title: The effect of an evidence-based medicine curriculum on breast cancer knowledge and satisfaction of surgical residents.
abstract: OBJECTIVE
  The current study was performed to determine if evidence-based medicine (EBM) curriculum would affect education of surgical residents.
  
  
  METHODS
  A 5-year prospective study was designed to determine if EBM curriculum could improve residents' satisfaction and understanding of breast cancer management during a breast surgical oncology rotation. During the first 2 years, 45 journal articles were used. During the subsequent 3 years, journal articles were not used. The proportion of patients seen in clinic was collected as an objective measure of the "effort" made by the resident. The final assessment was a 120-question examination.
  
  
  METHODS
  Maricopa Medical Center, Phoenix, AZ. Safety net institution with General Surgery residency program.
  
  
  METHODS
  Postgraduate year 2 general surgery residents.
  
  
  RESULTS
  Over 5 years, 30 postgraduate year 2 residents were involved. Univariate analysis showed that female sex (p = 0.04), residents with peer-reviewed publications (p = 0.03), younger age (p = 0.04), American Board of Surgery in-service training examination score (p = 0.01), and clinical effort (p < 0.01) were associated with higher scores. Although residents taught using the journal articles scored 7 points higher on the final examination, this was not significant (p = 0.10). Multivariate analysis showed that American Board of Surgery in-service training examination score and clinic efficiency remained statistically significant. Residents who were taught using the EBM curriculum had significantly higher satisfaction (4.4 vs 3.5, p = 0.001) compared with those who did not go through the EBM curriculum.
  
  
  CONCLUSIONS
  The current study demonstrates that an EBM curriculum significantly improved resident satisfaction with the rotation. The EBM curriculum may improve residents' breast cancer knowledge. The most important predictor of resident performance was the effort of resident.
authors: Department of Surgery, Maricopa Medical Center, Phoenix, Arizona; Arizona Cancer Center, University of Arizona, Tucson, Arizona. Electronic address: Komenaka@hotmail.com.
authors: Ian K
authors: IK
authors: Komenaka
authors: Department of Surgery, Maricopa Medical Center, Phoenix, Arizona.
authors: Meredith A
authors: MA
authors: Heberer
authors: Department of Surgery, Maricopa Medical Center, Phoenix, Arizona.
authors: Patrick J
authors: PJ
authors: O'Neill
authors: Arizona Cancer Center, University of Arizona, Tucson, Arizona; Mel and Enid Zuckerman Arizona College of Public Health, University of Arizona, Tucson, Arizona.
authors: Chiu-Hsieh
authors: CH
authors: Hsu
authors: Department of Surgery, Maricopa Medical Center, Phoenix, Arizona.
authors: Elizabeth M
authors: EM
authors: Nesset
authors: Department of Surgery, Maricopa Medical Center, Phoenix, Arizona.
authors: Ross F
authors: RF
authors: Goldberg
authors: Department of Surgery, Maricopa Medical Center, Phoenix, Arizona.
authors: Lisa M
authors: LM
authors: Winton
authors: Department of Surgery, Maricopa Medical Center, Phoenix, Arizona.
authors: Marcia E
authors: ME
authors: Bouton
authors: Department of Surgery, Maricopa Medical Center, Phoenix, Arizona.
authors: Daniel M
authors: DM
authors: Caruso
mesh_terms: D001130:Arizona; D001943:Breast Neoplasms / Q000601:surgery*; D003479:Curriculum; D004503:Education, Medical, Graduate; D004521:Educational Measurement; D019317:Evidence-Based Medicine / Q000193:education*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007396:Internship and Residency; D011446:Prospective Studies
keywords: Interpersonal and Communication Skills; Medical Knowledge; Patient Care; Practice-Based Learning and Improvement; education; evidence-based medicine; resident; satisfaction; trainee; training