The effectiveness of a clinically integrated e-learning course in evidence-based medicine: A cluster randomised controlled trial

BACKGROUND: To evaluate the educational effects of a clinically integrated e-learning course for teaching basic evidence-based medicine (EBM) among postgraduates compared to a traditional lecture-based course of equivalent content. METHODS: We conducted a cluster randomised controlled trial in the Netherlands and the UK involving postgraduate trainees in six obstetrics and gynaecology departments. Outcomes (knowledge gain and change in attitude towards EBM) were compared between the clinically integrated e-learning course (intervention) and the traditional lecture based course (control). We measured change from pre- to post-intervention scores using a validated questionnaire assessing knowledge (primary outcome) and attitudes (secondary outcome). RESULTS: There were six clusters involving teaching of 61 postgraduate trainees (28 in the intervention and 33 in the control group). The intervention group achieved slightly higher scores for knowledge gain compared to the control, but these results were not statistically significant (difference in knowledge gain: 3.5 points, 95% CI -2.7 to 9.8, p = 0.27). The attitudinal changes were similar for both groups. CONCLUSION: A clinically integrated e-learning course was at least as effective as a traditional lecture based course and was well accepted. Being less costly than traditional teaching and allowing for more independent learning through materials that can be easily updated, there is a place for incorporating e-learning into postgraduate EBM curricula that offer on-the-job training for just-in-time learning. TRIAL REGISTRATION: Trial registration number: ACTRN12609000022268

Effectiveness of an e-learning course in evidence-based medicine for foundation (internship) training

Aim To evaluate the educational effectiveness of a clinically integrated e-learning course for teaching basic evidence-based medicine (EBM) among postgraduate medical trainees compared to a traditional lecture-based course of equivalent content. Methods We conducted a cluster randomized controlled trial to compare a clinically integrated e-learning EBM course (intervention) to a lecture-based course (control) among postgraduate trainees at foundation or internship level in seven teaching hospitals in the UK West Midlands region. Knowledge gain among participants was measured with a validated instrument using multiple choice questions. Change in knowledge was compared between groups taking into account the cluster design and adjusted for covariates at baseline using generalized estimating equations (GEE) model. Results There were seven clusters involving teaching of 237 trainees (122 in the intervention and 115 in the control group). The total number of postgraduate trainees who completed the course was 88 in the intervention group and 72 in the control group. After adjusting for baseline knowledge, there was no difference in the amount of improvement in knowledge of EBM between the two groups. The adjusted post course difference between the intervention group and the control group was only 0.1 scoring points (95% CI −1.2–1.4). Conclusion An e-learning course in EBM was as effective in improving knowledge as a standard lecture-based course. The benefits of an e-learning approach need to be considered when planning EBM curricula as it allows standardization of teaching materials and is a potential cost-effective alternative to standard lecture-based teaching

Harmonising Evidence-based medicine teaching: a study of the outcomes of e-learning in five European countries-2

Support self-directed learning: a) a person is talking to the learner; b) the learner can follow the presentation by reading the notes; c) the slide summarises the core content of the presentation; it may contain hyperlinks to other topics in the same module; d) the sidebar provides orientation to the learner about the content of the lecture; e) the bottom bar allows the learner to pause, or quickly navigate forth and back.<p><b>Copyright information:</b></p><p>Taken from "Harmonising Evidence-based medicine teaching: a study of the outcomes of e-learning in five European countries"</p><p>http://www.biomedcentral.com/1472-6920/8/27</p><p>BMC Medical Education 2008;8():27-27.</p><p>Published online 29 Apr 2008</p><p>PMCID:PMC2386125.</p><p></p

Harmonising Evidence-based medicine teaching: a study of the outcomes of e-learning in five European countries-0

Support self-directed learning: a) a person is talking to the learner; b) the learner can follow the presentation by reading the notes; c) the slide summarises the core content of the presentation; it may contain hyperlinks to other topics in the same module; d) the sidebar provides orientation to the learner about the content of the lecture; e) the bottom bar allows the learner to pause, or quickly navigate forth and back.<p><b>Copyright information:</b></p><p>Taken from "Harmonising Evidence-based medicine teaching: a study of the outcomes of e-learning in five European countries"</p><p>http://www.biomedcentral.com/1472-6920/8/27</p><p>BMC Medical Education 2008;8():27-27.</p><p>Published online 29 Apr 2008</p><p>PMCID:PMC2386125.</p><p></p

Harmonising Evidence-based medicine teaching: a study of the outcomes of e-learning in five European countries-1

N (C) Evidence-based decision making is ' health care by numbers' (D) Contracts for health care professionals should include time taken away from patient care for reading and appraising the literature (E) I am confident that I can assess research evidence (F) Systematic reviews play a key role in informing evidence-based decision making (G) The health care system in my country should have its own programme of research about clinical effectiveness. Attitudinal gains were significant for questions E (p = 0.000) and G (p = 0.007) only; 41% and 32% of participants showed an attitudinal gain in questions E and G respectively (see methods section for details)<p><b>Copyright information:</b></p><p>Taken from "Harmonising Evidence-based medicine teaching: a study of the outcomes of e-learning in five European countries"</p><p>http://www.biomedcentral.com/1472-6920/8/27</p><p>BMC Medical Education 2008;8():27-27.</p><p>Published online 29 Apr 2008</p><p>PMCID:PMC2386125.</p><p></p