Occupational Medicine Advance Access published online on January 18, 2008
Occupational Medicine, doi:10.1093/occmed/kqm151
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Evaluation of a workshop on evidence-based medicine for social insurance physicians
1 Research Center for Insurance Medicine AMC-UWV-VUmc, Amsterdam, The Netherlands
2 Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
3 Finnish Institute of Occupational Health, Knowledge Transfer Team, Kuopio, Finland
Background Evidence-based medicine (EBM), a comprehensive method to support clinical decision making by using evidence, has been instrumental in clinical specialties but not yet in insurance medicine.
Aims We developed and evaluated a workshop on EBM for Dutch social insurance physicians who perform disability evaluations.
Methods Sixty-six social insurance physicians followed a 1-day introductory workshop that focused on teaching two EBM core skills: to ask answerable questions and to search for the best evidence. All outcomes were measured before, immediately after and 3 months after the workshop by means of self-assessment. The primary outcomes were knowledge, skills, attitude and intention to apply EBM in practice. The secondary outcomes were social influence, self-efficacy and behaviour.
Results Immediately after the workshop, a marked and significant improvement was seen in self-assessed skills (mean difference 4.2, 95% CI 3.7–4.6) and in self-efficacy to apply EBM (mean difference 0.7, 95% CI 0.6–0.8). For attitude, knowledge and intention, the improvements were small. Three months after the workshop, the improvements in skills (mean difference 2.3, 95% CI 1.8–2.9) and self-efficacy (mean difference 0.5, 95% CI 0.3–0.6) remained significant.
Conclusions The workshop improved self-assessed EBM skills and self-efficacy both in the short and long term. The workshop also resulted in limited short-term improvements in self-assessed knowledge and in the intention to apply EBM in practice. The EBM approach can be successfully taught to social insurance physicians working in the field of disability evaluation.
Keywords Continuous medical education; disability evaluation; disability [MeSH]; education (MeSH); evidence-based medicine; insurance medicine; postgraduate education
Correspondence to: Rob Kok, Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, PO Box 22700, 1100 DE Amsterdam, The Netherlands. Tel: +31 20 56 639 03; fax: +31 20 56 692 88; e-mail: r.kok{at}amc.uva.nl