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Thirty years of teaching evidence-based medicine: have we been getting it all wrong?

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Abstract

Evidence based medicine (EBM) has been synonymous to delivery of quality care for almost thirty years. Since the movement’s inception, the assumption has been that decisions based on high quality evidence would translate to better care for patients. Despite EBM’s many attractive features and the substantive attention it has received in the contemporary clinical and medical education literature, how it is defined and operationalized as a component of training is often unclear and problematic. How to practice EBM is not well articulated in the literature; therefore, it becomes difficult to teach and equally challenging to assess. In this paper, we put forward a call for deeper consideration of how EBM is taught, and for clarification on how it is defined and operationalized in medical education. In preparing this paper, we considered questions such as what it means to practice EBM, the role that medical education plays in helping realize EBM, how the teaching of EBM can change to reflect recent developments in clinical practice and education, and whether transformations in the practice of medicine necessitate a change in how we teach EBM. We end with four avenues that may be pursued to advance the teaching of EBM in medical education: (1) consensus on what we mean by EBM; (2) clear articulation of EBM-associated competencies; (3) empirically and theoretically supported means of promoting EBM competencies; (4) ways to assess both skill acquisition and use of EBM. We discuss implications for educators of EBM.

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Authors and Affiliations

  1. School of Physical and Occupational Therapy and Institute of Health Sciences Education, Faculty of Medicine and Health Sciences, McGill University and Centre for Interdisciplinary Research in Rehabilitation (CRIR), 3654 Promenade Sir William Osler, Montreal, QC, H3G-1Y5, Canada

    Aliki Thomas

  2. Division of Hematology, Department of Medicine and Rotman Institute of Philosophy, Western University, London, ON, Canada

    Benjamin Chin-Yee

  3. Department of Medicine, McMaster University, Hamilton, Canada

    Mathew Mercuri

  4. Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada

    Mathew Mercuri

  5. Institute for the Future of Knowledge, University of Johannesburg, Johannesburg, South Africa

    Mathew Mercuri

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  1. Aliki Thomas
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Thomas, A., Chin-Yee, B. & Mercuri, M. Thirty years of teaching evidence-based medicine: have we been getting it all wrong?. Adv in Health Sci Educ 27, 263–276 (2022). https://doi.org/10.1007/s10459-021-10077-4

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