November 29, 2018

Evidence-Based Medicine in Residency Education

Dr. Heidelbaugh and colleagues find that residency programs should develop and implement interventions in order to inspire a positive culture surrounding evidence-based medicine.

Joel J. Heidelbaugh, M.D., FAAFP, FACG
Joel J. Heidelbaugh, M.D.

Seeking knowledge about the culture of evidence-based medicine in family medicine programs and not finding enough information in the current literature, Joel J. Heidelbaugh, M.D., professor, and other members of the Society of Teachers of Family Medicine Group on Evidence-Based Medicine attempted to determine the factors that can affect a program’s culture.

Through statistical analysis of a validated survey of residency program directors, they developed an Evidence-based Medicine Culture Scale (ECS). 

The ECS showed that the most strongly endorsed items are:

  • The practice environment’s commitment to lifelong learning
  • The program’s cultivation of an atmosphere of mutual respect
  • The encouragement of residents as problem solvers.

And, the least strongly endorsed items are:

  • Faculty feedback to residents about evidence-based medicine skills
  • Faculty involvement in teaching evidence-based medicine
  • Protection of resident time for evidence-based medicine training.

The authors of the study found their results to be in accordance with the findings of other similar studies that point to the importance of environmental and contextual factors that contribute to the culture of evidence-based medicine learning within a residency program.

The authors suggest that the delivery of evidence-based medicine curriculum can be improved by a commitment from program directors to focus on authentic activity (eg, integrating and reinforcing evidence-based medicine teaching in the clinical environment), whole-residency involvement and commitment, and a suitable general and EBM-specific infrastructure for learning and application of learning.

“Our residency training program is fully committed to philosophy and science behind evidence-based medicine training,” noted Jean H.C. Wong, M.D., residency program director. “EMB training begins during our first month of internship and is integrated throughout residency. We are very privileged to work in an institution at the forefront of this movement, led by our fantastic faculty body, including Dr. Heidelbaugh.”

The study “Examining an Evidence-Based Medicine Culture in Residency Education” was published in the November-December 2018 issue of Family Medicine.