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Impact of an Evidence-Based Medicine Curriculum on Resident Use of Electronic Resources: A Randomized Controlled Study

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Abstract

Background

Evidence-based medicine (EBM) is widely taught in residency, but evidence for effectiveness of EBM teaching on changing residents’ behavior is limited.

Objective

To investigate the impact of an EBM curriculum on residents’ use of evidence-based resources in a simulated clinical experience.

Design/Participants

Fifty medicine residents randomized to an EBM teaching or control group.

Measurements

A validated test of EBM knowledge (Fresno test) was administered before and after intervention. Post intervention, residents twice completed a Web-based, multiple-choice instrument (15 items) comprised of clinical vignettes, first without then with access to electronic resources. Use of electronic resources was tracked using ProxyPlus software. Within group pre–post differences and between group post-test differences were examined.

Results

There was more improvement in EBM knowledge (100-point scale) for the intervention group compared to the control group (mean score increase 22 vs. 12, p = 0.012). In the simulated clinical experience, the most commonly accessed resources were Ovid (71% of residents accessed) and InfoPOEMs (62%) for the EBM group and UptoDate (67%) and MDConsult (58%) for the control group. Residents in the EBM group were more likely to use evidence-based resources than the control group. Performance on clinical vignettes was similar between the groups both at baseline (p = 0.19) and with access to information resources (p = 0.89).

Conclusions

EBM teaching improved EBM knowledge and increased use of evidence-based resources by residents, but did not improve performance on Web-based clinical vignettes. Future studies will need to examine impact of EBM teaching on clinical outcomes.

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Acknowledgement

We thank John Ellingsworth for developing a computerized survey to administer the clinical vignettes, Robert Cupryk for library orientation to residents, and Fengzhi Fan for his assistance with tracking residents’ Internet use. Finally, we thank the internal medicine residents for their participation in this study.

Conflicts of Interest

None disclosed.

Funding

This study was funded in part by the Division of General Internal Medicine, Robert Wood Johnson Medical School.

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Authors and Affiliations

  1. University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, NJ, USA

    Sarang Kim MD, Laura R. Willett MD, Kerry O’Rourke MLS & Ranita Sharma MD

  2. Johns Hopkins University School of Medicine, Baltimore, MD, USA

    David J. Murphy MD

  3. University of Pennsylvania School of Medicine, Philadelphia, PA, USA

    Judy A. Shea PhD

  4. Division of General Internal Medicine, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ, USA

    Sarang Kim MD

Authors
  1. Sarang Kim MD
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  2. Laura R. Willett MD
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  3. David J. Murphy MD
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  4. Kerry O’Rourke MLS
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  5. Ranita Sharma MD
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  6. Judy A. Shea PhD
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Corresponding author

Correspondence to Sarang Kim MD.

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Kim, S., Willett, L.R., Murphy, D.J. et al. Impact of an Evidence-Based Medicine Curriculum on Resident Use of Electronic Resources: A Randomized Controlled Study. J GEN INTERN MED 23, 1804–1808 (2008). https://doi.org/10.1007/s11606-008-0766-y

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  • DOI: https://doi.org/10.1007/s11606-008-0766-y

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