Comparison of directed and self-directed learning in evidence-based medicine: a randomised controlled trial.
OBJECTIVE
To compare 2 educational programmes for teaching evidence-based medicine (EBM).


METHODS
Prospective randomised controlled trial accompanied by a qualitative evaluation.


METHODS
University of Oslo, Norway, 2002-03.


METHODS
A total of 175 students entered the study. All tenth semester medical students from 3 semesters were eligible for inclusion if they completed baseline assessment and consent forms and either attended teaching on the first day of the semester or gave reasons for their absence on the first day in advance. Interventions One intervention was based on computer-assisted, self-directed learning (self-directed intervention), whilst the other was organised as workshops based on social learning theory (directed intervention). Both educational interventions consisted of 5 half-day sessions.


METHODS
The primary outcomes were knowledge about EBM and skills in critical appraisal. A secondary outcome measured attitudes to EBM. Outcomes were compared on an intention-to-treat basis using a stratified Wilcoxon rank-sum test.


RESULTS
There were no differences in outcomes for the 2 study groups in terms of EBM knowledge (mean deviation 0.0 [95% confidence interval - 1.0, 1.0], P = 0.8), critical appraisal skills (MD 0.1 [95% CI - 0.9, 1.1], P = 0.5), or attitudes to EBM (MD - 0.3 [95% CI - 1.4, 0.8], P = 0.5). Follow-up rates were 96%, 97% and 63%, respectively.


CONCLUSIONS
This trial and its accompanying qualitative evaluation suggest that self-directed, computer-assisted learning may be an alternative format for teaching EBM. However, further research is needed to confirm this and investigate alternative educational models.
Bradley
Peter
P
Norwegian Medicines Agency, Oslo, Norway. peter.bradley@suffolkwest-pct.nhs.uk
Oterholt
Christina
C
Herrin
Jeph
J
Nordheim
Lena
L
Bjørndal
Arild
A
D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D002983:Clinical Competence / Q000592:standards; D004504:Education, Medical, Undergraduate / Q000379:methods*; D019317:Evidence-Based Medicine / Q000193:education*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011380:Programmed Instructions as Topic; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D013663:Teaching / Q000379:methods*