In Search of Evidence

Chapter 10
What and How to Teach
Chapter 2 ends with a quote by Gordon Guyatt. ‘When I started, I thought we
were going to turn people into evidence-based practitioners, that they were really
going to understand the methodology, that they were really going to critique the
literature and apply the results to clinical practice. I no longer believe that. What I
believe now is that there will be a minority of people who will be evidence-based
practitioners, and that the other folk will be evidence users who will gain a respect for
the evidence and where it comes from...’ When I interviewed Guyatt in the autumn of
2013, I asked him what this means for his teaching. He answered that he still teaches
in the same way he always did. ‘But one thing I have learned about teaching evidencebased
practice…is that specific content is largely irrelevant. And the reason I say this is
that I’ve learned that people forget most of what you teach them. So the only purpose
is to inspire people. Inspire them and teach them an attitude... So I teach evidencebased
practice exactly the same way, I just have a different purpose when I’m teaching
it.’ (Barends & Briner, 2014)
I agree with Guyatt that the most important purpose of teaching evidence-based
practice is to inspire students and teach them a critical attitude. Making them
understand that human reasoning is fallible and affects the world we observe.
However, I think we must do more than that. I strongly believe that we should strive to
make people scientifically literate. Teach them skills to critically appraise the
trustworthiness of evidence, regardless of its source. It is my experience that teaching
students these skills is not that difficult, even when the evidence concerns a scientific
study published in an academic journal. The trustworthiness of a scientific study is first
and foremost determined by its methodological appropriateness — is the way in which
the study is designed the best way to answer the research question? As the building
blocks of a research design are limited (randomization, control group, before-after
measurement), determining a study’s design turns out to be not that difficult for
students. The same is true for methodological quality (the way in which the study is
conducted). From a practical point of view, appraisal questions can usually be limited
to two to three, covering those aspects that have the highest impact on a study’s
methodological quality. Answering these two to three questions does also not seem to
be too difficult for students and practitioners, especially when supported by quality
standards and tips on where and what to look for in an academic paper, for instance
using of an online tool or a smartphone app.
It is sometimes argued that in order to be able to critically appraise the quality of
research, students must first learn how to set up and carry out research themselves.
This argument can easily be countered by pointing out that this seems not to be true
for many other things in life. For example, being able to make wine is not a