Introducing an evidence-based medicine curriculum into a family practice residency--is it effective?
OBJECTIVE
To investigate whether teaching an evidence-based medicine (EBM) curriculum increased the knowledge and use of EBM principles in residents' continuity clinics.


METHODS
In 1999, the authors performed a needs assessment with residents and faculty of Cascades East Family Practice Residency in Oregon and constructed a ten-session EBM workshop series that was introduced into the curriculum in 2000. Resident-preceptor interactions during outpatient continuity clinic were tape-recorded prior to and six months following introduction of the curriculum. A 50-item, multiple-choice examination was administered before and after the workshop series. Residents at another FP residency at the same university served as a control group. The same assessments were applied to the experimental and control groups. The tape recordings were analyzed for interactions that contained key EBM phrases or words.


RESULTS
Pre-intervention multiple-choice test results were similar (control mean 56%, experimental 53%, p >.22 NS). Post-intervention test scores for the experimental group were significantly improved (mean 72%, p <.001). There was no significant improvement in test results among members of the control group (p >.05 NS). In the recorded resident-preceptor interactions, a marked increase in the use of EBM terms indicated awareness and/or use of EBM in the experimental group. In 1,165 minutes recorded prior to the workshops, EBM terms were used in a total of ten events. In 735 minutes recorded after the workshops, EBM terms were recorded in 67 events. A reduced number of EBM terms were recorded in the control group.


CONCLUSIONS
Administering a structured EBM curriculum increased residents' knowledge and use of EBM constructs during patient care.
Ross
Robert
R
Family Medicine at Oregon Health and Science University and Cascades East Family Practice Residency, in Klamath Falls, Oregon 97601, USA. robr@cdsnet.net
Verdieck
Alex
A
D003479:Curriculum; D004521:Educational Measurement; D019317:Evidence-Based Medicine / Q000193:education*; D005194:Family Practice / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D020380:Needs Assessment; D009922:Oregon; D011231:Preceptorship; D015397:Program Evaluation