What is the evidence that postgraduate teaching in evidence based medicine changes anything? A systematic review.

Abstract

To evaluate the effects of standalone versus clinically integrated teaching in evidence based medicine on various outcomes in postgraduates. Systematic review of randomised and non-randomised controlled trials and before and after comparison studies. Medline, Embase, ERIC, Cochrane Library, DARE, HTA database, Best Evidence, BEME, and SCI. 23 studies: four randomised trials, seven non-randomised controlled studies, and 12 before and after comparison studies. 18 studies (including two randomised trials) evaluated a standalone teaching method, and five studies (including two randomised trials) evaluated a clinically integrated teaching method. Knowledge, critical appraisal skills, attitudes, and behaviour. Standalone teaching improved knowledge but not skills, attitudes, or behaviour. Clinically integrated teaching improved knowledge, skills, attitudes, and behaviour. Teaching of evidence based medicine should be moved from classrooms to clinical practice to achieve improvements in substantial outcomes.