Introduction of a Novel Evidence-Based Medicine Curriculum in Emergency Medicine
Evidence-based medicine (EBM) has become the quintessential goal of clinical decision-making. The study objective is to determine if a novel interactive EBM curriculum will improve resident physician EBM comprehension, assessed via a common EBM evaluation instrument, the Berlin Questionnaire (BQ).
The BQ was administered to all residents at the start of the academic year and again following completion of the 12-month study period and EBM curriculum. The curriculum was designed based on readings from the JAMA Users’ Guides to the Medical Literature coupled with real-world, specialty-specific articles that reflect the major topic of each chapter of the text and was utilized to supplement the Emergency Medicine (EM) residency’s monthly “journal club.” Descriptive statistics, examination of self-evaluation, and analysis of test results were evaluated.
Fifty-four EM residents completed the course. Wilcoxon signed-rank testing revealed a significant difference between pre- and post-intervention scores: [Z = − 3.114, p = 0.002], [Z = −3.327, p = 0.001] for post-graduate year (PGY)1 and PGY2, respectively. PGY3 had a borderline significant difference pre to post with [Z = − 1.693, p = 0.05], and PGY4 had a non-significant difference with [Z = − 1.769, 0.77]. Kruskal-Wallis H testing confirmed a significant difference between PGY pre-intervention scores with χ2(3) = 13.957, p = 0.003. A pairwise comparison of PGYs demonstrated a significant difference between the pre-intervention scores of PGY4s compared to PGY1s (p = 0.006) and PGY2s (p = 0.015). There was no significant difference between other PGYs. Kruskal-Wallis H testing comparing post-intervention scores demonstrated no significant difference between PGYs with χ2(3) = 0.575, p = 0.902.
The post-intervention difference in PGY1, PGY2, and PGY3 BQ scores suggests improved knowledge after new EBM curriculum. Significant difference between pre-intervention scores of PGY1 or PGY2 when compared to PGY4 suggests that capacity to learn EBM is dependent on the training year. A clustering of high scores among all years post-intervention suggests that the EBM course improved PGY1 and PGY2 to PGY4 level over the course of 12 months.
KeywordsCurriculum Evidence based medicine Journal club
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
- 1.Guyatt G, Cairns J, Churchill D, et al. Evidence-based medicine. A new approach to teaching the practice of medicine. JAMA. 1992;268(17):2420–5.Google Scholar
- 7.Kunz R, Wegscheider K, Fritsche L, et al. Determinants of knowledge gain in evidence-based medicine short courses: an international assessment. Open Med. 2010;4(1):e3–e10.Google Scholar
- 12.Accreditation Council for Graduate Medical Education Common Program Requirements. 2011; http://www.acgme.org/acgmeweb/Portals/0/dh_dutyhoursCommonPR07012007.pdf. Accessed November 15, 2013.
- 22.Guyatt G, Rennie D, Evidence-Based Medicine Working Group., American Medical Association. Users' guides to the medical literature : a manual for evidence-based clinical practice. Chicago: AMA Press; 2002.Google Scholar