Evidence-based medicine training in internal medicine residency programs -A national survey

To characterize evidence-based medicine (EBM) curricula in internal medicin e residency programs, a written survey was mailed to 417 program directors of U.S. internal medicine residency programs. For programs offering a frees tanding (dedicated curricular time) EBM curriculum, the survey inquired abo ut its objectives, format, curricular time, attendance, faculty development , resources, and evaluation. All directors responded to questions regarding integrating EBM teaching into established educational venues. Of 417 progr am directors, 269 (65%) responded. Of these 269 programs, 99 (37%) offered a freestanding EBM: curriculum. Among these, the most common objectives wer e performing critical appraisal (78%), searching for evidence (53%), posing a focused question (44%), and applying the evidence in decision making (35 %). Although 97% of the programs provided MEDLINE. only 33% provided Best E vidence or the Cochrane Library. Evaluation was performed in 37% of the fre estanding curricula. Considering all respondents, most programs reported ef forts to integrate EBM teaching into established venues, including attendin g rounds (84%), resident report (82%), continuity clinic (76%), bedside rou nds (68%), and emergency department (35%). However, only 51% to 64% of the programs provided on-site electronic information and 31% to 45% provided si te-specific faculty development. One third of the training programs reporte d offering freestanding EBM curricula, which commonly targeted important EB M shills, utilized the residents' experiences, and employed an interactive format, Less than one half of the curricula, however, included curriculum e valuation, and many failed to provide important medical information sources , Most programs reported efforts to integrate EBM teaching, but many of the se attempts lacked important structural elements.