The status of evidence-based medicine education in urology residency

Abstract

Introduction: Evidence-based medicine (EBM) is the conscientious, explicit, and judicious use of the current best evidence in decision-making for the care of patients. Teaching best evidence practice in residency should include both formal or freestanding content, as well as integration into clinical scenarios and patient care. We sought to assess the attitudes, experience and knowledge of EBM in urology residency training across Canada.Methods: An anonymous, cross-sectional, self-report questionnaire was completed by a convenience sample of 29 residents, including all chief urology residents in English-speaking programs across Canada. The survey included both open-ended and closedended questions designed to assess familiarity and attitudes towards EBM and potential barriers to developing EBM skills in a surgical training program. Questions were formatted to determine the understanding of statistical and analytical concepts, as well as familiarity of available EBM resources. Descriptive and correlative statistics were used to analyze the responses. Results:The response rate was 100%. An overwhelming majority of residents felt that EBM is an important component of the urology residency and journal club was the most common vehicle for discussing best evidence concepts. However, there was significant variation in the presence of freestanding, formal curricula across programs, with only 28% of residents signifying that they received any formal training in their program. The apparent level of understanding of important EBM terminology and resources appears to be limited. The most frequently stated barriers to incorporating EBM curricula into urology training were time constraints and a perceived lack of expert educators. Conclusion:This self-report survey of urology chief residents identified the overwhelming acceptance of the importance of EBM in their training. Although best evidence practices appears to be addressed in journal clubs and in real-life clinical experiences, the obvious lack of familiarity and understanding of EBM content and resources would suggest a need for redoubling efforts to ensure appropriate exposure and instruction in our training programs.

Teaching Evidence Based Medicine to Surgery Residents-Is Journal Club the Best Format? A Systematic Review of the Literature

“…Although all studies have consistently shown high degrees of acceptance of EBM training amongst those surveyed, considerable variation in the existence or format of EBM training programs has been reported. [8][9][10][11][12] For instance, a survey of urology program directors found that the majority of programs (78%) reported having a formal educational activity related to EBM but the allotted time varied significantly across different programs (4.8-25.0 hours per year) and the majority devoted less time than what they thought was ideal. 10 A survey of urology residents found that while an overwhelming majority of residents felt EBM is an important part of their curriculum, only 28% reported receiving formal EBM training in their program.…”

“…10 A survey of urology residents found that while an overwhelming majority of residents felt EBM is an important part of their curriculum, only 28% reported receiving formal EBM training in their program. 12 The 2 most commonly reported barriers to the teaching of EBM were lack of time and lack of qualified EBM educators. 10,12 Similarly, surveys of residents in other surgical specialties including otolaryngology and obstetrics and gynecology have found that there is insufficient formal training in their programs.…”

“…12 The 2 most commonly reported barriers to the teaching of EBM were lack of time and lack of qualified EBM educators. 10,12 Similarly, surveys of residents in other surgical specialties including otolaryngology and obstetrics and gynecology have found that there is insufficient formal training in their programs. 8,9,11 Thus, it is evident that EBM training is not standardized across different surgical specialties and there exist considerable variations in the teaching methods ranging from half-day workshops or lectures to regularly scheduled journal clubs.…”

Tendencies of medical education researches in Turkey: Content analysis of 2000-2014 period

“…It is stated that this situation results from the difference between teaching of courses in basic sciences and clinical sciences [25].It is known that assessments are conducted periodically in this instructional level since it is important to determine how well the content and goals are acquired. However, the lack of feedback from the trainings given within the scope of continuing education can be a reason why the number of studies focusing on this instructional level is so low [5].Another reason of the high number of studies focusing on pre-graduate level is the effort to give a comprehensive education despite the individual differences [25].Some researches on post-graduate level are known to be conducted with the aim of learning about the contemporary medicine literature [26].…”

Attitudes of graduating Canadian urology residents on the job market: Is it getting better or are we just spinning our wheels?

“…The questionnaire was developed specifically for this survey and resulted from previous experiences with survey construction. [6][7][8] A limited number of residents and educators involved in postgraduate programs were asked to assess and modify the survey for clarity.…”