Letters

Value of educational visits in obstetrics

BMJ 1999; 318 doi: http://dx.doi.org/10.1136/bmj.318.7191.1143c (Published 24 April 1999) Cite this as: BMJ 1999;318:1143

Randomised controlled trial was unsuitable evaluation

  1. Jane Pannikar, Specialist registrar ([email protected]),
  2. Andrew Farkas, Consultant
  1. Department of Obstetrics and Gynaecology, Jessop Hospital for Women, Sheffield S3 7RE
  2. Department of Obstetrics and Gynaecology, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP
  3. Glan Clwyd District General Hospital NHS Trust, North Wales LL18 5UJ

    EDITOR—We are not surprised by the conclusions drawn by Wyatt et al that educational visits added little to the uptake of evidence into practice.1 We question whether randomised controlled trials can be applied to studies evaluating education, which may use qualitative as well as quantitative methods.

    A controlled trial may not be the appropriate tool to reflect changes of interventions in childbirth over time. It is not possible to isolate clinicians to one educational intervention (in this case an educational visit). Practice may also change as a result of experience as well as more formal learning such as reading journals and continuing medical education. Even if a change in practice had been shown by this study, a more qualitative approach would be required to determine if the change was due to the intervention being investigated.

    The practice of evidence based medicine is the integration of individual expertise with the best available external clinical evidence from systematic research.2 Research, whether primary or review, needs to be appraised critically. Only four interventions from the …

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