Harmonising evidence-based medicine teaching: a study of the outcomes of e-learning in five European countries.
BACKGROUND
We developed and evaluated the outcomes of an e-learning course for evidence based medicine (EBM) training in postgraduate medical education in different languages and settings across five European countries.


METHODS
We measured changes in knowledge and attitudes with well-developed assessment tools before and after administration of the course. The course consisted of five e-learning modules covering acquisition (formulating a question and search of the literature), appraisal, application and implementation of findings from systematic reviews of therapeutic interventions, each with interactive audio-visual learning materials of 15 to 20 minutes duration. The modules were prepared in English, Spanish, German and Hungarian. The course was delivered to 101 students from different specialties in Germany (psychiatrists), Hungary (mixture of specialties), Spain (general medical practitioners), Switzerland (obstetricians-gynaecologists) and the UK (obstetricians-gynaecologists). We analysed changes in scores across modules and countries.


RESULTS
On average across all countries, knowledge scores significantly improved from pre- to post-course for all five modules (p < 0.001). The improvements in scores were on average 1.87 points (14% of total score) for module 1, 1.81 points (26% of total score) for module 2, 1.9 points (11% of total score) for module 3, 1.9 points (12% of total score) for module 4 and 1.14 points (14% of total score) for module 5. In the country specific analysis, knowledge gain was not significant for module 4 in Spain, Switzerland and the UK, for module 3 in Spain and Switzerland and for module 2 in Spain. Compared to pre-course assessment, after completing the course participants felt more confident that they can assess research evidence and that the healthcare system in their country should have its own programme of research about clinical effectiveness.


CONCLUSIONS
E-learning in EBM can be harmonised for effective teaching and learning in different languages, educational settings and clinical specialties, paving the way for development of an international e-EBM course.
Kulier
Regina
R
The University of Birmingham, Edgbaston, Birmingham B15 2TG, UK. r.kulier@bham.ac.uk
Hadley
Julie
J
Weinbrenner
Susanne
S
Meyerrose
Berrit
B
Decsi
Tamas
T
Horvath
Andrea R
AR
Nagy
Eva
E
Emparanza
Jose I
JI
Coppus
Sjors F P J
SF
Arvanitis
Theodoros N
TN
Burls
Amanda
A
Cabello
Juan B
JB
Kaczor
Marcin
M
Zanrei
Gianni
G
Pierer
Karen
K
Stawiarz
Katarzyna
K
Kunz
Regina
R
Mol
Ben W J
BW
Khan
Khalid S
KS
D000328:Adult; D001291:Attitude of Health Personnel; D003194:Computer-Assisted Instruction / Q000379:methods*; D003258:Consumer Behavior; D003431:Cross-Cultural Comparison; D020375:Education, Distance / Q000379:methods*; D004501:Education, Medical; D004503:Education, Medical, Graduate / Q000379:methods*; D004521:Educational Measurement; D005060:Europe; D019317:Evidence-Based Medicine / Q000193:education*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008875:Middle Aged; D015397:Program Evaluation; D013038:Specialization; D011795:Surveys and Questionnaires