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Consensus on evidence-based medicine curriculum contents for healthcare schools in Brazil
  1. Gabriela Andrade Araujo1,
  2. Luis Claudio Lemos Correia2,
  3. Julia Rodrigues Siqueira1,
  4. Leandro Calazans Nogueira1,3,
  5. Ney Meziat-Filho3,
  6. Leonardo Oliveira Pena Costa4,
  7. Felipe J Reis1
  1. 1Physical Therapy, Instituto Federal do Rio de Janeiro, Rio de Janeiro, Brazil
  2. 2Centro de Medicina Baseada em Evidência, Escola Bahiana de Medicina e Saúde Pública, Salvador, Brazil
  3. 3Postgraduate Program in Rehabilitation Sciences, Centro Universitario Augusto Motta, Rio de Janeiro, Brazil
  4. 4Masters and Doctoral Programs in Physical Therapy, Universidade da Cidade de São Paulo, São Paulo, Brazil
  1. Correspondence to Professor Felipe J Reis, Physical Therapy, Instituto Federal do Rio de Janeiro, Rio de Janeiro CEP 21715-000, Brazil; felipe.reis{at}


Objectives Healthcare professionals need to take into account their knowledge, skills and attitudes to develop a focused clinical question, perform an effective search of the literature, critically appraise the evidence, and apply to the clinical context and evaluate the effectiveness of the process. To date, there is a lack of consensus on evidence-based medicine (EBM) curriculum for undergraduate healthcare students in Brazil. The aim of this study was to develop a consensus on EBM curriculum contents for healthcare schools in Brazil considering expert opinion.

Design Modified three-round Delphi methodology.

Setting Online survey.

Participants The expert panel was composed of 40 healthcare professionals from different specialties. Most of the participants (n=24; 60%) were female with the age between 30 and 44 years. Participants were also experts in the field of epidemiology, biostatistics or public health. The mean experience of experts in teaching EBM was 9.5 years.

Main outcome measures An online questionnaire consisting of 89 items related to EBM was sent to the experts. The experts ranked each item of EBM curriculum considering the importance of each item as omitted, mentioned, explained or practised. The last section of the questionnaire was composed of ‘additional content’ where the experts evaluated only if an item should be included or not, the form of offering the EBM contents and the total workload (in hours/semester). Open-ended questions were present in each section to give the opportunity to experts to insert suggestions. Items that reached values greater than or equal to 70% of agreement among experts was considered definitive for the curriculum. Items between 51% and 69% of agreement were included for the next round and those items with less than or equal to 50% of agreement were considered unnecessary and were excluded. In the third round, the EBM contents were classified according to the degree of consensus as follow: strong (≥70% of agreement), moderate (51%–69% of agreement) and weak (50% of agreement) based on the maximum consensus reached.

Results Of the 89 initial contents, 32 (35.9%) reached a strong degree of consensus, 23 (25.8%) moderate degree of consensus, two (2.2%) weak degree of consensus and 35 items were not recommended (≤50% of agreement). The workload suggested by experts should be between 61 and 90 hour/semester and an EBM curriculum should be offered with epidemiology and biostatistics as prerequisites. Regarding the importance of each item, 29 (72.5%) should be explained and 25 (27.5%) should be practised with exercises.

Conclusions The consensus on an EBM curriculum for Brazilian healthcare schools consists of 54 items. This EBM curriculum also presents the degree of consensus (strong, moderate and weak), the importance of each item (mentioned, explained and practised with exercises). A total workload of between 60 and 90 hours per semester was suggested and the EBM curriculum should be offered with epidemiology and biostatistics as prerequisites, but also EBM contents should be included within other disciplines throughout the entire undergraduate course.

  • evidence-based practice
  • global health
  • health

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  • Contributors All authors contributed to the development of this study including data collection, data analysis, text, text review and supervision.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval All ethical principles were followed and the study was approved by the Ethics and Research Committee of the Instituto Federal do Rio de Janeiro (CAAE 83262217.5.0000.5268).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available on reasonable request. All data relevant to the study are included in the article or uploaded as online supplemental information. Additional data should be asked by email to

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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