Faculty and Resident Perspectives on Teaching Pediatric Evidence-Based Medicine in the Clinical Setting: A Qualitative Study

Purpose: To describe how pediatric educators effectively teach evidence-based medicine (EBM) in the clinical setting. Secondarily, to identify barriers hindering effective practice and teaching of EBM and strategies to overcome these barriers. Methods: The authors conducted a cross-sectional multi-institutional qualitative study from July 2016 to December 2017 in which they interviewed pediatric educators across many subspecialties who were identified as exemplary teachers of EBM at 3 academic pediatric residency programs. Pediatric residents who had recently worked with these faculty members were also interviewed to allow triangulation between participants. Qualitative analysis was complete once saturation was achieved. Results: Twenty-six pediatric educators identified as exemplary teachers of EBM and 10 residents who worked with those educators participated in the study. Thirteen explicit teaching strategies and 2 implicit teaching strategies, namely disclosure of uncertainty and role modeling, were identified. Barriers to practicing clinical EBM included balancing patient responsibilities, inadequate time, and personal knowledge. Barriers to teaching clinical EBM were inadequate time and learner engagement. To overcome these barriers, faculty limit and focus teaching points, attempt to make EBM relevant to patient care, and incorporate follow-up strategies. Conclusions: Numerous teaching strategies are available to faculty to improve the clinical teaching of EBM and to overcome commonly encountered clinical EBM barriers. Familiarity with these clinical EBM teaching strategies can be used for faculty development and to enhance the teaching of EBM to learners.