A systematic review of postgraduate teaching in evidence-based medicine and critical appraisal

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Abstract
The knowledge and skills needed for critical literature appraisal and evidence-based practice have not been covered in undergraduate education until recently. These educational needs are, therefore, often met through postgraduate education via courses, workshops and journal clubs. Previous reviews have generally considered postgraduates and undergraduates together. However, there is evidence that the effectiveness of educational interventions varies between postgraduates and undergraduates. In this study the authors therefore examine the effectiveness of evidence-based medicine and critical appraisal teaching at postgraduate level. A comprehensive search was conducted in MEDLINE, EMBASE, ERIC, CCTR, CDSR, DARE, HTA, Best Evidence and SCI. Seventeen studies were identified: two randomized trials, six controlled trials without randomization and nine before-andafter studies. The studies showed a significant improvement in knowledge, but not in attitude, skills or behaviour. However, to draw robust conclusions, well-designed trials are needed that focus on curriculum content and delivery as well as how outcomes are assessed.