Does evidence-based medicine training improve doctors' knowledge, practice and patient outcomes? A systematic review

21 October, 2018

Unfortunately the full text of this paper is restricted access and the authors do not appear to have taken advantage of the publisher's permission to self-archive. Medical Teacher is a Romeo Green journal (author can archive post-print (ie final draft post-refereeing). http://www.sherpa.ac.uk/romeo/search.php

CITATION: Simons MR, Zurynski Y, Cullis J, Morgan MK, Davidson AS. Does evidence-based medicine training improve doctors' knowledge, practice and patient outcomes? A systematic review of the evidence.

Med Teach. 2018 Oct 17:1-7. doi: 10.1080/0142159X.2018.1503646.

ABSTRACT: Courses in Evidence-Based Medicine (EBM) for doctors have consistently demonstrated short-term improvements in knowledge. However, there is no strong evidence linking EBM training to changes in clinical practice or patient outcomes. This systematic review investigates whether EBM training leads to sustained improvements in doctors' knowledge and practice behaviors that may also facilitate changes in patient outcomes and experiences. A literature search was undertaken in Ovid Medline, Ovid Embase, The Cochrane Library, ERIC and Scopus. Studies published from 1997 to 2016 that assessed outcomes of EBM educational interventions amongst doctors and used measures of knowledge, skills, attitudes, practice or patient outcomes were included. Fifteen studies were included in the analysis: four randomized controlled trials (RCTs), three non-RCTs, and eight before-after (longitudinal cohort) studies. Heterogeneity among studies prevented meaningful comparisons. Varying degrees of bias due to the use of subjective measures were identified, limiting study validity. Results showed that EBM interventions can improve short-term knowledge and skills, but there is little reliable evidence of changes in long-term knowledge, attitudes, and clinical practice. No study measured improvement in patient outcomes or experiences. EBM training for medical practitioners needs to incorporate measures of behavioral changes while incorporating patient outcomes and experience measures.

Contact: mary.simons AT mq.edu.au

Best wishes, Neil

Coordinator, HIFA Project on Access to Health Research

http://www.hifa.org/working-groups/access-health-research

Coordinator, HIFA Project on Evidence-Informed Policy and Practice

http://www.hifa.org/projects/evidence-informed-policy-and-practice

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HIFA profile: Neil Pakenham-Walsh is coordinator of the HIFA global health campaign (Healthcare Information For All - www.hifa.org ), a global community with more than 18,000 members in 177 countries, interacting on five global forums in three languages. He also currently chairs the Dgroups Foundation (www.dgroups.info), which supports 800 communities of practice on international development, health and social justice. Twitter: @hifa_org FB: facebook.com/HIFAdotORG neil@hifa.org