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Teaching evidence-based medicine by using a systematic review framework: implementation in a Swedish university setting
  1. Maria Björklund1,
  2. Martin Ringsten2,
  3. Matteo Bruschettini2,3,
  4. Martin Garwicz4,5
  1. 1Library & ICT, Faculty of Medicine, Lunds University, Lund, Sweden
  2. 2Department of Research and Education, Lund University, Skåne University Hospital, Cochrane Sweden, Lund, Sweden
  3. 3Paediatrics, Department of Clinical Sciences Lund, Lund University, Skåne University Hospital, Lund, Sweden
  4. 4Department of Experimental Medical Science, Neuronano Research Center, Lunds University Faculty of Medicine, Lund, Sweden
  5. 5Birgit Rausing Centre for Medical Humanities, Department of Experimental Medical Science, Faculty of Medicine, Lund University, Lund, Sweden
  1. Correspondence to Ms Maria Björklund, Library & ICT, Lunds University Faculty of Medicine, Sölvegatan 19, 22240, Lund, Sweden; maria.bjorklund{at}

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Evidence-based practice improves healthcare and patient outcomes, by providing a framework for integrating research into clinical practice. Evidence-based practice is considered a core competency in medical education.1–6 Here, the term evidence-based medicine (EBM) describes evidence-based practice in medicine and healthcare. The core competencies in EBM are often described as the ability to:

  • Formulate a research question

  • Find best available research

  • Critically appraise research findings

  • Evaluate strength/certainty of evidence

Although these competencies are part of curricula for medical and health education programmes in Sweden, there is no consensus on which methods best support learning of EBM.7 8 Teaching varies between contexts regarding (a) emphasis on EBM in a curriculum, (b) teaching methods, (c) online versus in-classroom or clinical setting, (d) frequency of learning and (e) assessment of learning.4 8–13 There is a large number of models and tools designed to understand and facilitate EBM, for example, evidence hierarchy, critical appraisal or risk of bias assessment tools and checklists. It can be difficult for students to get an overview of which tools are relevant and when.6 At our university, students expressed a need for training in how to formulate questions, find relevant research and assess and grade the evidence. Application of EBM methods is something students found challenging and we have seen a need to help students better understand how they can approach the steps of EBM. As components of the EBM process are interdependent, we believe that it is essential to provide a framework for understanding, learning and practising EBM and related tools. It is reasonable to assume that teaching and learning the processes of EBM and systematic review methodology could benefit from being delivered with continuity and progression, which however does not always occur due to limited available resources. EBM education can be delivered in different …

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  • Presented at Parts of this paper were included in a short oral presentation by Maria Björklund at the Cochrane Colloquium in London, 4–6 September 2023. Björklund M, Garwicz M, Bruschettini M, Ringsten, M. Creating a systematic review infrastructure: Implementing Cochrane tools for students, teachers, researchers and clinicians in a university setting. Conference abstract available:

  • Contributors MBjörklund wrote the first draft. All authors contributed to revising the manuscript, figures and table. All authors gave final approval of the version to be published.

  • 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 All authors are members of Cochrane.

  • Provenance and peer review Commissioned; externally peer reviewed.

  • 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.