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Logo of bmcmeduBioMed Centralsearchsubmit a manuscriptregisterthis articleBMC Medical Education
 
BMC Med Educ. 2004; 4: 30.
Published online 2004 December 7. doi:  10.1186/1472-6920-4-30
PMCID: PMC539272
Critical appraisal skills training for health care professionals: a randomized controlled trial [ISRCTN46272378]
Rod S Taylor,corresponding author1 Barnaby C Reeves,2 Paul E Ewings,3 and Rebecca J Taylor4
1Department of Public Health & Epidemiology, University of Birmingham; Birmingham, UK
2Health Services Research Unit, School of Hygiene and Tropical Medicine; London, UK
3Somerset Research and Development Support Unit, Taunton & Somerset NHS Trust, Taunton; UK
4Health Economics Facility, University of Birmingham, Birmingham, UK
corresponding authorCorresponding author.
Rod S Taylor: r.s.taylor/at/bham.ac.uk; Barnaby C Reeves: barney.reeves/at/lshtm.ac.uk; Paul E Ewings: paul.ewings/at/tst.nhs.uk; Rebecca J Taylor: r.j.taylor/at/bham.ac.uk
Received August 16, 2004; Accepted December 7, 2004.
Abstract
Introduction
Critical appraisal skills are believed to play a central role in an evidence-based approach to health practice. The aim of this study was to evaluate the effectiveness and costs of a critical appraisal skills educational intervention aimed at health care professionals.
Methods
This prospective controlled trial randomized 145 self-selected general practitioners, hospital physicians, professions allied to medicine, and healthcare managers/administrators from the South West of England to a half-day critical appraisal skills training workshop (based on the model of problem-based small group learning) or waiting list control. The following outcomes were assessed at 6-months follow up: knowledge of the principles necessary for appraising evidence; attitudes towards the use of evidence about healthcare; evidence seeking behaviour; perceived confidence in appraising evidence; and ability to critically appraise a systematic review article.
Results
At follow up overall knowledge score [mean difference: 2.6 (95% CI: 0.6 to 4.6)] and ability to appraise the results of a systematic review [mean difference: 1.2 (95% CI: 0.01 to 2.4)] were higher in the critical skills training group compared to control. No statistical significant differences in overall attitude towards evidence, evidence seeking behaviour, perceived confidence, and other areas of critical appraisal skills ability (methodology or generalizability) were observed between groups. Taking into account the workshop provision costs and costs of participants time and expenses of participants, the average cost of providing the critical appraisal workshops was approximately £250 per person.
Conclusions
The findings of this study challenge the policy of funding 'one-off' educational interventions aimed at enhancing the evidence-based practice of health care professionals. Future evaluations of evidence-based practice interventions need to take in account this trial's negative findings and methodological difficulties.
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