Teaching evidence based medicine is difficult!. Yes, it is. One can speculate that teaching evidence based medicine requires understanding of difficult concepts, as opposed to content knowledge. If teaching evidence based medicine is not based on actual clinical cases then such understanding is often perceived as superfluous to clinical care, making trainees more resistant and impervious to acquiring knowledge and even more resistant to change practice.
A published systematic review (1) compared standalone teaching versus clinically integrated teaching in postgraduate settings. There were only 2 RCTs and the review concluded that standalone teaching improves knowledge, but has no effects on skills, attitudes, or practice. Whereas clinically integrated teaching improved knowledge, skills, attitudes, and practice.
Although the review has some limitations and the evidence remains insufficient, it is prudent to support the recommendation of moving EBM-teaching from the classroom to clinical practice. Clinical leaders who are advocates of evidence based practice can have a paramount impact on translating best evidence into practice.
- Coomarasamy, A. and K.S. Khan, What is the evidence that postgraduate teaching in evidence based medicine changes anything? A systematic review. Vol. 329. 2004. 1017.