BMJ  2004;329:1017 (30 October), doi:10.1136/bmj.329.7473.1017

Learning in practice

What is the evidence that postgraduate teaching in evidence based medicine changes anything? A systematic review

¹ Education Resource Centre, Birmingham Women's Hospital, Birmingham, B15 2TG

Abstract

Objective To evaluate the effects of standalone versus clinically integrated teaching in evidence based medicine on various outcomes in postgraduates.

Design Systematic review of randomised and non-randomised controlled trials and before and after comparison studies.

Data sources Medline, Embase, ERIC, Cochrane Library, DARE, HTA database, Best Evidence, BEME, and SCI.

Study selection 23 studies: four randomised trials, seven non-randomised controlled studies, and 12 before and after comparison studies. 18 studies (including two randomised trials) evaluated a standalone teaching method, and five studies (including two randomised trials) evaluated a clinically integrated teaching method.

Main outcome measures Knowledge, critical appraisal skills, attitudes, and behaviour.

Results Standalone teaching improved knowledge but not skills, attitudes, or behaviour. Clinically integrated teaching improved knowledge, skills, attitudes, and behaviour.

Conclusion Teaching of evidence based medicine should be moved from classrooms to clinical practice to achieve improvements in substantial outcomes.

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Rapid Responses:

Read all Rapid Responses

Single Patient Based Medicine “and” EBM improve medical practice.

Sergio Stagnaro
bmj.com, 29 Oct 2004 [Full text]

Teaching integrated into clinical practice for other subjects should work just as well!

Dukaydah van der Berg
bmj.com, 2 Nov 2004 [Full text]

Not a true comparison of teaching methods

Anna L Pozo
bmj.com, 10 Nov 2004 [Full text]

More research required for integrated teaching of evidence based medicine.

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Response to letters: standalone versus integrated teaching of EBM

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Some methodological defects

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