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Evidence‐based medical education – quo vadis ?
Author(s) -
Leung Gabriel M.,
Johnston Janice M.
Publication year - 2006
Publication title -
journal of evaluation in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.737
H-Index - 73
eISSN - 1365-2753
pISSN - 1356-1294
DOI - 10.1111/j.1365-2753.2006.00585.x
Subject(s) - set (abstract data type) , psychological intervention , health care , status quo , balanced scorecard , evidence based medicine , medical education , evidence based practice , psychology , outcome (game theory) , diversity (politics) , medicine , alternative medicine , computer science , nursing , sociology , political science , economics , management , mathematical economics , pathology , anthropology , law , programming language
The evidence base for most educational initiatives, at least until very recently, is largely composed of low‐level evidence. Four major barriers underlie this historical observation, namely: (1) perceived ethical and acceptability problems arising from the unequal treatment of learners in experimental designs; (2) limited choice of outcome measures and validated instruments; (3) time and resource constraints; and (4) methodological issues concerning contextual confounding and small sample sizes. We advocate the adoption of a ‘balanced scorecard’ approach in the evaluation of education interventions that brings together a comprehensive panel of outcomes under one framework. We require a diversity of rigorously applied methods to generate these outcomes, drawing from the quantitative and qualitative disciplines of epidemiology, psychology and economics. We further suggest that the research community discuss and agree on a standardized set of common metrics or benchmarks. We conclude with a case study examining whether a hand‐held computer clinical decision support tool improves clerkship learning of evidence‐based medicine. The era of Brownian motion in health education research is over. What we demand in terms of burden of proof for educational effectiveness should be no less rigorous than our call for an ever escalating threshold concerning evidence of clinical care.