What are the effects of teaching Evidence-Based Health Care
(EBHC) at different levels of health professions education? An
updated overview of systematic reviews

J 2021

What are the effects of teaching Evidence-Based Health Care (EBHC) at different levels of health professions education? An updated overview of systematic reviews

BALA, M. M., T. P. PERICIC, J. ZAJAC, A. ROHWER, Jitka KLUGAROVÁ et. al.

Basic information

Original name

What are the effects of teaching Evidence-Based Health Care (EBHC) at different levels of health professions education? An updated overview of systematic reviews

Authors

BALA, M. M. (guarantor), T. P. PERICIC, J. ZAJAC, A. ROHWER, Jitka KLUGAROVÁ (203 Czech Republic, belonging to the institution), M. VALIMAKI, T. LANTTA, L. PINGANI, Miloslav KLUGAR (203 Czech Republic, belonging to the institution), M. CLARKE and T. YOUNG

Edition

Plos one, San Francisco, Public Library Science, 2021, 1932-6203

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

10700 1.7 Other natural sciences

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

URL

Impact factor

Impact factor: 3.752

RIV identification code

RIV/00216224:14110/21:00122212

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1371/journal.pone.0254191

UT WoS

000678124900091

Keywords in English

Evidence-Based Health Care; health professions education; teaching

Abstract

V originále

Background Evidence-based healthcare (EBHC) knowledge and skills are recognised as core competencies of healthcare professionals worldwide, and teaching EBHC has been widely recommended as an integral part of their training. The objective of this overview of systematic reviews (SR) was to update evidence and assess the effects of various approaches for teaching evidence-based health care (EBHC) at undergraduate (UG) and postgraduate (PG) medical education (ME) level on changes in knowledge, skills, attitudes and behaviour. Methods and findings This is an update of an overview that was published in 2014. The process followed standard procedures specified for the previous version of the overview, with a modified search. Searches were conducted in Epistemonikos for SRs published from 1 January 2013 to 27 October 2020 with no language restrictions. We checked additional sources for ongoing and unpublished SRs. Eligibility criteria included: SRs which evaluated educational interventions for teaching EBHC compared to no intervention or a different strategy were eligible. Two reviewers independently selected SRs, extracted data and evaluated quality using standardised instrument (AMSTAR2). The effects of strategies to teach EBHC were synthesized using a narrative approach. Previously published version of this overview included 16 SR, while the updated search identified six additional SRs. We therefore included a total of 22 SRs (with a total of 141 primary studies) in this updated overview. The SRs evaluated different educational interventions of varying duration, frequency, and format to teach various components of EBHC at different levels of ME (UG, PG, mixed). Most SRs assessed a range of EBHC related outcomes using a variety of assessment tools. Two SRs included randomised controlled trials (RCTs) only, while 20 reviews included RCTs and various types of non-RCTs. Diversity of study designs and teaching activities as well as aggregated findings at the SR level prevented comparisons of the effects of different techniques. In general, knowledge was improved across all ME levels for interventions compared to no intervention or pre-test scores. Skills improved in UGs, but less so in PGs and were less consistent in mixed populations. There were positive changes in behaviour among UGs and PGs, but not in mixed populations, with no consistent improvement in attitudes in any of the studied groups. One SR showed improved patient outcomes (based on non-randomised studies). Main limitations included: poor quality and reporting of SRs, heterogeneity of interventions and outcome measures, and short-term follow up. Conclusions Teaching EBHC consistently improved EBHC knowledge and skills at all levels of ME and behaviour in UGs and PGs, but with no consistent improvement in attitudes towards EBHC, and little evidence of the long term influence on processes of care and patient outcomes. EBHC teaching and learning should be interactive, multifaceted, integrated into clinical practice, and should include assessments. Study registration The protocol for the original overview was developed and approved by Stellenbosch University Research Ethics Committee S12/10/262. Update of the overview Young T, Rohwer A, Volmink J, Clarke M. What are the effects of teaching evidence-based health care (EBHC)? Overview of systematic reviews. PLoS One. 2014;9(1):e86706. doi: .10.1371/journal.pone.0086706.

Links

LTC20031, research and development project

Name: Towards an International Network for Evidence-based Research in Clinical Health Research in the Czech Republic

Investor: Ministry of Education, Youth and Sports of the CR, INTER-COST

Citovat

BALA, M. M., T. P. PERICIC, J. ZAJAC, A. ROHWER, Jitka KLUGAROVÁ, M. VALIMAKI, T. LANTTA, L. PINGANI, Miloslav KLUGAR, M. CLARKE and T. YOUNG. What are the effects of teaching Evidence-Based Health Care (EBHC) at different levels of health professions education? An updated overview of systematic reviews. Plos one. San Francisco: Public Library Science, 2021, vol. 16, No 7, p. 1-28. ISSN 1932-6203. Available from: https://dx.doi.org/10.1371/journal.pone.0254191.

@article{1789178,
   author = {Bala, M. M. and Pericic, T. P. and Zajac, J. and Rohwer, A. and Klugarová, Jitka and Valimaki, M. and Lantta, T. and Pingani, L. and Klugar, Miloslav and Clarke, M. and Young, T.},
   article_location = {San Francisco},
   article_number = {7},
   doi = {http://dx.doi.org/10.1371/journal.pone.0254191},
   keywords = {Evidence-Based Health Care; health professions education; teaching},
   language = {eng},
   issn = {1932-6203},
   journal = {Plos one},
   title = {What are the effects of teaching Evidence-Based Health Care (EBHC) at different levels of health professions education? An updated overview of systematic reviews},
   url = {https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0254191},
   volume = {16},
   year = {2021}
}

TY  - JOUR
ID  - 1789178
AU  - Bala, M. M. - Pericic, T. P. - Zajac, J. - Rohwer, A. - Klugarová, Jitka - Valimaki, M. - Lantta, T. - Pingani, L. - Klugar, Miloslav - Clarke, M. - Young, T.
PY  - 2021
TI  - What are the effects of teaching Evidence-Based Health Care (EBHC) at different levels of health professions education? An updated overview of systematic reviews
JF  - Plos one
VL  - 16
IS  - 7
SP  - 1-28
EP  - 1-28
PB  - Public Library Science
SN  - 19326203
KW  - Evidence-Based Health Care
KW  - health professions education
KW  - teaching
UR  - https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0254191
N2  - Background Evidence-based healthcare (EBHC) knowledge and skills are recognised as core competencies of healthcare professionals worldwide, and teaching EBHC has been widely recommended as an integral part of their training. The objective of this overview of systematic reviews (SR) was to update evidence and assess the effects of various approaches for teaching evidence-based health care (EBHC) at undergraduate (UG) and postgraduate (PG) medical education (ME) level on changes in knowledge, skills, attitudes and behaviour. Methods and findings This is an update of an overview that was published in 2014. The process followed standard procedures specified for the previous version of the overview, with a modified search. Searches were conducted in Epistemonikos for SRs published from 1 January 2013 to 27 October 2020 with no language restrictions. We checked additional sources for ongoing and unpublished SRs. Eligibility criteria included: SRs which evaluated educational interventions for teaching EBHC compared to no intervention or a different strategy were eligible. Two reviewers independently selected SRs, extracted data and evaluated quality using standardised instrument (AMSTAR2). The effects of strategies to teach EBHC were synthesized using a narrative approach. Previously published version of this overview included 16 SR, while the updated search identified six additional SRs. We therefore included a total of 22 SRs (with a total of 141 primary studies) in this updated overview. The SRs evaluated different educational interventions of varying duration, frequency, and format to teach various components of EBHC at different levels of ME (UG, PG, mixed). Most SRs assessed a range of EBHC related outcomes using a variety of assessment tools. Two SRs included randomised controlled trials (RCTs) only, while 20 reviews included RCTs and various types of non-RCTs. Diversity of study designs and teaching activities as well as aggregated findings at the SR level prevented comparisons of the effects of different techniques. In general, knowledge was improved across all ME levels for interventions compared to no intervention or pre-test scores. Skills improved in UGs, but less so in PGs and were less consistent in mixed populations. There were positive changes in behaviour among UGs and PGs, but not in mixed populations, with no consistent improvement in attitudes in any of the studied groups. One SR showed improved patient outcomes (based on non-randomised studies). Main limitations included: poor quality and reporting of SRs, heterogeneity of interventions and outcome measures, and short-term follow up. Conclusions Teaching EBHC consistently improved EBHC knowledge and skills at all levels of ME and behaviour in UGs and PGs, but with no consistent improvement in attitudes towards EBHC, and little evidence of the long term influence on processes of care and patient outcomes. EBHC teaching and learning should be interactive, multifaceted, integrated into clinical practice, and should include assessments. Study registration The protocol for the original overview was developed and approved by Stellenbosch University Research Ethics Committee S12/10/262. Update of the overview Young T, Rohwer A, Volmink J, Clarke M. What are the effects of teaching evidence-based health care (EBHC)? Overview of systematic reviews. PLoS One. 2014;9(1):e86706. doi: .10.1371/journal.pone.0086706.
ER  -

BALA, M. M., T. P. PERICIC, J. ZAJAC, A. ROHWER, Jitka KLUGAROVÁ, M. VALIMAKI, T. LANTTA, L. PINGANI, Miloslav KLUGAR, M. CLARKE and T. YOUNG. What are the effects of teaching Evidence-Based Health Care (EBHC) at different levels of health professions education? An updated overview of systematic reviews. \textit{Plos one}. San Francisco: Public Library Science, 2021, vol.~16, No~7, p.~1-28. ISSN~1932-6203. Available from: https://dx.doi.org/10.1371/journal.pone.0254191.

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