Best Evidence Medical Education.

Abstract

Best evidence Medical Practice (BEMP) has given much needed direction to medical practice in the last quarter of a century. I vividly remember that during my education in Dow Medical College in early 80s, and later during my practice in UK in mid 80s and part of mid 90s, we practiced what we saw or sometimes read. In other words, Medical practice was based on fixed opinions. From early 90s, it was obvious that most doctors, especially those working in teaching hospitals, were becoming more sensitive towards the need for evidence before accepting any change in their practice. This was made easy by publication of meta-analyses, review articles, editorials, guidelines and invited lectures on key issues in conferences and seminars. Today we see doctors and researchers seeking best available evidence in decision- making and problem solving. However, unfortunately I see little change in attitudes as far as medical education is concerned. We, as medical teachers still prefer to follow our believes and instincts, seriously follow the myth and stay away from following or even finding best evidence. Something we so eagerly do in our clinical practice and while conducting research. As Petersen has put it in the words of teachers of medicine "I know about medical education. I'm not going, to change."
Why do these attitudes persist? What are the barriers to effective, evidence based medical education, and how may they be overcome1?
When this problem is highlighted in informal meetings, various explanations are given. These include unlike clinical practice and research that teaching is an art and not a science and hence cannot be evidence driven". However there are research articles regularly published in journals of medical education and Meta analyses being conducted. Here I would like to give some examples od such research articles and meta analysis.

I would like to particularly refer to a study conducted in Coventry hospital on final year medical students. It was found that those students who had interactive lectures performed significantly better in solving MCQs than those whose learning of the subject was through game playing2.