Summary
This cluster randomised controlled trial compared integrated EBM training—wherein evidence-based medicine is embedded within clinical practice through joint trainee–supervisor assignments and teaching sessions based on real patient dilemmas—against stand-alone institute-based EBM training in Dutch GP specialty trainees. The study found no statistically significant differences between the two approaches in guideline adherence, information-seeking behaviour, EBM attitude, or knowledge, either at the end of third-year training or one year after graduation, challenging the assumption that integration necessarily improves EBM behaviour in clinical practice.
UK applicability
These findings are relevant to UK GP training programmes, which similarly emphasise EBM within specialty training. The null result suggests that restructuring GP training curricula to integrate EBM more closely may not yield expected improvements in practising physicians' behaviour, warranting reconsideration of training design assumptions in UK postgraduate medical education.
Key measures
Relative risks for guideline adherence (with 95% CIs) and information-seeking behaviour; EBM attitude and knowledge scores from questionnaires; data from logbooks recording 7614 consultations at baseline, 4973 at end of third year, and 3307 one year post-graduation
Outcomes reported
The study measured EBM behaviour through guideline adherence and information-seeking behaviour in GP trainees, assessed via logbooks during training and one year post-graduation. Secondary outcomes included EBM attitude and knowledge, measured through questionnaires.
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