Teaching Evidence-Based Complementary and Alternative Medicine (EBCAM); Changing behaviours in the face of reticence: A cross-over trial

BACKGROUND: The effectiveness of teaching critical appraisal to students of Complementary and Alternative Medicine (CAM) has not been studied. In this study we attempt to determine if a workshop for final year students at a naturopathic college improved their ability to utilize critical appraisal concepts. METHODS: We assigned 83 Naturopathic Interns to two groups: Group A (n = 47) or Group B (n = 36). We conducted a baseline assessment of all subjects' critical appraisal skills. Group A was assigned to receive a 3 ½ hour workshop on Evidence Based Medicine (EBM) and Group B received a workshop on bioethics (control intervention). The groups critical appraisal skills were re-evaluated at this time. We then crossed over the intervention so that Group B received the EBM workshop while Group A received the bioethics workshop. Assessment of critical appraisal skills of the two groups was again performed. RESULTS: The students mean scores were similar in Group A (14.8) and Group B (15.0) after Group A had received the intervention and Group B had received the control (p = 0.75). Group scores were not significantly improved at the end of the trial compared to at the beginning of the study (Group A: 15.1 to 16.1) (Group B 15.6 to 15.9). Student's confidence in reading research papers also did not improve throughout the course of the study. CONCLUSION: The final year is a difficult but important time to teach critical appraisal and evidence skills. Single, short intervention programs will likely yield negligible results. A multi-factorial approach may be better suited to implementing EBCAM than single short interventions

The assessment-curriculum relationship, consequences for teacher instruction and student assessment

grantor: University of TorontoThis interpretive case study compared the relationships between assessment and curriculum, and their consequences on teacher instruction and student assessment in the classrooms of two research sites. One research site was in an early, the other was in a more advanced stage of use with an assessment innovation (the Toronto Benchmark Program). The Program emphasized mastery learning, and standards of performance at key stages in students' education. In the early site, where the curriculum was found to be content-driven, the assessment procedures had limited interaction with classroom instruction. Assessment practices were mainly summative, and instruction was growth-centred. In the advanced site, where the curriculum was standards-driven, the assessment and instructional procedures interacted with each other to a greater extent. The assessment was mainly formative, and instruction was information-centred. Simultaneously, data emerged that clarified how contextual, and background factors influenced classroom use of the innovation. This study may be relevant for practitioners as well as researchers since technical and management dimensions of change have been portrayed through the "first-voice" experiences of those most closely associated with the development, implementation, and consequences of an assessment innovation.Ph.D