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Comparative Study
. 2004 Oct 30;329(7473):1017.
doi: 10.1136/bmj.329.7473.1017.

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

Arri Coomarasamy  1 , Khalid S Khan
Affiliations
Comparative Study

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

Arri Coomarasamy et al. BMJ. .

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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Figures

Fig 1
Fig 1
Changes in knowledge, skills, attitude, and behaviour after critical appraisal skills or EBM teaching, grouped by quality of studies. Data presented as 100% stacked bar chart with numbers inside bars indicating number of studies that provided information for a particular outcome (see tables 1 and 2 for details of each study)
Fig 2
Fig 2
Reasons why integrated teaching may achieve better outcomes than standalone teaching
See this image and copyright information in PMC

Comment in

References

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