title: Evaluation of a workshop on evidence-based medicine for social insurance physicians.
abstract: BACKGROUND
  Evidence-based medicine (EBM), a comprehensive method to support clinical decision making by using evidence, has been instrumental in clinical specialties but not yet in insurance medicine.
  
  
  OBJECTIVE
  We developed and evaluated a workshop on EBM for Dutch social insurance physicians who perform disability evaluations.
  
  
  METHODS
  Sixty-six social insurance physicians followed a 1-day introductory workshop that focused on teaching two EBM core skills: to ask answerable questions and to search for the best evidence. All outcomes were measured before, immediately after and 3 months after the workshop by means of self-assessment. The primary outcomes were knowledge, skills, attitude and intention to apply EBM in practice. The secondary outcomes were social influence, self-efficacy and behaviour.
  
  
  RESULTS
  Immediately after the workshop, a marked and significant improvement was seen in self-assessed skills (mean difference 4.2, 95% CI 3.7-4.6) and in self-efficacy to apply EBM (mean difference 0.7, 95% CI 0.6-0.8). For attitude, knowledge and intention, the improvements were small. Three months after the workshop, the improvements in skills (mean difference 2.3, 95% CI 1.8-2.9) and self-efficacy (mean difference 0.5, 95% CI 0.3-0.6) remained significant.
  
  
  CONCLUSIONS
  The workshop improved self-assessed EBM skills and self-efficacy both in the short and long term. The workshop also resulted in limited short-term improvements in self-assessed knowledge and in the intention to apply EBM in practice. The EBM approach can be successfully taught to social insurance physicians working in the field of disability evaluation.
authors.affiliation: Research Center for Insurance Medicine AMC-UWV-VUmc, Amsterdam, The Netherlands. r.kok@amc.uva.nl
authors.forename: Rob
authors.initials: R
authors.lastname: Kok
authors.forename: Jan L
authors.initials: JL
authors.lastname: Hoving
authors.forename: Jos H
authors.initials: JH
authors.lastname: Verbeek
authors.forename: Frederieke G
authors.initials: FG
authors.lastname: Schaafsma
authors.forename: Paul B A
authors.initials: PB
authors.lastname: Smits
authors.forename: Frank J H
authors.initials: FJ
authors.lastname: van Dijk
mesh_terms: D002983:Clinical Competence; D003657:Decision Making; D004185:Disability Evaluation; D004502:Education, Medical, Continuing / Q000379:methods*; D019317:Evidence-Based Medicine / Q000193:education*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D009787:Occupational Medicine / Q000193:education*; D020377:Self Efficacy; D012943:Social Security