Li Ka Shing Faculty of Medicine, School of Public Health, The University of Hong Kong, Pokfulam, Hong Kong, PR China.
BMC Med Educ. 2009 Sep 29;9:63. doi: 10.1186/1472-6920-9-63.
As the overall evidence for the effectiveness of teaching of evidence based medicine (EBM) is not strong, and the impact of cultural and societal influences on teaching method is poorly understood, we undertook a randomised-controlled trial to test the effectiveness and learning satisfaction with two different EBM teaching methods (usual teaching vs. problem based learning (PBL)) for undergraduate medical students.
A mixed methods study that included a randomised-controlled crossover trial with two intervention arms (usual teaching and PBL) and a nested qualitative study with focus groups to explore student perceptions of learning and to assess the effectiveness and utility of the two teaching methods.All 129 second-year medical students at the University of Hong Kong in 2007.The main outcomes measures were attitudes towards EBM; personal application and current use of EBM; EBM knowledge; future use of EBM.
PBL was less effective at imparting knowledge than usual teaching consisting of a lecture followed by a group tutorial. After usual teaching students showed improvement in scores for 'attitudes towards EBM', 'personal application and current use of EBM' and 'EBM knowledge, which were not evident after PBL. In contrast to the usual teaching, students found PBL difficult as they lacked the statistical knowledge necessary to support discussion, failed to understand core concepts, and lost direction.
The evidence presented here would suggest that the teaching of EBM within an Asian environment should adopt a format that facilitates both the acquisition of knowledge and encourages enquiry.
由于循证医学（EBM）教学效果的整体证据并不强，且文化和社会影响对教学方法的影响也知之甚少，我们进行了一项随机对照试验，以测试两种不同的循证医学教学方法（常规教学与基于问题的学习（PBL））对本科医学生的有效性和学习满意度。
这是一项混合方法研究，包括一项随机对照交叉试验，有两个干预组（常规教学和 PBL），以及一项嵌套的焦点小组定性研究，以探索学生的学习感知，并评估两种教学方法的有效性和实用性。2007 年，香港大学的 129 名二年级医学生参加了这项研究。主要结局指标是对 EBM 的态度；个人应用和当前 EBM 的使用；EBM 知识；未来 EBM 的使用。
PBL 在传授知识方面不如常规教学有效，常规教学包括讲座和小组辅导。在常规教学后，学生在“对 EBM 的态度”、“个人应用和当前 EBM 的使用”和“EBM 知识”方面的得分有所提高，而在 PBL 后则没有明显提高。与常规教学相比，学生认为 PBL 很难，因为他们缺乏支持讨论所需的统计学知识，无法理解核心概念，也迷失了方向。
这里提供的证据表明，在亚洲环境中教授 EBM 应该采用一种既能获取知识又能鼓励探究的模式。
