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

BMJ. 2004 Oct 30;329(7473):1017. doi: 10.1136/bmj.329.7473.1017.


Objective: To evaluate the effects of standalone versus clinically integrated teaching in evidence based medicine on various outcomes in postgraduates.

Design: Systematic review of randomised and non-randomised controlled trials and before and after comparison studies.

Data sources: Medline, Embase, ERIC, Cochrane Library, DARE, HTA database, Best Evidence, BEME, and SCI.

Study selection: 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.

Main outcome measures: Knowledge, critical appraisal skills, attitudes, and behaviour.

Results: Standalone teaching improved knowledge but not skills, attitudes, or behaviour. Clinically integrated teaching improved knowledge, skills, attitudes, and behaviour.

Conclusion: Teaching of evidence based medicine should be moved from classrooms to clinical practice to achieve improvements in substantial outcomes.

Publication types

  • Comparative Study
  • Review
  • Systematic Review

MeSH terms

  • Clinical Competence / standards
  • Controlled Clinical Trials as Topic
  • Education, Medical, Graduate / methods*
  • Education, Medical, Graduate / standards
  • Evidence-Based Medicine*
  • Health Knowledge, Attitudes, Practice
  • Randomized Controlled Trials as Topic
  • Teaching / methods*
  • Teaching / standards