Teaching evidence-based medicine (EBM) in China

Article type
Authors
Chen J, Li J, Li Y
Abstract
Background: The rapid expansion of medical knowledge and concerns about quality of care, have led to the birth of evidence based medicine (EBM). Teaching EBM in medical students will be helpful to bridge the gap between research and clinical practice, improve quality of clinical decision, make good clinical doctors and behalf of patients.

Objective: To evaluate the effectiveness of teaching EBM in China.

Methods: Setting: Huaxi medical college of Sichuan University. Participants: The participants from freshman, fourth-year undergraduates, postgraduates and resident doctors in Huaxi medical college of Sichuan University. Total number of participants was about 2500 persons from 2000 to 2003. Intervention: 1). Introducing EBM teaching material in Chinese. 2). A various design EBM courses including the principle of EBM, question formulation, literature searching, critical appraisal, application of evidence were offered for participants based on their various learning goal and bases in evidence-based medicine. 3). We mixed elements of these differing approaches and emphasize interactive, student-center, problem-based activities for motivated, self-directed learners. Combining classical lecture with small group teaching methods. 4). Total hours of the course were different from 3 to 30 hours. Main outcome measurement: Evaluations including student satisfaction, the number of published paper related EBM, and a test of knowledge and skill in question formulation, evidence searching, critical appraisal, application of evidence (The full marks of the test was 100 scores).

Results: 1). 36 Cochrane systematic review title were registered in Cochrane systematic review groups; 17 Cochrane systematic review protocol and 6 Cochrane systematic reviews were published in Cochrane Library; 62 EBM research papers were published on Chinese Journal of EBM from 2000 to 2003. 2). The mean score of postgraduate test in knowledge and skill of EBM was 76.72 (6.16) in 2003. 3). Questionnaires answered from all 112 postgraduates of participating EBM course in 2003 revealed: 77.6%, 22.4% of postgraduates considered this EBM course was very helpful and helpful for them respectively; 14.3%, 80% of postgraduates achieved completely or achieved in greater part their anticipative goal by the EBM course respectively. The main reason of no achieving their anticipation goal was a lack of time to reading and attending the course. Around 61.2% to 80% and 16.3%to 32.7% of postgraduates deemed that the teaching contents was very good and good respectively; 61.2% to 75.5% and 12.3% to 28.6% postgraduate feedbacks on this teaching model was very good and good respectively G44.9% postgraduates hope to increase hours of EBM course, increase discusses, increase EBM practice in future; 10.2% responses indicated the questions of test were hard to solve.

Conclusion: Teaching EBM in China lead to a meaningful increase in knowledge and skill of EBM. It needs to be perfected further.