Teaching evidence based medicine in surgical education; the challenges and techniques in training

Evidence Based Medicine integrates clinical expertise, best available clinical evidence, as well as patient’s values and preferences to manage the care of patients. Surgeons have traditionally performed surgery according to their mentor teachings, these techniques being passed down through several generations. Current surgeon culture must evolve to integrate EBM into their clinical practice. The knowledge and skills required for searching and appraising critical literature needs to be taught to enable surgeons to implement it effectively. Evidence based surgery (EBS) will encourage surgeons to apply the best up-to-date knowledge to find the most effective surgical management plan for their patients. Several methods of teaching EBS to surgical trainees have shown to be effective including workshops, small group discussions, lecture style teaching and courses involving a combination of techniques. Journal clubs have gained in popularity and provided excellent teaching environments for surgeons to learn critical appraisal. Recently EBM has been introduced into the undergraduate programme to provide young medical practitioners with a strong foundation in EBM competency, and a positive attitude towards applying EBM to clinical practice. In this review, we aim to provide an overview of the principles of EBM and the success and challenges of teaching methods to deliver EBM for the surgical field.