What Are the Effects of Teaching Evidence-Based Health Care (EBHC)? Overview of Systematic Reviews

Abstract

BackgroundAn evidence-based approach to health care is recognized internationally as a key competency for healthcare practitioners. This overview systematically evaluated and organized evidence from systematic reviews on teaching evidence-based health care (EBHC).Methods/FindingsWe searched for systematic reviews evaluating interventions for teaching EBHC to health professionals compared to no intervention or different strategies. Outcomes covered EBHC knowledge, skills, attitudes, practices and health outcomes. Comprehensive searches were conducted in April 2013. Two reviewers independently selected eligible reviews, extracted data and evaluated methodological quality. We included 16 systematic reviews, published between 1993 and 2013. There was considerable overlap across reviews. We found that 171 source studies included in the reviews related to 81 separate studies, of which 37 are in more than one review. Studies used various methodologies to evaluate educational interventions of varying content, format and duration in undergraduates, interns, residents and practicing health professionals. The evidence in the reviews showed that multifaceted, clinically integrated interventions, with assessment, led to improvements in knowledge, skills and attitudes. Interventions improved critical appraisal skills and integration of results into decisions, and improved knowledge, skills, attitudes and behaviour amongst practicing health professionals. Considering single interventions, EBHC knowledge and attitude were similar for lecture-based versus online teaching. Journal clubs appeared to increase clinical epidemiology and biostatistics knowledge and reading behavior, but not appraisal skills. EBHC courses improved appraisal skills and knowledge. Amongst practicing health professionals, interactive online courses with guided critical appraisal showed significant increase in knowledge and appraisal skills. A short workshop using problem-based approaches, compared to no intervention, increased knowledge but not appraisal skills.ConclusionsEBHC teaching and learning strategies should focus on implementing multifaceted, clinically integrated approaches with assessment. Future rigorous research should evaluate minimum components for multifaceted interventions, assessment of medium to long-term outcomes, and implementation of these interventions.

Awareness, attitudes and knowledge of evidence-based medicine: A cross-sectional baseline survey among academic healthcare practitioners in Namibia

“…EBM is a key competency for all healthcare practitioners and is highly recommended (Guyatt et al, 2000;Straus et al, 2011;Young et al, 2014). Academic healthcare professionals in higher education are also expected to have competency in EBM (Guyatt et al, 2000;Thangaratinam et al, 2009;Straus et al, 2011) to base their teachings on the best possible evidence.…”

Perspectives of undergraduate module convenors at a South African academic institution on medical student training in evidence-based health care: a qualitative study

“…6,14,15 In a similar local study among academic healthcare practitioners in South Africa, McInerney et al 16 , using quantitative methods, also identified a need to incorporate EBHC into teaching, perceived 'implicit' teaching of EBHC and found that perceived barriers to the use of EBHC included workload, competing priorities and lack of EBHC knowledge. A study among nurse educators in the United States 17 also highlighted the need for faculty development to have competent lecturers facilitating the teaching and learning of EBHC.…”

“…5 Learning EBHC is best achieved using clinically integrated teaching and learning with assessment. 6 Basic concepts successfully introduced in the first year of study 7 can be reinforced in subsequent years to form a 'golden thread' throughout the medical curriculum. Bedside student learning is particularly useful for learning how EBHC can be applied in practice, but needs point-of-care access to literature, requiring adequate information technology support.…”

Using the Smiley Faces task to teach the fundamentals for good clinical trials

“…As Young et al state; "It is been recommended that evidenced based health care (EBHC) becomes a core component of the curriculum for all healthcare professional, since learning the fundamentals of research and how to apply an evidence-based approach are essential in the implementation of EBHC and subsequently improvement in the quality of health care." (Young et al, 2014). It is known that the best options for improving EBHC knowledge, skills and attitudes, is by clinically integrating teaching and learning, although the method of delivery can vary from lecture-based to online teaching, interactive online courses to workshops, with varying degrees of success (Young et al, 2015;Young et al, 2014).…”

“…(Young et al, 2014). It is known that the best options for improving EBHC knowledge, skills and attitudes, is by clinically integrating teaching and learning, although the method of delivery can vary from lecture-based to online teaching, interactive online courses to workshops, with varying degrees of success (Young et al, 2015;Young et al, 2014). However, although clinical trials are a key part of EBHC, they take many years to complete, much longer than a student module or educational term.…”