An increasing number of medical schools and residency programs are instituting
curricula for teaching the principles and practice of evidence-based medicine
(EBM). For example, 95% of US internal medicine residency programs have journal
clubs1 and 37% of US and Canadian internal
medicine residencies have time dedicated for EBM.2
Curricula based on EBM are increasingly popular in residency programs in other
specialties, including family medicine, pediatrics, obstetrics/gynecology,
and surgery.3 Despite the widespread teaching
of EBM, however, most of what is known about the outcomes of evidence-based
curricula relies on observational data. Although evaluation of the quality
of research evidence is a core competency of EBM, the quantity and quality
of the evidence for effectively teaching EBM are poor. Ironically, if one
were to develop guidelines for how to teach EBM based on these results, they
would be based on the lowest level of evidence.