Introducing an evidence-based medicine curriculum into a family practice residency--is it effective?

PURPOSE: To investigate whether teaching an evidence-based medicine (EBM) curriculum increased the knowledge and use of EBM principles in residents' continuity clinics.
METHOD: In 1999, the authors performed a needs assessment with residents and faculty of Cascades East Family Practice Residency in Oregon and constructed a ten-session EBM workshop series that was introduced into the curriculum in 2000. Resident-preceptor interactions during outpatient continuity clinic were tape-recorded prior to and six months following introduction of the curriculum. A 50-item, multiple-choice examination was administered before and after the workshop series. Residents at another FP residency at the same university served as a control group. The same assessments were applied to the experimental and control groups. The tape recordings were analyzed for interactions that contained key EBM phrases or words.
RESULTS: Pre-intervention multiple-choice test results were similar (control mean 56%, experimental 53%, p >.22 NS). Post-intervention test scores for the experimental group were significantly improved (mean 72%, p <.001). There was no significant improvement in test results among members of the control group (p >.05 NS). In the recorded resident-preceptor interactions, a marked increase in the use of EBM terms indicated awareness and/or use of EBM in the experimental group. In 1,165 minutes recorded prior to the workshops, EBM terms were used in a total of ten events. In 735 minutes recorded after the workshops, EBM terms were recorded in 67 events. A reduced number of EBM terms were recorded in the control group.
CONCLUSION: Administering a structured EBM curriculum increased residents' knowledge and use of EBM constructs during patient care.