Effectiveness of clinical integrated short course training of evidence based medicine for postgraduate medical specialty students in Ethiopia in 2022: A randomized control trial

Abstract

Background Evidence based medicine (EBM) is a newly emerged philosophy of medical education and health care service which brings quality of health service, efficient use of materials, and patient satisfaction. Objective To investigate the effectiveness of clinical integrated short course training of EBM for post-graduation medical specialty students in Ethiopia, 2022. Method Randomized, single blind, superiority trial, and multi-centric experimental study design employed. The eligible candidates randomly assigned to the interventional group and the control group (waitlisted). The allocation of the participant concealed from the principal investigator and participant. Sample size was determined with a two-sided test and α level of 5% and 80% power with the total of 52 calculated sample size and 44 (21 for intervention and 23 for control group) students were used for final analysis. Mann Whitney U test and Independent Sample T test used to test mean difference between intervention and control group after checking normality distributions to estimates the amount by which the training changes the outcome on average compared with the control. The result of the final model expressed in terms of adjusted mean difference and 95% CI; statistical significance declared if the P-value is less than 0.05. Results Among 44 postgraduate students, only 29.5% practices EBM during delivering of clinical services. Overall EBM knowledge was changed with adjusted mean difference (Mean±SD 17.55 (13.9, 21.3), p<000). This training provided significant change in all main domain of EBM, more in validity evaluation of the study (Mean±SD, 3.8(1.3, 6.2), p<0.0018) and impact of study design (Mean±SD, 3.8(2.6, 5.1), p<0.000). There was also significant change of overall attitude with adjusted mean difference (Mean±SD, -8.2(-9.6,-6.7), p = 000). Conclusion Clinical integrated EBM training brought significant change of knowledge and skills of principles and foundations of EBM. Adopting principles of EBM into curricula of postgraduate specialty students would assure the quality of medical care and educations.