Learning needs analysis to guide teaching evidence-based medicine: knowledge and beliefs amongst trainees from various specialities

BackgroundWe undertook a needs assessment exercise using questionnaire survey of junior doctors' knowledge and beliefs concerning evidence-based medicine (EBM) and critical literature appraisal, as this is a core competence in postgraduate medical education.MethodsWe surveyed 317 junior doctors in various specialities in the UK West Midlands Deanery. Using validated questionnaires we compared the needs of different trainee groups. Results overall were internally consistent (Cronbach's alpha 0.929).ResultsRespondents' generally felt that they had poor training in EBM (Mean score 2.2, possible range 1 – 6) and that they needed more education (Mean score 5.3, possible range 1–6). Male trainees felt more confident at evaluating statistical tests than females (p = 0.002). Female trainees considered patient choice above the evidence more often than males (p = 0.038). Trainees from surgical speciality felt more confident at assessing research evidence (p = 0.009) whereas those from medical speciality felt more confident at evaluating statistical tests (p = 0.038) than other specialities. However, non-surgical specialities tended to believe that EBM had little impact on practice (p = 0.029). Respondents who had been qualified for 11 years or over felt overall more confident in their knowledge relating to EBM than those who had been qualified less than 10 years. In particular, they felt more confident at being able to assess study designs (p = < 0.001) and the general worth of research papers (p = < 0.001). Trainees with prior research experience were less likely to find original work confusing (p = 0.003) and felt more confident that they can assess research evidence (p = < 0.001) compared to those without previous research experience. Trainees without previous research experience felt that clinical judgement was more important than evidence (p = < 0.001).ConclusionThere is a perceived deficit in postgraduate doctors' EBM knowledge and critical appraisal skills. Learning needs vary according to gender, place of basic medical qualification, time since graduation, prior research experience and speciality. EBM training curricular development should take into account the findings of our needs assessment study.

[1]  R. Pierson,et al.  Physicians' attitudes toward evidence based obstetric practice: a questionnaire survey , 1998, BMJ.

[2]  Esteve Xavier Rifà Ros,et al.  FIELD, A. (2005). Discovering Statistics Using SPSS. London: SAGE Publications , 2006 .

[3]  L. Dwarakanath,et al.  Assessments in evidence-based medicine workshops: loose connection between perception of knowledge and its objective assessment , 2001, Medical teacher.

[4]  Lawrence Manion,et al.  Research Methods in Education, 7th Edition , 2011 .

[5]  R M Harden,et al.  Ten questions to ask when planning a course or curriculum , 1986, Medical education.

[6]  Godfrey Pell,et al.  Use and misuse of Likert scales , 2005, Medical education.

[7]  J. Morrison,et al.  ABC of learning and teaching in medicine: Evaluation. , 2003, BMJ.

[8]  S. Jamieson.  Likert scales: how to (ab)use them , 2004, Medical education.

[9]  T. Greenhalgh,et al.  Do short courses in evidence based medicine improve knowledge and skills? Validation of Berlin questionnaire and before and after study of courses in evidence based medicine , 2002, BMJ : British Medical Journal.

[10]  G. Guyatt,et al.  Practitioners of evidence based care , 2000, BMJ : British Medical Journal.

[11]  A. Bowling.  Research Methods in Health , 1998 .

[12]  D. Wall.  Curriculum for the foundation years in postgraduate education and training* , 2005, Medical teacher.

[13]  A. Field.  Discovering statistics using SPSS for Windows. , 2000 .

[14]  L. Cohen,et al.  Research Methods in Education , 1980 .

[15]  P. Ewings,et al.  Development and validation of a questionnaire to evaluate the effectiveness of evidence‐based practice teaching , 2001, Medical education.

[16]  Khalid S. Khan,et al.  Postgraduate obstetrics and gynaecology trainees' views and understanding of evidence-based medicine , 2000 .

[17]  P. Boynton,et al.  Administering, analysing, and reporting your questionnaire , 2004, BMJ : British Medical Journal.

[18]  Sue Ziebland,et al.  Analysing qualitative data , 2000, BMJ : British Medical Journal.