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January 8, 2003

Research in Medical Education

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2003;289(2):176. doi:10.1001/jama.289.2.176-d

To the Editor: In their Commentary, Drs Hatala and Guyatt1 argue that better evidence is needed to assess the teaching of evidence-based medicine (EBM). I have some fundamental questions about these authors' assumptions. Is there high-quality evidence that practicing EBM affects patients' outcomes? I ask this question not to propose that such studies be undertaken but to raise the point that we can know some things are good and useful without performing randomized controlled studies. If so, should then the teaching of EBM be held to a higher standard than its practice? Is there equipoise as to the merits of other bases for teaching students and residents? If not, then should we subject learners to randomized controlled studies to catalog more evidence about what is already evident? Instead of turning to the field of health services research for ideas about ever more complex research designs to improve teaching, perhaps we should look to the field of education for models to evaluate the methods and to reinvigorate the teaching of EBM.

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