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      Computer-based teaching is as good as face to face lecture-based teaching of evidence based medicine: a randomised controlled trial

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          At postgraduate level evidence based medicine (EBM) is currently taught through tutor based lectures. Computer based sessions fit around doctors' workloads, and standardise the quality of educational provision. There have been no randomized controlled trials comparing computer based sessions with traditional lectures at postgraduate level within medicine.


          This was a randomised controlled trial involving six postgraduate education centres in the West Midlands, U.K. Fifty five newly qualified foundation year one doctors (U.S internship equivalent) were randomised to either computer based sessions or an equivalent lecture in EBM and systematic reviews. The change from pre to post-intervention score was measured using a validated questionnaire assessing knowledge (primary outcome) and attitudes (secondary outcome).


          Both groups were similar at baseline. Participants' improvement in knowledge in the computer based group was equivalent to the lecture based group (gain in score: 2.1 [S.D = 2.0] versus 1.9 [S.D = 2.4]; ANCOVA p = 0.078). Attitudinal gains were similar in both groups.


          On the basis of our findings we feel computer based teaching and learning is as effective as typical lecture based teaching sessions for educating postgraduates in EBM and systematic reviews.

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          Most cited references 18

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          The CONSORT statement: revised recommendations for improving the quality of reports of parallel-group randomised trials.

          To comprehend the results of a randomised controlled trial (RCT), readers must understand its design, conduct, analysis, and interpretation. That goal can be achieved only through total transparency from authors. Despite several decades of educational efforts, the reporting of RCTs needs improvement. Investigators and editors developed the original CONSORT (Consolidated Standards of Reporting Trials) statement to help authors improve reporting by use of a checklist and flow diagram. The revised CONSORT statement presented here incorporates new evidence and addresses some criticisms of the original statement. The checklist items pertain to the content of the Title, Abstract, Introduction, Methods, Results, and Discussion. The revised checklist includes 22 items selected because empirical evidence indicates that not reporting this information is associated with biased estimates of treatment effect, or because the information is essential to judge the reliability or relevance of the findings. We intended the flow diagram to depict the passage of participants through an RCT. The revised flow diagram depicts information from four stages of a trial (enrollment, intervention allocation, follow-up, and analysis). The diagram explicitly shows the number of participants, for each intervention group, included in the primary data analysis. Inclusion of these numbers allows the reader to judge whether the authors have done an intention-to-treat analysis. In sum, the CONSORT statement is intended to improve the reporting of an RCT, enabling readers to understand a trial's conduct and to assess the validity of its results.
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            Statistics notes: Analysing controlled trials with baseline and follow up measurements.

             A J Vickers,  D Altman (2001)
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              Validation of the Fresno test of competence in evidence based medicine.

              To describe the development and validation of a test of knowledge and skills in evidence based medicine. Cross sectional study. Family practice residency programme in California; a list server for those who teach evidence based medicine; and an evidence based medicine seminar series. Family practice residents and faculty members (n=43); volunteers self identified as experts in evidence based medicine (n=53); family practice teachers (19) beginning a seminar series on evidence based medicine. The Fresno test is a performance based measure for use in medical education that assesses a wide range of evidence based medicine skills. Open ended questions are scored with standardised grading rubrics. Calculation skills are assessed by fill in the blank questions. Inter-rater reliability, internal reliability, item analyses, and construct validity. Inter-rater correlations ranged from 0.76 to 0.98 for individual items. Cronbach's alpha was 0.88. Item difficulties ranged from moderate to difficult, all with positive and strong ability to discriminate between candidates. Experts scored consistently higher than novices. On the 212 point test, the novice mean was 95.6 and the expert mean was 147.5 (P<0.001). On individual items, a higher proportion of experts than novices earned passing scores on 15 of the 17 items. The Fresno test is a reliable and valid test for detecting the effect of instruction in evidence based medicine. Its use in other settings requires further exploration.

                Author and article information

                BMC Med Educ
                BMC Medical Education
                BioMed Central
                20 July 2007
                : 7
                : 23
                [1 ]The Education Resource Centre, The Birmingham Women's Hospital NHS Trust, Edgbaston, Birmingham, B15 2TG, UK
                [2 ]The Medical Education Unit, The University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
                [3 ]Clinical Biostatistics Unit, Hospital Ramon y Cajal, Ctra. Colmenar km 9.100, 2803 Madrid, Spain
                Copyright ©2007 Davis et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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