Education And Debate

Evaluating the teaching of evidence based medicine: conceptual framework

BMJ 2004; 329 doi: http://dx.doi.org/10.1136/bmj.329.7473.1029 (Published 28 October 2004) Cite this as: BMJ 2004;329:1029
  1. Sharon E Straus, associate professor (sharon.straus@utoronto.ca)1,
  2. Michael L Green, associate professor2,
  3. Douglas S Bell, assistant professor3,
  4. Robert Badgett, associate professor4,
  5. Dave Davis, professor5,
  6. Martha Gerrity, associate professor6,
  7. Eduardo Ortiz, associate chief of staff7,
  8. Terrence M Shaneyfelt, assistant professor8,
  9. Chad Whelan, assistant professor9,
  10. Rajesh Mangrulkar, assistant professor10

    the Society of General Internal Medicine Evidence-Based Medicine Task Force

  1. 1 Department of medicine, Toronto General Hospital, 200 Elizabeth Street, 9ES-407, Toronto, Ontario M5G 2C4, Canada
  2. 2 Department of internal medicine, Yale University School of Medicine, New Haven, CT, USA
  3. 3 Department of medicine, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
  4. 4 Department of medicine, University of Texas Health Science Centre at San Antonio, TX, USA
  5. 5 Department of health policy, management and evaluation, University of Toronto, Toronto, Canada
  6. 6 Department of medicine, Oregon Health Sciences University, Portland OR, USA
  7. 7 Washington DC VA Medical Centre, Washington, DC, USA
  8. 8 Department of medicine, VA Medical Affairs, Birmingham, AL, USA
  9. 9 Department of medicine, University of Chicago, Chicago, IL, USA
  10. 10 Department of medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
  1. Correspondence to: S E Straus

    Although evidence for the effectiveness of evidence based medicine has accumulated, there is still little evidence on what are the most effective methods of teaching it.

    Introduction

    Interest in evidence based medicine (EBM) has grown exponentially, and professional organisations and training programmes have shifted their agenda from whether to teach EBM to how to teach it. However, there is little evidence about the effectiveness of different methods,1 and this may be related to the lack of a conceptual framework within which to structure evaluation strategies. In this article we propose a potential framework for evaluating methods of teaching EBM. Showing the effectiveness of such teaching methods relies both on psychometrically strong measurements and methodologically rigorous and appropriate study designs, and our framework addresses the former.

    This effort was initiated by the Society of General Internal Medicine Evidence-Based Medicine Task Force.2 In an attempt to tackle the challenges in designing and evaluating a series of teaching workshops on EBM for busy practising clinicians, the task force created a conceptual framework for evaluating teaching methods. This was done by a working group of clinicians interested in the subject. They completed a literature review of instruments used for evaluating teaching of EBM (manuscript in preparation), and two members of the task force used the information to draft a conceptual framework. This framework and relevant background materials were discussed and revised at a consensus conference including 10 physicians interested in EBM, evaluation of education methods, or programme development. We then sent a revised framework to all members of the task force and six other international colleagues interested in the subject. We incorporated their suggestions into the framework presented in this article.

    When formulating clinical questions, advocates of EBM suggest using the “PICO” approach—defining …

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