Teaching evidence-based medicine to internal medicine residents: the efficacy of conferences versus small-group discussion.

BACKGROUND

Evidence-based medicine (EBM) is a required component of the Accreditation Council for Graduate Medical Education's Practice-Based Learning core competency.

PURPOSE

To compare the efficacy of conferences and small-group discussions in enhancing EBM competency.

METHODS

EBM conferences and small-group discussions were integrated into an internal medicine curriculum. EBM competency was assessed by written examination following participation in both groups and compared with residents who had not participated in either format.

RESULTS

Small-group discussion participants (n = 10) scored higher on an EBM exam (17.8 +/- 4.5 correct out of 25) when compared with 10 conference participants (12.2 +/- 4.6, p = .010) and 26 residents who did not participate in either format (12.0 +/- 4.5, p = .002). Small-group discussion participants also reported increased confidence and high satisfaction.

CONCLUSIONS

Although more resource intensive, small-group discussions resulted in increased EBM knowledge, increased confidence with critical appraisal skills, and high satisfaction compared with a conference-based format.