Does a one-day workshop improve clinical faculty’s comfort and behaviour in practising and teaching evidence-based medicine? A Canadian mixed methods study

OBJECTIVE The purpose of this study was to determine the impact of a 1-day evidence-based medicine (EBM) workshop on physician attitudes and behaviours around teaching and practicing EBM. DESIGN A mixed methods study using a before/after cohort. SETTING A medical school delivering continuing professional development to 1250 clinical faculty over a large geographic area in Canada. PARTICIPANTS 105 physician clinical faculty members. INTERVENTION A 1-day workshop presented at 11 different sites over an 18-month period focusing on EBM skills for teaching and clinical practice. OUTCOME MEASURES (1) A quantitative survey administered immediately before and after the workshop, and 3-6 months later, to assess the hypothesis that comfort with teaching and practising EBM can be improved.(2) A qualitative survey of the expectations for, and impact of the workshop on, participant behaviours and attitudes using a combination of pre, post and 3 to 6-month follow-up questionnaires, and telephone interviews completed 10-14 months after the workshop. RESULTS Physician comfort with their EBM clinical skills improved on average by 0.93 points on a 5-point Likert scale, and comfort with EBM teaching skills by 0.97 points (p values 0.001). Most of this improvement was sustained 3-6 months later. Three to fourteen months after the workshop, half of responding participants reported that they were using the Population Intervention Comparator Outcome (PICO) methodology of question framing for teaching, clinical practice or both. CONCLUSIONS Comfort in teaching and practicing EBM can be improved by a 1-day workshop, with most of this improvement sustained 3-6 months later. PICO question framing can be learnt at a 1-day workshop, and is associated with a self-reported change in clinical and teaching practice 3-14 months later. This represents both level 2 (attitudes) and level 3 (behaviours) change using the Kirkpatrick model of evaluation.