Evidence-based medicine in internal medicine clerkships: a national survey.

Background: Although evidence-based medicine (EBM) has become widely accepted, the extent of its implementation during clinical clerkships is not well described. This study was done to characterize the implementation of formal EBM curricula in internal medicine clerkships.

Methods: In 1999, the Clerkship Directors in Internal Medicine surveyed its membership from 123 medical schools. The EBM section of the four-part survey addressed implementation, teaching and evaluation techniques, and barriers to implementing EBM.

Results: Survey response was 89%. Of 109 respondents, 38.5% reported having a formal EBM curriculum at some time during the third year and/or fourth year. Variability existed in curricular materials and evaluation tools used. The most common barriers to implementing EBM were lack of time and inadequately trained faculty.

Conclusions: Evidence-based medicine has been formally incorporated into relatively few internal medicine clerkships. Faculty development programs in conjunction with innovative teaching methods may help overcome these barriers.