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

A clinically integrated curriculum in Evidence-based Medicine for just-in-time learning through on-the-job training: The EU-EBM project

Background: Over the last years key stake holders in the healthcare sector have increasingly recognised evidence based medicine (EBM) as a means to improving the quality of healthcare. However, there is considerable uncertainty about the best way to disseminate basic knowledge of EBM. As a result, huge variation in EBM educational provision, setting, duration, intensity, content, and teaching methodology exists across Europe and worldwide. Most courses for health care professionals are delivered outside the work context ('stand alone') and lack adaptation to the specific needs for EBM at the learners' workplace. Courses with modern 'adaptive' EBM teaching that employ principles of effective continuing education might fill that gap. We aimed to develop a course for post-graduate education which is clinically integrated and allows maximum flexibility for teachers and learners. Methods: A group of experienced EBM teachers, clinical epidemiologists, clinicians and educationalists from institutions from eight European countries participated. We used an established methodology of curriculum development to design a clinically integrated EBM course with substantial components of e-learning. An independent European steering committee provided input into the process. Results: We defined explicit learning objectives about knowledge, skills, attitudes and behaviour for the five steps of EBM. A handbook guides facilitator and learner through five modules with clinical and e-learning components. Focussed activities and targeted assignments round off the learning process, after which each module is formally assessed. Conclusion: The course is learner-centred, problem-based, integrated with activities in the workplace and flexible. When successfully implemented, the course is designed to provide just-in-time learning through on-the-job-training, with the potential for teaching and learning to directly impact on practice. </p

A clinically integrated curriculum in Evidence-based Medicine for just-in-time learning through on-the-job training: The EU-EBM project-1

<p><b>Copyright information:</b></p><p>Taken from "A clinically integrated curriculum in Evidence-based Medicine for just-in-time learning through on-the-job training: The EU-EBM project"</p><p>http://www.biomedcentral.com/1472-6920/7/46</p><p>BMC Medical Education 2007;7():46-46.</p><p>Published online 27 Nov 2007</p><p>PMCID:PMC2228282.</p><p></p>ing: a) a person is talking to the learner; b) the learner can follow the presentation by reading the notes; c) the slide summarizes 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

A clinically integrated curriculum in Evidence-based Medicine for just-in-time learning through on-the-job training: The EU-EBM project-0

<p><b>Copyright information:</b></p><p>Taken from "A clinically integrated curriculum in Evidence-based Medicine for just-in-time learning through on-the-job training: The EU-EBM project"</p><p>http://www.biomedcentral.com/1472-6920/7/46</p><p>BMC Medical Education 2007;7():46-46.</p><p>Published online 27 Nov 2007</p><p>PMCID:PMC2228282.</p><p></p>helps in formulating targeted questions. Hereafter, the learner attends the e-learning modules and consequently completes small activities and an assignment. All five modules are collected in a portfolio. After successful completion of the course, the student will receive a course certificate

A clinically integrated curriculum in Evidence-based Medicine for just-in-time learning through on-the-job training: The EU-EBM project-2

<p><b>Copyright information:</b></p><p>Taken from "A clinically integrated curriculum in Evidence-based Medicine for just-in-time learning through on-the-job training: The EU-EBM project"</p><p>http://www.biomedcentral.com/1472-6920/7/46</p><p>BMC Medical Education 2007;7():46-46.</p><p>Published online 27 Nov 2007</p><p>PMCID:PMC2228282.</p><p></p>cational programs to student orientated, problem based learning programs. The size of the arrows in this figure indicates the magnitude of change between a traditional and the EU-EBM course

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

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

PUBLISHED VERSION The effectiveness of a clinically integrated e-learning course in evidence-based medicine: a cluster randomised controlled trial CC BY 2.0 BMC Medical Education The effectiveness of a clinically integrated e-learning course in evidence-b

Abstract 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