Kumaravel, Bharathy and Hearn, Jasmine Heath and Jahangiri, Leila and Pollard, Rachel and Stocker, Claire Joanne and Nunan, David
(2020)
A systematic review and taxonomy of tools
for evaluating evidence-based medicine
teaching in medical education.
BMC systematic reviews, 9 (91).
ISSN 2046-4053
Abstract
Background The importance of teaching the skills and practice of Evidence Based Medicine (EBM) for medical professionals has steadily grown in recent years. Alongside this growth is a need to evaluate the effectiveness of EBM curriculum as assessed by competency in the five ‘A’s’: Asking, Acquiring, Appraising, Applying and Assessing (impact and performance). EBM educators in medical education will benefit from a compendium of existing assessment tools for assessing EBM competencies in their settings. The purpose of this review is to provide a systematic review and taxonomy of validated tools that evaluate EBM teaching in medical education. Methods We searched MEDLINE, EMBASE, Cochrane library, Educational Resources Information Centre (ER-IC), Best Evidence Medical Education (BEME) databases and references of retrieved articles pub-lished between January 2005 and March 2019. We have presented the identified tools along with their psychometric properties including validity, reliability; relevance to the five domains of EBM practice and dimensions of EBM learning. We also assessed the quality of the tools to identify high quality tools as those supported by established interrater reliability (if applicable), objective (non-self-reported) outcome measures and achieved ≥3 types of established validity evidence. We have re-ported our study in accordance with the PRISMA guidelines. Results We identified 1719 potentially relevant articles of which 63 full text articles were assessed for eligibility against inclusion and exclusion criteria. Twelve articles each with a unique and newly identified tool were included in the final analysis. Of the twelve tools, all of them assessed the third step of EBM practice (Appraise) and five assessed just that one step. None of the twelve tools assessed the last step of EBM practice (Assess). Of the seven domains of EBM learning, ten tools assessed knowledge gain, ten assessed skills, two assessed attitude, and one assessed change in behaviour. None addressed reaction to EBM teaching, self-efficacy or patient benefit. Of the twelve tools identi-fied, six were high quality. We have also provided a taxonomy of tools using the CREATE framework, for EBM teachers in medical education. Conclusions Six tools of reasonable validity are available for evaluating most steps of EBM and some domains of EBM learning. Further development and validation of tools that evaluate all the steps in EBM and all educational outcome domains are needed. Systematic Review registration PROSPERO CRD4201811620 Key words Evidence based medicine, competency, medical education, assessment
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