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.