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A cluster randomized controlled trial to evaluate the effectiveness of the clinically integrated RHL evidence -based medicine course

机译：一项随机分组的随机对照试验，以评估临床综合RHL循证医学课程的有效性

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Background and objectives: Evidence-based health care requires clinicians to engage with use of evidence in decision-making at the workplace. A learner-centred, problem-based course that integrates e-learning in the clinical setting has been developed for application in obstetrics and gynaecology units. The course content uses the WHO reproductive health library (RHL) as the resource for systematic reviews. This project aims to evaluate a clinically integrated teaching programme for incorporation of evidence provided through the WHO RHL. The hypothesis is that the RHL-EBM (clinically integrated e-learning) course will improve participants' knowledge, skills and attitudes, as well as institutional practice and educational environment, as compared to the use of standard postgraduate educational resources for EBM teaching that are not clinically integrated. Methods: The study will be a multicentre, cluster randomized controlled trial, carried out in seven countries (Argentina, Brazil, Democratic Republic of Congo, India, Philippines, South Africa, Thailand), involving 50-60 obstetrics and gynaecology teaching units. The trial will be carried out on postgraduate trainees in the first two years of their training. In the intervention group, trainees will receive the RHL-EBM course. The course consists of five modules, each comprising self-directed e-learning components and clinically related activities, assignments and assessments, coordinated between the facilitator and the postgraduate trainee. The course will take about 12 weeks, with assessments taking place pre-course and 4 weeks post-course. In the control group, trainees will receive electronic, self-directed EBM-teaching materials. All data collection will be online. The primary outcome measures are gain in EBM knowledge, change in attitudes towards EBM and competencies in EBM measured by multiple choice questions (MCQs) and a skills-assessing questionniare administered eletronically. These questions have been developed by using questions from validated questionnaires and adapting them to the current course. Secondary outcome measure will be educational environment towards EBM which will be assessed by a specifically developed questionnaire. Expected outcomes: The trial will determine whether the RHL EBM (clinically integrated e-leraning) course will increase knowledge, skills and attitudes towards EBM and improve the educational environment as compared to standard teaching that is not clinically integrated. If effective, the RHL-EBM course can be implemented in teaching institutions worldwide in both, low-and middle income countries as well as industrialized settings. The results will have a broader impact than just EBM training because if the approach is successful then the same educational strategy can be used to target other priority clinical and methodological areas.
机译：背景和目标：基于证据的医疗保健要求临床医生在工作场所的决策中参与证据的使用。已经开发了以学习者为中心，以问题为基础的课程，该课程在临床环境中集成了电子学习功能，可用于妇产科。该课程内容使用WHO生殖健康图书馆（RHL）作为系统评价的资源。该项目旨在评估一项临床综合教学计划，以纳入通过WHO RHL提供的证据。假设是，与使用标准的研究生教育资源进行EBM教学相比，RHL-EBM（临床集成电子学习）课程将提高参与者的知识，技能和态度以及机构实践和教育环境。没有临床整合。方法：该研究将是一项多中心，整群随机对照试验，在七个国家（阿根廷，巴西，刚果民主共和国，印度，菲律宾，南非，泰国）进行，涉及50-60个妇产科教学单位。该试验将在培训的头两年对研究生进行。在干预小组中，学员将接受RHL-EBM课程。该课程由五个模块组成，每个模块都包括自我指导的电子学习组件以及与临床相关的活动，作业和评估，并在辅导员和研究生之间进行协调。该课程大约需要12周，评估是在课前和课后4周进行的。在对照组中，学员将获得电子的，自我指导的EBM教学材料。所有数据收集将在线进行。主要结局指标是通过选择题（MCQ）衡量的EBM知识的获得，对EBM态度的变化以及EBM的能力以及通过电子方式进行的技能评估问题。这些问题是通过使用经过验证的问卷中的问题并使它们适应当前课程而开发出来的。次要结果衡量指标是针对EBM的教育环境，将通过专门开发的调查表对其进行评估。预期成果：与没有临床整合的标准教学相比，RHL EBM（临床整合电子学习）课程将确定是否会增加对EBM的知识，技能和态度，并改善教育环境。如果有效，RHL-EBM课程可以在中低收入国家以及工业化地区的全球教学机构中实施。结果将比单纯的EBM培训具有更广泛的影响，因为如果成功的话，可以使用相同的教育策略来瞄准其他优先的临床和方法学领域。

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