Skip to main content
SpringerLink
Log in

Teaching Evidence-Based Psychiatry: Integrating and Aligning the Formal and Hidden Curricula

  • Original Article
  • Published:
Academic Psychiatry Aims and scope Submit manuscript

Abstract

Objective

The authors argue that adopting evidence-based psychiatry will require a paradigm shift in the training of psychiatry residents, and offer some suggestions for how this transformation might be achieved.

Methods

The authors review the growing literature that addresses how best to teach evidence-based medicine and highlight several examples of innovative instructional and assessment methods.

Results

Little is known about how best to instill among residents the attitudes, knowledge, skills, and behaviors that are necessary to practice evidence-based psychiatry. However there are indications that the integration of evidence-based medicine instruction into routine clinical care and the alignment of the “hidden curriculum” with evidence-based practice are important.

Conclusion

A whole-program approach may be necessary to create the conditions required in postgraduate training to produce evidence-based psychiatrists.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Sackett DL, Rosenberg WM, Gray JA, et al: Evidence-based medicine: what it is and what it isn’t. BMJ 1996; 312: 71–72

    Article  CAS  PubMed  Google Scholar 

  2. Straus SE, McAlister FA: Evidence-based medicine: a commentary on common criticisms. CMAJ 2000; 163: 837–841

    CAS  PubMed Central  PubMed  Google Scholar 

  3. Hafferty FW, Franks R: The hidden curriculum, ethics teaching, and the structure of medical education. Acad Med 1994; 69: 861–871

    Article  CAS  PubMed  Google Scholar 

  4. Lempp H, Seale C: The hidden curriculum in undergraduate medical education: qualitative study of medical students’ perceptions of teaching. BMJ 2004; 329: 770–773

    Article  PubMed  Google Scholar 

  5. Alguire PC: A review of journal clubs in postgraduate medical education. J Gen Intern Med 1998; 13: 347–353

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  6. Coomarasamy A, Khan KS: What is the evidence that postgraduate teaching in evidence-based medicine changes anything? A systematic review. BMJ 2004; 329: 1017

    Article  PubMed  Google Scholar 

  7. Coomarasamy A, Taylor R, Khan KS: A systematic review of postgraduate teaching in evidence-based medicine and critical appraisal. Med Teach 2003; 25: 77–81

    Article  PubMed  Google Scholar 

  8. Ebbert JO, Montori VM, Schultz HJ: The journal club in postgraduate medical education: a systematic review. Med Teach 2001; 23: 455–461

    CAS  PubMed  Google Scholar 

  9. Green ML: Graduate medical education training in clinical epidemiology, critical appraisal, and evidence-based medicine: a critical review of curricula. Acad Med 1999; 74: 686–694

    Article  CAS  PubMed  Google Scholar 

  10. Norman GR, Shannon SI: Effectiveness of instruction in critical appraisal (evidence-based medicine) skills: a critical appraisal. CMAJ 1998; 158: 177–181

    CAS  PubMed Central  PubMed  Google Scholar 

  11. Parkes J, Hyde C, Deeks J, et al: Teaching critical appraisal skills in health care settings. Cochrane Database Syst Rev 2001; 3: CD001270

    PubMed  Google Scholar 

  12. Taylor R, Reeves B, Ewings P, et al: A systematic review of the effectiveness of critical appraisal skills training for clinicians. Med Educ 2000; 34: 120–125

    Article  CAS  PubMed  Google Scholar 

  13. Fu C, Hodges B, Regehr G, et al: Is a journal club effective for teaching critical appraisal skills? A controlled trial with residents in psychiatry. Acad Psychiatry 1999; 23: 205–209

    Google Scholar 

  14. Bradley P, Nordheim L, De La Harpe D, et al: A systematic review of qualitative literature on educational interventions for evidence-based practice. Learning in Health and Social Care 2005; 4: 89–109

    Article  Google Scholar 

  15. Hatala R, Guyatt G: Evaluating the teaching of evidence-based medicine. JAMA 2002; 288: 1110–1112

    Article  PubMed  Google Scholar 

  16. Mazmanian P, Davis D: Continuing medical education and the physician as learner: guide to the evidence. JAMA 2002; 288: 1057–1060

    Article  PubMed  Google Scholar 

  17. Fixsen DL, Naoom SF, Blase KA, et al: Implementation research: a synthesis of the literature. Tampa, Fla, University of South Florida, Louis de la Parte Florida Mental Health Institute, National Implementation Research Network, 2005

    Google Scholar 

  18. Hatala R, Keitz SA, Wilson MC, et al: Beyond journal clubs: moving toward an integrated evidence-based medicine curriculum. J Gen Intern Med 2006; 21: 538–541

    Article  PubMed Central  PubMed  Google Scholar 

  19. Green ML, Ciampi MA, Ellis PJ: Residents’ medical information needs in clinic: are they being met? Am J Med 2000; 109: 218–223

    Article  CAS  PubMed  Google Scholar 

  20. Green ML, Ruff TR: Why do residents fail to answer their clinical questions? A qualitative study of barriers to practicing evidence-based medicine. Acad Med 2005; 80: 176–182

    Article  PubMed  Google Scholar 

  21. Richardson WS: Teaching evidence-based practice on foot. ACP J Club 2005; 143: A10–12

    PubMed  Google Scholar 

  22. Straus SE: Evidence-based medicine: how to practice and teach EBM, 3rd ed. Edinburgh; New York, Elsevier/Churchill Livingstone, 2005

    Google Scholar 

  23. Fung MF, Walker M, Fung KF, et al: An internet-based learning portfolio in resident education: the KOALA multicentre programme. Med Educ 2000; 34: 474–479

    Article  CAS  PubMed  Google Scholar 

  24. Crowley SD, Owens TA, Schardt CM, et al: A web-based compendium of clinical questions and medical evidence to educate internal medicine residents. Acad Med 2003; 78: 270–274

    Article  PubMed  Google Scholar 

  25. Kallen AJ, Wilson CT, Russell MA, et al: Group writing of letters to the editor as the goal of journal club. JAMA 2006; 296: 1053–1054

    Article  CAS  PubMed  Google Scholar 

  26. Shaneyfelt T, Baum KD, Bell D, et al: Instruments for evaluating education in evidence-based practice: a systematic review. JAMA 2006; 296: 1116–1127

    Article  CAS  PubMed  Google Scholar 

  27. Ramos KD, Schafer S, Tracz SM: Validation of the Fresno test of competence in evidence based medicine. BMJ 2003; 326: 319–321

    Article  PubMed  Google Scholar 

  28. Fritsche L, Greenhalgh T, Falck-Ytter Y, et al: Do short courses in evidence-based medicine improve knowledge and skills? Validation of Berlin questionnaire and before and after study of courses in evidence-based medicine. BMJ 2002; 325: 1338–1341

    Article  CAS  PubMed  Google Scholar 

  29. Davidson RA, Duerson M, Romrell L, et al: Evaluating evidence-based medicine skills during a performance-based examination. Acad Med 2004; 79: 272–275

    Article  PubMed  Google Scholar 

  30. Institute of Medicine (U.S.). Committee on Crossing the Quality Chasm: Adaptation to Mental Health and Addictive Disorders. Improving the quality of health care for mental and substance-use conditions. Washington, DC, National Academies Press, 2006

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Psychiatry and Behavioural Neurosciences, McMaster University, 2757 King Street East, Hamilton, Ontario, L8G 5E4, Canada

    Sacha Agrawal M.D., Peter Szatmari M.D., M.Sc. & Mark Hanson M.D., M.Ed.

Authors
  1. Sacha Agrawal M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Peter Szatmari M.D., M.Sc.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mark Hanson M.D., M.Ed.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sacha Agrawal M.D..

Additional information

The authors thank Karen Saperson, Allyn Walsh, Robert Zipursky, and the anonymous reviewers for their helpful comments.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Agrawal, S., Szatmari, P. & Hanson, M. Teaching Evidence-Based Psychiatry: Integrating and Aligning the Formal and Hidden Curricula. Acad Psychiatry 32, 470–474 (2008). https://doi.org/10.1176/appi.ap.32.6.470

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1176/appi.ap.32.6.470

Keywords

Search

Navigation