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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of directed and self-directed learning in evidence-based medicine: a randomised controlled trial.
- Peter Bradley, Christina Oterholt, Jeph Herrin, Lena Nordheim, and Arild Bjørndal.
- Norwegian Medicines Agency, Oslo, Norway. peter.bradley@suffolkwest-pct.nhs.uk
- Med Educ. 2005 Oct 1; 39 (10): 1027-35.
ObjectivesTo compare 2 educational programmes for teaching evidence-based medicine (EBM).DesignProspective randomised controlled trial accompanied by a qualitative evaluation.SettingUniversity of Oslo, Norway, 2002-03.ParticipantsA total of 175 students entered the study. All tenth semester medical students from 3 semesters were eligible for inclusion if they completed baseline assessment and consent forms and either attended teaching on the first day of the semester or gave reasons for their absence on the first day in advance. Interventions One intervention was based on computer-assisted, self-directed learning (self-directed intervention), whilst the other was organised as workshops based on social learning theory (directed intervention). Both educational interventions consisted of 5 half-day sessions.Main Outcome MeasuresThe primary outcomes were knowledge about EBM and skills in critical appraisal. A secondary outcome measured attitudes to EBM. Outcomes were compared on an intention-to-treat basis using a stratified Wilcoxon rank-sum test.ResultsThere were no differences in outcomes for the 2 study groups in terms of EBM knowledge (mean deviation 0.0 [95% confidence interval - 1.0, 1.0], P = 0.8), critical appraisal skills (MD 0.1 [95% CI - 0.9, 1.1], P = 0.5), or attitudes to EBM (MD - 0.3 [95% CI - 1.4, 0.8], P = 0.5). Follow-up rates were 96%, 97% and 63%, respectively.ConclusionsThis trial and its accompanying qualitative evaluation suggest that self-directed, computer-assisted learning may be an alternative format for teaching EBM. However, further research is needed to confirm this and investigate alternative educational models.
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