Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
The design, fate and impact of a hospital-wide training program in evidence-based medicine for physicians: An observational study
Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Karolinska institutet.ORCID iD: 0000-0003-1814-4478
Karolinska institutet.
Karolinska institutet.
2016 (English)In: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 16, 86Article in journal (Refereed) Published
Abstract [en]

Background: Many doctors fail to practice Evidence-Based Medicine (EBM) effectively, in part due to insufficient training. We report on the design, fate and impact of a short learner-centered EBM train-the-trainer program aimed at all 2400 doctors at the Karolinska University Hospital in Sweden on the heels of a tumultuous merger, focusing particularly on whether it affected the doctors' knowledge, attitudes and skills regarding EBM. 

Methods: We used a validated EBM instrument in a before-and-after design to assess the impact of the training. Changes in responses were analyzed at the individual level using the Wilcoxon matched pairs test. We also reviewed documentation from the program - including the modular EBM training schedule and the template for participants' Critically Appraised Topic reports - to describe the training's content, design, conduct, and fate. 

Results: The training, designed to be delivered in modules of 45 min totaling 1.5 days, failed to reach most doctors at the hospital, due to cost cutting pressures and competing demands. Among study participants (n = 174), many reported suboptimal EBM knowledge and skills before the training. Respondents' strategies for solving clinical problems changed after the training: the proportion of respondents reporting to use (or intend to use) secondary sources "Often/very often" changed from 5 % before the training to 76 % after the training; in parallel, reliance on textbooks and on colleagues fell (48 to 23 % and 79 to 65 %, respectively). Participants' confidence in assessing scientific articles increased and their attitudes toward EBM became more positive. The proportion of correct answers in the EBM knowledge test increased from 52 to 71 %. All these changes were statistically significant at p < 0.05. 

Conclusions: Many study participants, despite working at a university hospital, lacked basic EBM knowledge and skills and used the scientific literature suboptimally. The kind of short learner-centered EBM training evaluated here brought significant improvements among the minority of hospital doctors who were able to participate and, if applied widely, could contribute to better, safer and more cost-effective care.

Place, publisher, year, edition, pages
2016. Vol. 16, 86
Keyword [en]
Delivery of Health Care, Integrated/organization & administration, Education, Medical, Evidence Based Medicine/education, Inservice Training/organization & administration, Problem-Based Learning/methods, Program Development, Program Evaluation
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
URN: urn:nbn:se:hj:diva-35018DOI: 10.1186/s12909-016-0601-9ISI: 000371765100001PubMedID: 26956890Scopus ID: 2-s2.0-84960348109OAI: oai:DiVA.org:hj-35018DiVA: diva2:1071927
Available from: 2017-02-06 Created: 2017-02-06 Last updated: 2017-11-29Bibliographically approved

Open Access in DiVA

fulltext(951 kB)22 downloads
File information
File name FULLTEXT01.pdfFile size 951 kBChecksum SHA-512
9bc8b7d27774b560ee8c1a25fb4f6d9951759b96d29a8cc8d1d0598116b5f74617de760fbccda72111f31d3e7d24d9d76f69a7c02459b376ea1ae739ab8fe8d9
Type fulltextMimetype application/pdf

Other links

Publisher's full textPubMedScopus

Authority records BETA

Thor, Johan

Search in DiVA

By author/editor
Thor, Johan
By organisation
The Jönköping Academy for Improvement of Health and Welfare
In the same journal
BMC Medical Education
Health Care Service and Management, Health Policy and Services and Health Economy

Search outside of DiVA

GoogleGoogle Scholar
Total: 22 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 54 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf