Effect of teaching evidence-based medicine in medical postgraduates

Article type
Authors
Chen,Jing Li J, Li J, Dong B
Abstract
Background: Evidence-based Medicine (EBM) is the integration of best research evidence with clinical expertise and patient values. The aim of EBM is to provide evidence-based care to our patients and improve clinical outcome. So how to practise EBM is a key of teaching EBM.
Objectives: To evaluate the effectiveness of teaching EBM in postgraduates.

Methods: One hundred and thirteen second year postgraduates who selected the EBM course were included. The course lasted four weeks with twice a week, 3 hours every time and total 21 hours. The lectures were delivered in combination with cases. The teaching effect was evaluated by requesting the students presenting an evidence-based case-report based on the five steps of evidence-based practice. One teacher assessed the reports independently.

Results: The mean score of 107 EBM case-reports was 51.35 (11.38). Distribution of the mean score was nearly normal. Score distribution of the items: The full marks rate was 97% for case depiction and 62% for evidence search. Stratified analysis: 1. Formulating Answerable Clinical Questions: the full marks rate was 88% for clearly statement of patient type, 89% for clear statement of intervention, 35% for control and 36% for outcome statement, respectively. 2. Evidence searching: the full marks rate was 95% for selecting relevant database(such as Cochrane Library), 90% for searching term, 68% for searching strategy and 79% for search result depiction, respectively. 3. Critical appraisal of evidence: the full marks rate of critical appraisal of the clinical importance and validity of evidence was very low (35%, 7%respectively). 4. Applying evidence for the patients: the full marks rate of intervention's benefit and risk for individual patient and patient's value was higher than that of applying evidence to patients and intervention feasibility (24% and 21%, 16% and 12%). 5. Evaluation: the full marks rate of clinical result evaluation was higher than that of performance of evidence-based practice (55%, 17%).

Conclusion: Teaching EBM in postgraduates is successful, we need to strengthen the practice of critical appraisal and applying evidence for patients further in the future EBM course.