Impact of an evidence-based medicine curriculum on resident use of electronic resources: a randomized controlled study.

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.