Evaluation of a workshop on evidence-based medicine for social insurance physicians.
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.
Kok
Rob
R
Research Center for Insurance Medicine AMC-UWV-VUmc, Amsterdam, The Netherlands. r.kok@amc.uva.nl
Hoving
Jan L
JL
Verbeek
Jos H
JH
Schaafsma
Frederieke G
FG
Smits
Paul B A
PB
van Dijk
Frank J H
FJ
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