title: Teaching evidence-based medicine skills can change practice in a community hospital.
abstract: 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.
authors.affiliation: Department of Medicine, University of Toronto, University Health Network, Toronto, Ontario, Canada. sharon.straus@utoronto.ca
authors.forename: Sharon E
authors.initials: SE
authors.lastname: Straus
authors.forename: Chris
authors.initials: C
authors.lastname: Ball
authors.forename: Nick
authors.initials: N
authors.lastname: Balcombe
authors.forename: Jonathon
authors.initials: J
authors.lastname: Sheldon
authors.forename: Finlay A
authors.initials: FA
authors.lastname: McAlister
mesh_terms: 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