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Introducing an Evidence‐based Medicine Curriculum into a Family Practice Residency—Is It Effective?

Ross, Robert MD, MScEd; Verdieck, Alex MD

Research Reports

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.

Dr. Ross is associate professor of Family Medicine at Oregon Health and Science University and Cascades East Family Practice Residency, in Klamath Falls, Oregon. At the time of this study, Dr. Verdieck was a chief resident at Oregon Health and Science University in Portland.

Correspondence and requests for reprints should be addressed to Dr. Ross, Cascades East FPR/Oregon Health Sciences University, 2801 Daggett, Klamath Falls, OR 97601; telephone: (541) 885-4612; fax: (541) 885-0328; e-mail: 〈robr@cdsnet.net〉.

© 2003 Association of American Medical Colleges