Thirty years of teaching evidence-based medicine: have we been getting it all wrong?

Has anything changed in Evidence-Based Medicine?

“… [38] Therefore, several initiatives as for example the European Union Evidence-Based Medicine project, [39] the teaching programs of the Oxford Centre for EBM and McMaster University to disseminate EBM teaching, the uptake of teaching resources is low. [ 40 , 41 ] Several strategies both face-to-face and virtual have being implemented to more effectively teach EBM including journal clubs, lectures, workshops, group work, seminars, collaboration with librarians and newer methods as well including simulations, gaming and the use of mobile phones. [40] Sadly, the bedside practice of EBM by is “irregular” at best, and even those “trained”, do not exhibit a change of behaviour giving a reason of “lack of skills”.…”

“… [42] Talking about change , over 300 articles have been published on the teaching of EBM, [43] and despite the vast amount of literature, the teaching of EBM remains problematic. [ [40] , [41] , [42] , 44 ] There is ongoing discussion and debate with no universal consensus regarding the best approach as the acquisition of skills in EBM is fairly complex, related to contextual factors, needs clinical integration and positive role models. [42] It looks like the change from theory to effective practice in the teaching of EBM has not been accomplished.…”

Challenges and future directions in the measurement of evidence‐based practice: Qualitative analysis of umbrella review findings

“…There has been no shortage of discussion on the philosophical, methodological and practical underpinnings of EBP 1,3,7,10,12–14,16,22–30 . These discussions have led to an evolution in how EBP is conceptualized 31 . For instance, there is greater recognition that evidence‐based decision‐making is not only a complex context‐specific process, but that it is greatly influenced by systems, organizations and clinician as well as patient beliefs 32,33 .…”

“…For instance, there is greater recognition that evidence‐based decision‐making is not only a complex context‐specific process, but that it is greatly influenced by systems, organizations and clinician as well as patient beliefs 32,33 . The question ‘what constitutes evidence’ has been the topic of much deliberation, with a subtle shift towards a pluralistic and more inclusive view of the evidence, and an acceptance of methodologies other than RCTs (e.g., observational, case studies) 15,16,29,31,33–38 . While these shifts may better cater to the multifaceted nature of the clinical decision‐making process, there is no consensus on how we can best teach, practice and measure EBP 39 .…”

“…While these shifts may better cater to the multifaceted nature of the clinical decision‐making process, there is no consensus on how we can best teach, practice and measure EBP 39 . Recently, scholars have considered the need for a renewed collective reflection and consensus to support a more contemporary conceptualization of EBP 31 …”