Educating physicians in evidence based medicine: current practices and curricular strategies

Abstract

IntroductionEvidence-based medicine (EBM) is an expectation of professional healthcare and a requisite component of medical school curricula. However, upon graduation medical students’ EBM skills have been found lacking suggesting a need to examine EBM training.MethodsThis PhD report presents two studies on EBM education. The first study is a literature review that describes and attempts to assess educational interventions for teaching medical students EBM. The second study presents a multi-institutional case study conducted in North America using interviews and curricular materials to identify EBM instructors’ perceptions of challenges that may impede medical students’ efforts to learn EBM.ResultsThe literature review analyzed 20 learning interventions from 12 countries that were presented in classrooms (75 %) and clinics (25 %). The steps of EBM were addressed to varying degrees. It was not possible to draw conclusions about the efficacy of the interventions due to lack of detailed reporting. The qualitative study identified four learning challenges: sub-optimal role models, student lack of willingness to admit uncertainty, lack of clinical context, and difficulty mastering EBM skills. To meet these challenges, participants described interventions such as integrating EBM skills with other content/courses, incorporating clinical content into EBM teaching, providing faculty development, using whole-task EBM activities, and longitudinal integration of EBM across the curriculum.ConclusionThis PhD report takes steps to describe and assess EBM learning interventions, presents student learning challenges and looks at approaches institutions take to meet them. Educators can use these findings to examine their curriculum and learning environments and, if desired, adopt them for their training.

Evidence-based medicine, shared decision making and the hidden curriculum: a qualitative content analysis

“…Clinical decision making is not uniform and opinions regarding the "proper" management may differ among clinicians; however, these various courses of actions need to be grounded in the best available evidence, acknowledge limitations in the evidence, and patients values and preferences. Role modeling has been shown to play an important role in transferring positive aspects of the hidden curriculum [41,42] and EBM skills [43]. Our results suggest that PowerPoint slides should be con-sidered as an additional medium to model EBM and SDM skills during day-to-day clinical didactic teaching.…”

Improving case study research in medical education: a systematised review

“…Among the 72 articles included in the review (see Appendix S1, online, for a full list), 10 papers reported findings from four overarching studies. These included three papers by Rodr ıguez et al, [15][16][17] one paper by L opez-Roig et al, 18 two papers by Van Hoof et al, 19,20 one paper by Maggio 21 and one by Maggio et al, 22 and two papers by Preston et al 23,24 The articles reviewed utilised a CSR approach for a diverse range of topics (Appendix S1).…”

Dental training in evidence-based dentistry: A replication study

“…According to the literature, teaching of EbM content can be successfully achieved in various settings (teacher-centred, e-learning, blended learning) [13,27,28]. In the present study, the resource was defi ned as an optional means for students' self-study.…”