difference, 9.6 [95% CI, -6.8 to 26.1]; P = .25), there was an associated mean improvement in the domains of general relationships and support (-0.5 [95% CI, -1.5 to 0.4] vs 0.3 [95% CI, -0.6 to 1.1]; adjusted difference, 2.3 [95% CI, 0.2 to 4.3]; P = .03) and EBM application opportunities (0.5 [95% CI, -0.7 to 1.8] vs 2.9 [95%, CI, 1.8 to 4.1]; adjusted difference, 3.3 [95% CI, 0.1 to 6.5]; P = .04). In a group of LMICs, a clinically integrated e-learning EBM curriculum in reproductive health compared with a self-directed EBM course resulted in higher knowledge and skill scores and improved educational environment. anzctr.org.au Identifier: ACTRN12609000198224.

Evidenzbasierte Medizin online zum ärztlichen Berufsstart– eine randomisiert-kontrollierte Studie

Evidence-based Medicine (EbM) was originally developed as a teaching tool for young doctors, but in Germany the last surveys among residents in 2009 and 2011 demonstrated that, across all topics, the largest deficits were seen in the field of EbM. One reason may be a deficit in customised offers for continuing medical education in EbM. In a randomised controlled trial with a wait-control design we investigated a possible gain in knowledge and the acceptance of an online course in EbM for first-year residents. All first-year residents at the Hospital of the Goethe University in Frankfurt received the offer to voluntarily take part in an online EbM course. The tutored course consisted of five modules according to the five steps of EbM, each module being complemented by practical tasks. The participants were randomised via telephone to the course right away or after a three-month waiting period. The primary endpoint (i.e., knowledge) was tested via two sets of 13 multiple choice questions before and after the course and after 6 and 12 months. The participants were asked to subjectively evaluate the course by using an A-F grading system and to semiquantitatively assess its level of difficulty; they were also asked to evaluate the usefulness of its content in their clinical setting. 114 out of the 120 randomised participants took part. After 3 months the immediate intervention group (n=58) achieved a median of 10 (95% confidence interval 10 to 11) correct answers following the course, whereas the waiting intervention group only received a median of 4 (95% confidence interval 4 to 5) correct answers after the three month waiting period (p≤0.0001). The median gain in knowledge for both groups throughout the course was 5 correct answers (p≤0.0001), and this proved to remain constant within a twelve month period. Six months after the course, this course was rated as clinically useful by 96.4% of the participants, and 38.1% stated that they would volunteer again in further teaching activities. The course received a median grade of B. A German online EbM course for first-year residents leads to a remarkable and sustainable gain in knowledge, is well marked, and its contents were regarded as clinically relevant. This tutored practical course is applicable to various settings and could provide an important contribution to EbM residency programs.

An Evidence-Based Course in Complementary Medicines

To evaluate the impact of an evidence-based course in complementary medicines on the attitudes, knowledge, and professional practice behavior of undergraduate pharmacy students. A required 12-week evidence-based complementary medicine course was designed and introduced into the third-year undergraduate pharmacy curriculum. The course included a combination of traditional lectures, interactive tutorial sessions, and a range of formal assessments. Pre- and post-course survey instruments were administered to assess changes in students' attitudes, perceptions, knowledge, and the likelihood they would recommend the use of complementary medicines in a pharmacy practice environment. Completion of a required evidence-based complementary medicines course resulted in a positive change in pharmacy students' perceptions of the value of various complementary medicines as well as in their willingness to recommend them, and provided students with the required knowledge to make patient-centered recommendations for use of complementary medicines in a professional pharmacy practice setting. These findings support the need for greater evidence-based complementary medicine education within pharmacy curricula to meet consumer demand and to align with pharmacists' professional responsibilities.

Teaching of evidence-based medicine to medical students in Mexico: a randomized controlled trial

BackgroundEvidence-Based Medicine (EBM) is an important competency for the healthcare professional. Experimental evidence of EBM educational interventions from rigorous research studies is limited. The main objective of this study was to assess EBM learning (knowledge, attitudes and self-reported skills) in undergraduate medical students with a randomized controlled trial.MethodsThe educational intervention was a one-semester EBM course in the 5th year of a public medical school in Mexico. The study design was an experimental parallel group randomized controlled trial for the main outcome measures in the 5th year class (M5 EBM vs. M5 non-EBM groups), and quasi-experimental with static-groups comparisons for the 4th year (M4, not yet exposed) and 6th year (M6, exposed 6 months to a year earlier) groups. EBM attitudes, knowledge and self-reported skills were measured using Taylor’s questionnaire and a summative exam which comprised of a 100-item multiple-choice question (MCQ) test.Results289 Medical students were assessed: M5 EBM=48, M5 non-EBM=47, M4=87, and M6=107. There was a higher reported use of the Cochrane Library and secondary journals in the intervention group (M5 vs. M5 non-EBM). Critical appraisal skills and attitude scores were higher in the intervention group (M5) and in the group of students exposed to EBM instruction during the previous year (M6). The knowledge level was higher after the intervention in the M5 EBM group compared to the M5 non-EBM group (p<0.001, Cohen's d=0.88 with Taylor's instrument and 3.54 with the 100-item MCQ test). M6 Students that received the intervention in the previous year had a knowledge score higher than the M4 and M5 non-EBM groups, but lower than the M5 EBM group.ConclusionsFormal medical student training in EBM produced higher scores in attitudes, knowledge and self-reported critical appraisal skills compared with a randomized control group. Data from the concurrent groups add validity evidence to the study, but rigorous follow-up needs to be done to document retention of EBM abilities.

EBM E-learning: Feasible and Effective for Occupational Physicians in Different Countries

ObjectivesAlthough evidence-based medicine (EBM) is a useful method for integrating evidence into the decision-making process of occupational physicians, occupational physicians lack EBM knowledge and skills, and do not have the time to learn the EBM method. In order to enable them to educate themselves at the time and place they prefer, we designed an electronic EBM course. We studied the feasibility and utility of the course as well as its effectiveness in increasing EBM knowledge, skills, and behaviour.MethodsOccupational physicians from various countries were included in a within-subjects study. Measurements were conducted on participants' EBM knowledge, skills, behaviour, and determinants of behaviour at baseline, directly after finishing the course and 2 months later (n = 36). The feasibility and utility of the course were evaluated directly after the course (n = 42).ResultsThe course is applicable as an introductory course on EBM for occupational physicians in various countries. The course is effective in enhancing EBM knowledge and self-efficacy in practising EBM. No significant effect was found on EBM skills, behaviour, and determinants of behaviour. After the course, more occupational physicians use the international journals to solve a case.ConclusionAn electronic introductory EBM course is suitable for occupational physicians. Although it is an effective method for increasing EBM knowledge, it does not seem effective in improving skills and behaviour. We recommend integrating e-learning courses with blended learning, where it can be used side by side with other educational methods that are effective in changing behaviour.

Students' View of Evidence-Based Medicine: A Survey in Switzerland

Objective: Training in Evidence-based medicine (EBM) has been implemented in Swiss medical schools for the last 8 to 10 years. Still, there is little known about the undergraduates’ perception of EBM and Medical Statistics. Methods: Between February and July 2007, fifth- to sixth-year medical students during surgical clerkship at 15 adult surgical departments in German-speaking Switzerland were asked to participate in an anonymous survey. At the end of the surgical clerkship each student received a self-administered questionnaire on EBM. It included questions concerning the perception of the practical use of EBM, eight multiple-choice questions regarding the statistical literacy and 26 questions about the view of Science and Scientific Methods. Results: A total of 185/344 (53.8%) medical students participated in the study. On a seven-point Likert scale, the importance of teaching and knowledge in EBM was rated as high (5.7±1.1 and 5.9±1.0). The subjective knowledge on EBM was considered moderate on a five-point Likert scale (3.4±1.0), corresponding with the median percentage knowledge score of 33 (range 0-47). The frequency of literature research and number of publications as co-author proved to be the only significant predictors for a higher knowledge in EBM and Medical Statistics of medical students (p=0.01). The attitude toward Science was good with a total score for the value of Science and research of 80.0 ± 8.3 out of a maximum of 130. The main impediments for using EBM were lack of time (57/165, 35%), ignorance (36/165, 22%), and difficulties in integration into everyday life (32/165, 19%). Conclusions: Medical students in Switzerland were aware of their moderate knowledge in EBM and Medical Statistics and aimed for an improvement. More courses in EBM and journal clubs must be introduced and access to information resources must be ensured with an early introduction in search engines (i.e. MEDLINE, Cochrane Library, etc.). A general strengthening of the knowledge on EBM and Medical Statistics among medical students may be a good way of educating the critical number of academic physicians and establishing a foundation for their future academic environment.