In this theme issue we ask how the evolution of evidence based medicine (EBM) has made a difference to the way we practice medicine and whether it has improved care for patients. So what is the evidence so far? The material we have collected shows that the answer is not straightforward, and it is still early days to be definitive about the success of the EBM movement. However, we hope this issue will fuel the debate by reflecting on the progress that has been made in practising and teaching EBM over the last 10 years and by drawing attention to those areas with which we continue to struggle.

EBM is now an integral part of many undergraduate, postgraduate, and continuing education activities.1^–4 Coomarasamy and Khan identified 23 studies of educational interventions involving EBM in the postgraduate environment and found that clinically integrated teaching improved knowledge, skills, attitudes, and self reported behaviours (p 1017).2 …