Extended Evaluation of a Longitudinal Medical School Evidence-Based Medicine Curriculum

Abstract

BACKGROUND: Evidence-based medicine (EBM) is an important element of medical education. However, limited information is available on effective curricula. OBJECTIVE: To evaluate a longitudinal medical school EBM curriculum using validated instruments. DESIGN, PARTICIPANTS, MEASUREMENTS: We evaluated EBM attitudes and knowledge of medical students as they progressed through an EBM curriculum. The first component of the curriculum was an EBM "short course" with didactic and small-group sessions occurring at the end of the second year. The second component integrated EBM assignments with third-year clinical rotations. The 15-point Berlin Questionnaire was administered before the course in 2006 and 2007, after the short course, and at the end of the third year. The 212-point Fresno Test was administered before the course in 2007 and 2008, after the short course, and at the end of the third year. Selfreported knowledge and attitudes were also assessed in all three classes of medical students. RESULTS: EBM knowledge scores on the 15-point Berlin Questionnaire increased from baseline by 3.0 points (20.0%) at the end of the second year portion of the course (p<001) and by 3.4 points (22.7%) at the end of the third year (p<001). EBM knowledge scores on the 212-point Fresno Test increased from baseline by 39.7 points (18.7%) at the end of the second year portion of the course (p<001) and by 54.6 points (25.8%) at the end of the third year (p<001). On a 5-point scale, self-rated EBM knowledge increased from baseline by 1.0 and 1.4 points, respectively (both p<001). EBM was felt to be of high importance for medical education and clinical practice at all time points, with increases noted after both components of the curriculum. CONCLUSIONS: A longitudinal medical school EBM was associated with markedly increased EBM knowledge on two validated instruments. Both components of the curriculum were associated with gains in knowledge. The curriculum was also associated with increased perceptions of the importance of EBM for medical education and clinical practice.KEY WORDS: medical education; evidence-based medicine; medical school.

Evaluation of the Long-Term Impact of a Curriculum-Integrated Medical Information Literacy Program

“…The Berlin and Fresno tests are often mentioned as valid EBM tests, but were unfortunately not applicable to this study. The Berlin test [3,10] does not include assessment of skills, such as literature searching, and the Fresno test [11] is very demanding in time and resources. The EPIC scale [12] only has one question about the perceived ability to conduct a literature search, whereas the ACE tool [13] asks four questions about the PICO question and search strategy for a given patient scenario.…”

“…Part 1 focused on attitudes and behaviours and part 2 required the students to answer some knowledge questions based on the Queen's University medical information literacy objectives. Although many authors [7,10] mention that selfrating of EBM skills is not reliable and does not correlate to knowledge, this survey asked the students to rate their confidence levels with the two components of EBM of interest: question formulation and information searching. The goal was to link the confidence levels to the knowledge questions within the survey, attempting to either confirm or disprove the results of earlier studies.…”

Evidence Based Medicine Teaching in Undergraduate Medical Education: A Literature Review

“…Barnett et al (2000) evaluated EBM instruction integrated into the first-year medical education curriculum and clinical education; while the study by West et al (2011) reported the outcomes of a longitudinal EBM into the second-year preclinical education and third-year core clinical rotations. Studies on EBM during clinical rotations were conducted at various settings of clerkships of internal medicine, family medicine, and pediatrics on community campuses (Wadland et al, 1999), outpatient internal medicine clerkship (Ghali et al, 2000;Thomas & Cofrancesco, 2001), inpatient portion of internal medicine clerkship blocks (Sastre et al, 2011), family medicine clerkship (Cayley, 2005;Schilling et al, 2006), or core clinical clerkship rotations such as internal medicine, surgery, pediatrics, obstetrics and gynecology, neurology, and psychiatry (Aronoff et al, 2010;Barnett et al, 2000;West et al, 2011).…”

“…The primary goal of EBM instruction in the 13 studies was to develop medical students' essential skills for evidence based practice and evidence based problem solving; other goals included developing lifelong learners (Barnett et al, 2000;Dorsch et al, 2004), introducing basic concepts of epidemiology and biostatistics (West et al, 2011), and developing and presenting a research proposal (Wadland et al, 1999). EBM skills were the main focus of the EBM interventions in the studies; however, the EBM interventions reported in three studies included no content on the second step of the EBM process -acquiring the evidence (Srinivasan et al, 2002;Wadland et al, 1999;West et al, 2011).…”

A Longitudinal Evidence-Based Medicine Curriculum and Its Impact on the Attitudes and Perceptions of Student Pharmacists

“…3 Today, most medical schools include EBM in their curricula, although its' implementation is not standardized. [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] Several studies have examined the knowledge, skills, behaviors and/or attitudes of physicians and medical students, as well as in other health professions, such as, nursing and physical therapy. [4][5][6]9,10,12,14,15,[19][20][21][22] A J P E…”