What is the evidence that postgraduate teaching in evidence based medicine changes anything? A systematic review.
OBJECTIVE
To evaluate the effects of standalone versus clinically integrated teaching in evidence based medicine on various outcomes in postgraduates.


METHODS
Systematic review of randomised and non-randomised controlled trials and before and after comparison studies.


METHODS
Medline, Embase, ERIC, Cochrane Library, DARE, HTA database, Best Evidence, BEME, and SCI.


METHODS
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.


METHODS
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.


CONCLUSIONS
Teaching of evidence based medicine should be moved from classrooms to clinical practice to achieve improvements in substantial outcomes.
Coomarasamy
Arri
A
Education Resource Centre, Birmingham Women's Hospital, Birmingham, B15 2TG. arricoomar@blueyonder.co.uk
Khan
Khalid S
KS
D002983:Clinical Competence / Q000592:standards; D018849:Controlled Clinical Trials as Topic; D004503:Education, Medical, Graduate / Q000379:methods* / Q000592:standards; D019317:Evidence-Based Medicine; D007722:Health Knowledge, Attitudes, Practice; D016032:Randomized Controlled Trials as Topic; D013663:Teaching / Q000379:methods* / Q000592:standards