A pediatrics-based instrument for assessing resident education in evidence-based practice.
OBJECTIVE
The principles of evidence-based practice (EBP) are a mandated component of the pediatric residency curriculum; however, a pediatrics-based assessment tool validated with pediatric residents does not exist.


METHODS
We designed an assessment instrument composed of items in 4 categories: 1) demographics; 2) comfort level; 3) self-reported practice of EBP; and 4) EBP knowledge. This last section required participants to identify best evidence and most appropriate study design by using pediatric-based scenarios, develop searchable questions, and use existing published research to address diagnostic and treatment issues. Four groups completed the instrument: preclinical medical students (MS-2), incoming pediatric interns (PGY-1), incoming second- and third-year pediatric residents (PGY2-3), and expert tutors (expert). We determined internal consistency, interrater reliability, content validity, item difficulty, and construct validity.


RESULTS
Fifty-six subjects completed tests (MS-2, n = 13; PGY-1, n = 13; PGY2-3, n = 22; expert, n = 8). Internal reliability was good, with Cronbach's alpha = .80. Interrater reliability was high (kappa = 0.94). Items were free of floor or ceiling effects. Comfort level and self-reported practice of EBP increased with expertise level and prior EBP experience (P < .01). Scores on the knowledge section (out of 50 +/- SD) rose with training level (MS-2: 14.8 +/- 5.7; PGY-1: 22.2 +/- 3.4; PGY2-3: 31.7 +/- 6.1; experts: 43 +/- 4.0; P < .01). Scores also correlated with prior EBP education.


CONCLUSIONS
We have developed a reliable and valid instrument to assess knowledge and skill in EBP taught to pediatric residents. This instrument can aid pediatric educators in monitoring the impact of the EBP curriculum.
Department of Pediatrics, Division of Pediatric Emergency Medicine, Columbia University, New York, NY 10032, USA.
Lauren
L
Chernick
Martin
M
Pusic
Heather
H
Liu
Hector
H
Vazquez
Maria
M
Kwok
D000328:Adult; D002983:Clinical Competence; D019317:Evidence-Based Medicine / Q000193:education*; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008297:Male; D010372:Pediatrics / Q000193:education*; D015203:Reproducibility of Results; D012655:Self-Evaluation Programs