Evidence-based medicine training during residency: a randomized controlled trial of efficacy

This randomized controlled trial included 48 internal medicine residents at an academic medical center. Twenty-three residents were randomized to attend a 4-hour interactive workshop in their PGY-2 year. All residents completed a 25-item EBM knowledge and skills test and a self-reported survey of literature searching and resource usage in their PGY-1, PGY-2, and PGY-3 years.There was no difference in mean EBM test scores between the workshop and control groups at PGY-2 or PGY-3. However, mean EBM test scores significantly increased over time for both groups in PGY-2 and PGY-3. Literature searches, and resource usage also increased significantly in both groups after the PGY-1 year.We were unable to detect a difference in EBM knowledge between residents who did and did not participate in our workshop. Significant improvement over time in EBM scores, however, suggests EBM skills were learned during residency. Future rigorous studies should determine the best methods for improving residents' EBM skills as well as their ability to apply evidence during clinical practice.Competent clinical decision-making is a complex and critical process[1] and leaders in graduate medical education have long sought to hone residents' decision-making skills [2]. The introduction of evidence-based medicine (EBM) in 1992[3] and its subsequent inclusion by the Accreditation Council for Graduate Medical Education (ACGME) as a core component of practice-based learning and improvement[4] served as a catalyst for residency programs to incorporate evidence-based practice concepts into their curricula [5].After two decades and a multitude of systematic reviews, non-randomized controlled studies, and pre- and post-intervention studies, the impact of formal EBM training on resident knowledge, skills, attitudes, and behavior remains unclear [6]. Challenges remain for translating EBM knowledge into clinical practice [7,8], and barriers to successful implementation of EBM skills have not yet been resol