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      Effectiveness of training in evidence-based medicine skills for healthcare professionals: a systematic review

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          Abstract

          Background

          Basic skills in evidence-based medicine (EbM) are indispensable for healthcare professionals to promote consumer-centred, evidence-based treatment. EbM training courses are complex interventions – a fact that has not been methodologically reflected by previous systematic reviews.

          This review evaluates the effects of EbM training for healthcare professionals as well as the quality of reporting of such training interventions.

          Methods

          We searched PubMed, EMBASE, CINAHL, Cochrane Library, ERIC, Campbell Library and PsycINFO up to 9/2014. Randomised controlled trials, controlled clinical trials as well as before-after trials were included. Authors were contacted in order to obtain missing data. Two independent reviewers extracted data and assessed risk of bias.

          Results

          We reviewed 14.507 articles; n = 61 appeared potentially eligible; n = 13 involving 1,120 participants were included. EbM training shows some impact on knowledge and skills, whereas the impact on practical EbM application remains unclear. Risk of bias of included trials raises uncertainty about the effects. Description of complex interventions was poor.

          Conclusions

          EbM training has some positive effects on knowledge and skills of healthcare professionals. Appropriate methods for development, piloting, evaluation, reporting and implementation of the training should be applied.

          Electronic supplementary material

          The online version of this article (doi:10.1186/s12909-016-0616-2) contains supplementary material, which is available to authorized users.

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          Most cited references74

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          Criteria for Reporting the Development and Evaluation of Complex Interventions in healthcare: revised guideline (CReDECI 2)

          Background Many healthcare interventions are of complex nature, consisting of several interacting components. Complex interventions are often described inadequately. A reporting guideline for complex interventions was published in 2012 (Criteria for Reporting the Development and Evaluation of Complex Interventions in healthcare, CReDECI) and was recently checked for its practicability. The reporting guideline was developed following the recommendations of the EQUATOR network but excluding a formal consensus process. Therefore, a consensus process was initiated, to revise the reporting guideline. Methods We used a three-phase consensus process consisting of (1) a web-based feedback survey on the published reporting guideline, (2) a face-to-face consensus conference, and (3) a final online review and feedback round to create the revised CReDECI. The consensus process was organized and conducted via the REFLECTION network. Results A total of 45 attendees from 16 European countries took part in the face-to-face consensus conference. The revised reporting guideline (CReDECI 2) comprises 13 items on three stages: development, feasibility and piloting, and evaluation of a complex intervention. Each item is illustrated by an explanation and an example. In contrast with most of the available reporting guidelines, CReDECI 2 does not focus on a specific study design, to reflect the use of different qualitative and quantitative designs and methods in the development and evaluation of complex interventions. Conclusions CReDECI 2 is a formally consented reporting guideline aiming to improve the reporting quality of the development and evaluation stages of complex interventions in healthcare. Since the guideline does not focus on a specific study design, design-specific reporting guidelines may additionally be used. Electronic supplementary material The online version of this article (doi:10.1186/s13063-015-0709-y) contains supplementary material, which is available to authorized users.
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            Barriers to evidence-based medicine: a systematic review.

            Evidence-based medicine (EBM) has emerged as an effective strategy to improve health care quality. The aim of this study was to systematically review and carry out an analysis on the barriers to EBM.
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              A hierarchy of effective teaching and learning to acquire competence in evidenced-based medicine

              Background A variety of methods exists for teaching and learning evidence-based medicine (EBM). However, there is much debate about the effectiveness of various EBM teaching and learning activities, resulting in a lack of consensus as to what methods constitute the best educational practice. There is a need for a clear hierarchy of educational activities to effectively impart and acquire competence in EBM skills. This paper develops such a hierarchy based on current empirical and theoretical evidence. Discussion EBM requires that health care decisions be based on the best available valid and relevant evidence. To achieve this, teachers delivering EBM curricula need to inculcate amongst learners the skills to gain, assess, apply, integrate and communicate new knowledge in clinical decision-making. Empirical and theoretical evidence suggests that there is a hierarchy of teaching and learning activities in terms of their educational effectiveness: Level 1, interactive and clinically integrated activities; Level 2(a), interactive but classroom based activities; Level 2(b), didactic but clinically integrated activities; and Level 3, didactic, classroom or standalone teaching. Summary All health care professionals need to understand and implement the principles of EBM to improve care of their patients. Interactive and clinically integrated teaching and learning activities provide the basis for the best educational practice in this field.
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                Author and article information

                Contributors
                +49 04361/513-130 , hecht@red-institut.de
                susanne.buhse@uni-hamburg.de
                gabriele.meyer@medizin.uni-halle.de
                Journal
                BMC Med Educ
                BMC Med Educ
                BMC Medical Education
                BioMed Central (London )
                1472-6920
                4 April 2016
                4 April 2016
                2016
                : 16
                : 103
                Affiliations
                [ ]University of Witten/Herdecke, Faculty of Health, School of Nursing Science, Witten/Herdeke, Germany
                [ ]RED Institute for Medical Research and Education, Mühlenkamp 5, 23758 Oldenburg, Germany
                [ ]University of Hamburg, Faculty of Mathematics, Informatics and Natural Sciences, Unit of Health Sciences and Education, Hamburg, Germany
                [ ]Martin Luther University Halle-Wittenberg, Medical Faculty, Institute for Health and Nursing Science, Halle, Germany
                Article
                616
                10.1186/s12909-016-0616-2
                4820973
                27044264
                3ffd4584-a00b-4ec2-aca2-f04df93083bb
                © Hecht et al. 2016

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 7 October 2015
                : 11 March 2016
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2016

                Education
                evidence-based medicine,evidence-based nursing,complex intervention,education,health personnel

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