Background: To evaluate the educational effects of a clinically integrated e-learning course for teaching basic evidence-based medicine (EBM) among postgraduates compared to a traditional lecture-based course of equivalent content.

SummaryAim To evaluate the educational effectiveness of a clinically integrated e-learning course for teaching basic evidence-based medicine (EBM) among postgraduate medical trainees compared to a traditional lecture-based course of equivalent content.Methods We conducted a cluster randomized controlled trial to compare a clinically integrated e-learning EBM course (intervention) to a lecture-based course (control) among postgraduate trainees at foundation or internship level in seven teaching hospitals in the UK West Midlands region. Knowledge gain among participants was measured with a validated instrument using multiple choice questions. Change in knowledge was compared between 288 groups taking into account the cluster design and adjusted for covariates at baseline using generalized estimating equations (GEE) model. DECLARATIONS Competing interests None declared Funding ResultsThere were seven clusters involving teaching of 237 trainees (122 in the intervention and 115 in the control group). The total number of postgraduate trainees who completed the course was 88 in the intervention group and 72 in the control group. After adjusting for baseline knowledge, there was no difference in the amount of improvement in knowledge of EBM between the two groups. The adjusted post course difference between the intervention group and the control group was only 0.1 scoring points (95% CI −1.2-1.4).Conclusion An e-learning course in EBM was as effective in improving knowledge as a standard lecture-based course. The benefits of an e-learning approach need to be considered when planning EBM curricula as it allows standardization of teaching materials and is a potential cost-effective alternative to standard lecture-based teaching. AimAcquiring knowledge, skills and attitudes to practice evidence-based medicine (EBM) is a core competence for all junior doctors.1 For EBM teaching and learning to be effective it should be clinically integrated.2 However, the majority of teaching of EBM and critical appraisal takes place in the classroom away from a clinical setting. Integrating EBM teaching into a clinical setting is not a straightforward task and risks distracting from service delivery as it can be time-consuming. The pool of teachers trained in providing face-to-face teaching on the foot is limited. 3To address the lack of time and capacity to deliver EBM teaching on the go, we developed an e-learning EBM course for just-in-time learning through on-thejob training for postgraduate medical trainees.4,5 Its feasibility was piloted in different languages and settings across five European countries in a before-andafter study. It showed that knowledge improved significantly and both trainees and tutors found the e-learning course acceptable.5 How would such a course fare against delivery of equivalent content in the traditional lecture mode during foundation (internship) training? We determined the effect of the e-EBM course on participant's knowledge of EBM in a randomized controlled trial. Methods DesignWe conducted a cluster r...

Background: We developed and evaluated the outcomes of an e-learning course for evidence based medicine (EBM) training in postgraduate medical education in different languages and settings across five European countries.

Role playing and interaction with real patients are equally efficient and both more powerful learning tools than web-based learning with or without a lecture.

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