Teaching Evidence-Based Complementary and Alternative Medicine (EBCAM); changing behaviours in the face of reticence: a cross-over trial.
BACKGROUND
The effectiveness of teaching critical appraisal to students of Complementary and Alternative Medicine (CAM) has not been studied. In this study we attempt to determine if a workshop for final year students at a naturopathic college improved their ability to utilize critical appraisal concepts.


METHODS
We assigned 83 Naturopathic Interns to two groups: Group A (n = 47) or Group B (n = 36). We conducted a baseline assessment of all subjects' critical appraisal skills. Group A was assigned to receive a 3(1/2) hour workshop on Evidence Based Medicine (EBM) and Group B received a workshop on bioethics (control intervention). The groups critical appraisal skills were re-evaluated at this time. We then crossed over the intervention so that Group B received the EBM workshop while Group A received the bioethics workshop. Assessment of critical appraisal skills of the two groups was again performed.


RESULTS
The students mean scores were similar in Group A (14.8) and Group B (15.0) after Group A had received the intervention and Group B had received the control (p = 0.75). Group scores were not significantly improved at the end of the trial compared to at the beginning of the study (Group A: 15.1 to 16.1) (Group B 15.6 to 15.9). Student's confidence in reading research papers also did not improve throughout the course of the study.


CONCLUSIONS
The final year is a difficult but important time to teach critical appraisal and evidence skills. Single, short intervention programs will likely yield negligible results. A multi-factorial approach may be better suited to implementing EBCAM than single short interventions.
Mills
Edward
E
Department of Research, The Canadian College of Naturopathic Medicine, North York, Canada. emills@ccnm.edu
Hollyer
Taras
T
Saranchuk
Ron
R
Wilson
Kumanan
K
D035843:Biomedical Research; D002983:Clinical Competence / Q000592:standards*; D000529:Complementary Therapies / Q000193:education* / Q000523:psychology; D016001:Confidence Intervals; D018592:Cross-Over Studies; D003657:Decision Making; D019317:Evidence-Based Medicine / Q000193:education*; D006801:Humans; D009324:Naturopathy; D011932:Reading; D012649:Self Concept