A study on how using an interactive multimedia e-book improves teachers’ ability to teach evidence-based medicine depending on their seniority

(2021) 21:547 Liao et al. BMC Med Educ https://doi.org/10.1186/s12909-021-02984-2 Open Access RESEARCH A study on how using an interactive multimedia e‑book improves teachers’ ability to teach evidence‑based medicine depending on their seniority Yu‑Hsuan Liao1, Kuo‑Shu Tang1, Chih‑Jen Chen1, Ying‑Hsien Huang1 and Mao‑Meng Tiao1,2,3* Abstract Background: Teaching evidence-based medicine (EBM) is not an easy task. The role of the electronic book (e-book) is a useful supplement to traditional methods for improving skills. Our aim is to use an interactive e-book or Power‑ Point to evaluate instructors’ teaching effects on EBM. Methods: Our study group was introduced to learning EBM using an interactive e-book available on the Internet, while the control group used a PowerPoint presentation. We adopted the Modified Fresno test to assess EBM skills both before and after their learning. EBM teaching sessions via e-book or PowerPoint were 20–30 min long, followed by students’ feedback. We adopted Student’s t-test to compare teachers’ evaluation of their EBM skills prior to the class and the students’ assessment of the teachers’ instruction. We also adopted repeated measures ANCOVA to compare teachers’ evaluation of their EBM skills using the Fresno test both before and after the class. Results: We observed no difference regarding EBM skills between the two groups prior to their experimental learn‑ ing, which was assessed by the Modified Fresno test. After learning, physicians in the study group ranked higher in choosing a case to explain which kind of research design was used for the study type of the question and explaining their choice (P = 0.024) as assessed by the post-test to pre-test Fresno test. Teaching effect was better in the e-book group than in the control group for the items, “I am satisfied with this lesson,” “The teaching was of high quality,” “This was a good teaching method,” and “It aroused my interest in EBM.” However, no differences were observed between the two groups in physicians who had more than 10 years’ experience. Conclusions: The use of interactive e-books in clinical teaching can enhance a teacher’s EBM skills, though not in more senior physicians. This may suggest that teaching methodology and activities differ for teachers’ varying years of experience. Keywords: Evidenced-based medicine, e-books, Teaching *Correspondence: 1 Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan Full list of author information is available at the end of the article Background Using the best evidence for determining a patient’s therapy is important [1]. Traditionally, the ability to make treatment decisions was limited to a physician’s own experience with the problem, which carries the potential risk of error [2–5]. The value of evidencebased medicine (EBM), which involves using updated, © The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativeco mmons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. Liao et al. BMC Med Educ (2021) 21:547 relevant, and trustworthy evidence to inform medical decisions, has been broadly acknowledged [6]. As a result, teaching EBM has become crucial for medical students’ development into lifelong independent learners and critical thinkers that can offer high-quality patient care [7]. The research problem is that physicians—even senior ones—may miss some of the important nuances of EBM, which subsequently impacts the quality of their teaching [7]. Given the lack of EBM teaching aids, we considered whether an interactive e-learning tool using SimMAGIC software [8] could be used as an effective teaching aid for EBM. In this study, our aim was to use an interactive e-book or PowerPoint to evaluate instructors’ teaching effects on EBM. Chiu reported that, according to a national survey in Taiwan, the knowledge, skills, and attitudes regarding evidence-based practice (EBP) improved among physicians and nurses after undergoing training [9], thus indicating that the practice of EBM is important and can be improved through training [10]. Using Internet information sources to answer patient-related questions has taken an ever more important place in the daily practice of physicians [11]. A practical new instrument for measuring good-quality clinical application is vital for educating teachers and evaluating the effect of their teaching [12]. Electronic learning (e-learning) differs from traditional educational methods in that it uses digital platforms for learning [13, 14]. Using technology for learning has the benefit of being more student-focused and flexible [15]. The learner becomes a more active participant in the acquisition of knowledge, as opposed to being a passive recipient [13]. Cook reported that e-learning performs on par with traditional classroom teaching [16]. However, other researchers have reported that e-learning is no better than traditional classroom education for improving the proficiency of novices [17]. In modern curricula, e-book technology is considered a useful supplement to traditional methods [18, 19]. However, no studies have yet indicated whether the teaching effect of a lecturer is better after learning from an online e-book than traditional learning. Our aim was to use an interactive e-book or PowerPoint to evaluate instructors’ teaching effects on EBM in order to evaluate the effectiveness of a clinical teaching EBM e-book to improve teacher-related skills, as well as to foster both teachers’ and learners’ interest in studying EBM. One month later, we arranged for every teacher to teach an EBM class and to have students assess the effectiveness of their teaching. This method may be a promising and effective way to improve physicians’ EBMteaching skills in the future. Page 2 of 9 Methods Ethical process This study was approved by the institutional review board of the ethics and clinical research committee of CGMH (104-9177B). All teachers and students provided their consent (...truncated)