BMJ  2004;329:1032 (30 October), doi:10.1136/bmj.329.7473.1032

Commentary

A conceptual framework may be of limited value

¹ Department of clinical epidemiology and biostatistics, McMaster University, Hamilton, Canada norman@mcmaster.ca

The first 150 words of the full text of this article appear below.

Straus et al provide a conceptual framework for evaluation of strategies for teaching evidence based medicine (EBM).¹ They correctly state that there is little evidence of effectiveness of teaching EBM, a deficiency frequently identified by critics.^{2 3} The authors' assumption is that provision of a conceptual framework will lead to better studies. But will it? Is it really the case that a conceptual framework leads naturally to well designed studies? If so, this represents a reorientation of the first author, who previously stated that "no investigative team has yet overcome the problems of sample size, contamination and blinding that such a trial raises,"³ which puts the problem squarely in the court of methodology. And I think she is at least partially right.⁴ It is well nigh impossible to conceive of an effective educational intervention where the teachers were standardised and participants were blinded, hence unaware that they had received the intervention.

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Evaluating the teaching of evidence based medicine: conceptual framework

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