Background: A key component of systematic reviews of healthcare interventions is assessing the risk of bias in included randomized controlled trials (RCTs). Conducting a reliable risk of bias assessment requires effective training.
Objectives: To assess the effectiveness of comprehensive training in improving risk of bias assessment.
Methods: Medical students with no prior formal training in systematic reviews were recruited to participate in a non-randomized study. All participants received a 90-minute workshop by an expert Cochrane author using Cochrane standard author training material. The workshop was in the form of 10-15 minute presentation segments blended with class discussion. Both groups received a PDF of Chapter 8 of the Cochrane Handbook as a study guide. The intervention group (comprehensive training) included 58 students who received a second workshop (90 minutes) that was entirely dedicated to practice using Review Manager and a published RCT. The final phase of the comprehensive training was on the job work. Each student assessed the risk of bias in one RCT included in an ongoing systematic review. After completing the training course, participants of both groups took an exam by completing a Cochrane 'Risk of bias' assessment for a published trial. The examiner developed an answer key and marked all answers. We used SAS University Edition to calculate the odds ratio (OR) and its 95% confidence interval (CI) to measure the effect of intervention.
Results: We included 82 participants. We provided standard training to 24 participants and comprehensive training to 58 participants. Comprehensive training improved skills of assessing the risk of bias compared to standard training (sequence generation: OR 3.05, 95% CI 1.07 to 8.67; allocation sequence concealment: OR 6.96, 95% CI 2.42 to 20.06; blinding of participants and personnel: OR 2.66, 95% CI 0.98 to 7.25; blinding of outcome assessment: OR 3.46, 95% CI 1.26 to 9.51; incomplete outcome data: OR 5.77, 95% CI 2.06 to 16.18; selective outcome reporting OR: 5.05, 95% CI 1.79 to 14.25).
Conclusions: Comprehensive training results in large gains and help both new authors and editorial boards.