Effect of evidence-based Medical Education on knowledge and ability to use and apply it among clinical students of Bushehr University of Medical Sciences: a controlled trial

Abstract

Background: Evidence Based Medicine is the ability of physicians to use and integrate the best clinical evidence based in accordance with patient's condition, that this evidence have obtained from reliable clinical trials and without bias. In recent years To improve the clinical care quality provided to patients, physicians clinical experience have been combined with research evidence of similar clinical case. The aim of this study was to determine the effect of short-term implementation of evidence-based medical education on knowledge and ability to apply it among clinical students of Bushehr University of Medical Sciences. Materials & Methods: this study was a pre and post control quasi-experimental study which was performed on two groups of clinical medicine (senior students studying in the academic year 2012-13) in Bushehr University of Medical Sciences. The students were selected by census method. At the beginning of course, in the intervention group, after providing a description of the operational objectives, students trained four sessions for four hours and carried out by professor's guidance 5 standard step implementation of evidencebased medicine included question, search, critical evaluation of evidence, implementation and evaluation respectively. The knowledge and ability of students were evaluated by using valid and reliable questionnaire, pre-test and post-test (the intervention group within three months of training) about the use of evidence-based medicine in intervention group (26 students) and control group (23 students). Results: The results showed that increasing the students' familiarity with the terminology and sources used in evidence-based medicine (p=0.000). Also this study showed the increasing of students' knowledge level from evidence-based medicine implementation process and also the ability of them in implementation and application of evidence-based medicine after intervention (p=0.000 & p=0.000, respectively) Conclusion: It seems that there are the need for training of medical students in clinical courses about epidemiology of concepts and terms used in discussing evidence-based medicine toward epidemiological concepts and terms which used in the discussion of evidence-based medicine in order to enhance their ability in critical analysis of studied articles with the aim of increasing the ability of them in making appropriate and correct clinical decisions especially in the form of workshops and practical training.

Teaching Evidence-Based Medicine (EBM) to Undergraduate Medical Students through Flipped Classroom Approach

“…The lowest posttest scores were in the domain of biostatistics; this may be due to unfamiliarity of medical students with these concepts. The same results were observed in our previous study (7,14).…”

“…Other studies showed the positive effects of EBM education on students' knowledge (5,7,9). The results of posttest scores based on the EBM domains revealed that the best result is obtained in teaching PICO, which is due to the fact that clinical cases for EBM teaching are straightforward and clearly talk about the 4 constituents of the PICO questions.…”

“…EBM addresses these issues to keep clinicians up-to-date about new information. In our previous articles, we found that in spite of positive attitude toward EBM, different groups of residents were not familiar with EBM due to the lack of education about EBM in their undergraduate period (7,14,15).…”

“…We also used questionnaires based on Berlin questionnaire (6) to measure students' knowledge, attitude, and practice about the EBM course in a pre-and posttest design. The validity and reliability of the questionnaire had been approved in our previous study (7). Moreover, the result of a summative examination after finishing the course was used as a measure of course goal achievement.…”

“…The undergraduate education in the 21st century project in the United States of America acknowledged practicing EBM as one of the 9 capacities to be combined into the medical school curriculum in the clinical years (4). The model of EBM and its educational implication have distributed quickly in recent years (5).The report of EBM education in most medical schools all over the world indicated that knowledge and satisfaction of students were increased after participating in these workshops (6)(7)(8)(9).…”