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Teaching Evidence-Based Complementary and Alternative Medicine (EBCAM); Changing behaviours in the face of reticence: A cross-over trial

  • Mills, Edward1
  • Hollyer, Taras1
  • Saranchuk, Ron1
  • Wilson, Kumanan2
  • 1 The Canadian College of Naturopathic Medicine, Department of Research, North York, Canada , North York (Canada)
  • 2 University of Toronto, Department of Medicine, Toronto, Canada , Toronto (Canada)
Published Article
BMC Medical Education
Springer (Biomed Central Ltd.)
Publication Date
Jan 14, 2002
DOI: 10.1186/1472-6920-2-2
Springer Nature


BackgroundThe effectiveness of teaching critical appraisal to students of Complementary and Alternative Medicine (CAM) has not been studied. In this study we attempt to determine if a workshop for final year students at a naturopathic college improved their ability to utilize critical appraisal concepts.MethodsWe assigned 83 Naturopathic Interns to two groups: Group A (n = 47) or Group B (n = 36). We conducted a baseline assessment of all subjects' critical appraisal skills. Group A was assigned to receive a 3 ½ hour workshop on Evidence Based Medicine (EBM) and Group B received a workshop on bioethics (control intervention). The groups critical appraisal skills were re-evaluated at this time. We then crossed over the intervention so that Group B received the EBM workshop while Group A received the bioethics workshop. Assessment of critical appraisal skills of the two groups was again performed.ResultsThe students mean scores were similar in Group A (14.8) and Group B (15.0) after Group A had received the intervention and Group B had received the control (p = 0.75). Group scores were not significantly improved at the end of the trial compared to at the beginning of the study (Group A: 15.1 to 16.1) (Group B 15.6 to 15.9). Student's confidence in reading research papers also did not improve throughout the course of the study.ConclusionThe final year is a difficult but important time to teach critical appraisal and evidence skills. Single, short intervention programs will likely yield negligible results. A multi-factorial approach may be better suited to implementing EBCAM than single short interventions.

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