Teaching evidence-based medicine skills can change practice in a community hospital.
OBJECTIVE
Several studies have evaluated whether evidence-based medicine (EBM) training courses can improve skills such as literature searching and critical appraisal but to date, few data exist on whether teaching EBM skills and providing evidence-based resources result in change in behavior or clinical outcomes. This study was conducted to evaluate whether a multifaceted EBM intervention consisting of teaching EBM skills and provision of electronic evidence resources changed clinical practice.


METHODS
Before/after study.


METHODS
The medical inpatient units at a district general hospital.


METHODS
Thirty-five attending physicians and 12 medicine residents.


METHODS
A multicomponent EBM intervention was provided including an EBM training course of seven 1-hour sessions, an EBM syllabus and textbook, and provision of evidence-based resources on the hospital network.


RESULTS
The primary outcome of the study was the quality of evidence in support of therapies initiated for the primary diagnoses in 483 consecutive patients admitted during the month before and the month after the intervention. Patients admitted after implementation of the EBM intervention were significantly more likely to receive therapies proven to be beneficial in randomized controlled trials (62% vs 49%; P= .016). Of these trial-proven therapies, those offered after the EBM intervention were significantly more likely to be based on high-quality randomized controlled trials (95% vs 87%; P= .023).


CONCLUSIONS
A multifaceted intervention designed to teach and support EBM significantly improved evidence-based practice patterns in a district general hospital.
Straus
Sharon E
SE
Department of Medicine, University of Toronto, University Health Network, Toronto, Ontario, Canada. sharon.straus@utoronto.ca
Ball
Chris
C
Balcombe
Nick
N
Sheldon
Jonathon
J
McAlister
Finlay A
FA
D000368:Aged; D019317:Evidence-Based Medicine / Q000193:education*; D005260:Female; D006764:Hospitals, Community; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D007396:Internship and Residency; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D011787:Quality of Health Care; D006113:United Kingdom