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Type: Journal article
Title: Harmonising evidence-based medicine teaching: a study of the outcomes of e-learning in five European countries
Author: Kulier, R.
Hadley, J.
Weinbrenner, S.
Meyerrose, B.
Decsi, T.
Horvath, A.
Nagy, E.
Emparanza, J.
Coppus, S.
Arvanitis, T.
Burls, A.
Cabello, J.
Kaczor, M.
Zanrei, G.
Pierer, K.
Stawiarz, K.
Kunz, R.
Mol, B.
Khan, K.
Citation: BMC Medical Education, 2008; 8(1):27-1-27-10
Publisher: BioMed Central
Issue Date: 2008
ISSN: 1472-6920
Statement of
Regina Kulier, Julie Hadley, Susanne Weinbrenner, Berrit Meyerrose, Tamas Decsi, Andrea R Horvath, Eva Nagy, Jose I Emparanza, Sjors FPJ Coppus, Theodoros N Arvanitis, Amanda Burls, Juan B Cabello, Marcin Kaczor, Gianni Zanrei, Karen Pierer, Katarzyna Stawiarz, Regina Kunz, Ben WJ Mol and Khalid S Khan
Abstract: BACKGROUND We developed and evaluated the outcomes of an e-learning course for evidence based medicine (EBM) training in postgraduate medical education in different languages and settings across five European countries. METHODS We measured changes in knowledge and attitudes with well-developed assessment tools before and after administration of the course. The course consisted of five e-learning modules covering acquisition (formulating a question and search of the literature), appraisal, application and implementation of findings from systematic reviews of therapeutic interventions, each with interactive audio-visual learning materials of 15 to 20 minutes duration. The modules were prepared in English, Spanish, German and Hungarian. The course was delivered to 101 students from different specialties in Germany (psychiatrists), Hungary (mixture of specialties), Spain (general medical practitioners), Switzerland (obstetricians-gynaecologists) and the UK (obstetricians-gynaecologists). We analysed changes in scores across modules and countries. RESULTS On average across all countries, knowledge scores significantly improved from pre- to post-course for all five modules (p < 0.001). The improvements in scores were on average 1.87 points (14% of total score) for module 1, 1.81 points (26% of total score) for module 2, 1.9 points (11% of total score) for module 3, 1.9 points (12% of total score) for module 4 and 1.14 points (14% of total score) for module 5. In the country specific analysis, knowledge gain was not significant for module 4 in Spain, Switzerland and the UK, for module 3 in Spain and Switzerland and for module 2 in Spain. Compared to pre-course assessment, after completing the course participants felt more confident that they can assess research evidence and that the healthcare system in their country should have its own programme of research about clinical effectiveness. CONCLUSION E-learning in EBM can be harmonised for effective teaching and learning in different languages, educational settings and clinical specialties, paving the way for development of an international e-EBM course.
Keywords: Humans
Program Evaluation
Attitude of Health Personnel
Health Knowledge, Attitudes, Practice
Evidence-Based Medicine
Cross-Cultural Comparison
Education, Distance
Education, Medical, Graduate
Education, Medical
Educational Measurement
Computer-Assisted Instruction
Middle Aged
Consumer Behavior
Surveys and Questionnaires
Rights: © 2008 Kulier et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
DOI: 10.1186/1472-6920-8-27
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Obstetrics and Gynaecology publications

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