Critical appraisal of RCTs by 3rd year undergraduates after short courses in EBM compared to expert appraisal

Development and evaluation of an evidence-based medicine module in the undergraduate medical curriculum

BACKGROUND

Evidence-based medicine (EBM) is a core competence in both undergraduate and postgraduate medical curricula. However, its integration into curricula varies widely. Our study will help medical colleges develop, implement and evaluate their EBM courses. We assessed the effectiveness of workshops in improving critical appraisal skills among medical students.

METHODS

A before-and-after study design without a control group was used. A 5-week short EBM module including lectures, workshops, and online search sessions was conducted with 52 fourth-year medical students during their primary healthcare course at the College of Medicine, Princess Nourah bint Abdulrahman University. Statistical analysis was performed using SPSS statistical software (version 20, SPSS Inc., Chicago, US). Parametric tests as well as Student's paired t-test for pre- and post-test comparisons were used.

RESULTS

Forty-nine (49) participants completed the pre- and post-training Fresno tests, and 44.9% of the participants had a GPA of 4.0 or higher. The mean Fresno test score increased from 45.63 (SD 21.89) on the pre-test to 64.49 (SD 33.31) on the post-test, with significant improvements in the following items: search strategies, relevance, internal validity, magnitude and significance of results, statistical values of diagnosis studies (sensitivity, specificity, and LR), statistical values of therapy studies (ARR, RRR, and NNT), and best study design for diagnosis and prognosis (P < 0.05).

CONCLUSION

This study supports that a short course in EBM that is incorporated into the undergraduate curriculum, especially in the clinical years, might be effective in improving medical students' knowledge and skills in EBM. However, prospective studies are necessary to assess the long-term impact of these interventions and ultimately their effectiveness for clinical decision making.

Self-reported attitudes, knowledge and skills of using evidence-based medicine in daily health care practice: A national survey among students of medicine and health sciences in Hungary

In order to map attitudes, knowledge and skills related to evidence-based medicine (EBM) in students of medical and health sciences faculties, we performed an online survey during the spring semester 2019 in all medical and health sciences faculties in Hungary. In total, 1080 students of medicine and 911 students of health sciences completed the online questionnaire. The attitude towards EBM was generally positive; however, only a small minority of students rated their EBM-related skills as advanced. There were large differences in the understanding of different EBM-related terms, with 'sample size' as the term with the highest (65%) and 'intention-to-treat analysis' with the lowest (7%) proportion of medical students being able to properly explain the meaning of the expression. Medical students who already participated in some EBM training rated their skills in searching and evaluating medical literature and their knowledge of EBM-related terms significantly better and had a more positive attitude towards using EBM in the practice than students without previous EBM training. EBM trained medical students were more likely to choose online journals (17.5% compared to 23.9%, p<0.05) and professional guidelines (15.4% compared to 6.1%, p<0.001) instead of printed books (33.6% compared to 52.6, p<0.001) as the main source of healthcare information retrieval and used Pubmed/Medline, Medscape and the Cochrane Library to a significant higher rate than students without any previous EBM training. Healthcare work experience (OR = 1.59; 95% CI = 1.01–2.52), conducting student research (OR = 2.02; 95% CI = 1.45–2.82) and upper year university students (OR = 1.65; 95% CI = 1.37–1.98) were other factors significantly influencing EBM-related knowledge. We conclude that the majority of students of medical and health sciences faculties are keen to acquire EBM-related knowledge and skills during their university studies. Significantly higher EBM-related knowledge and skills among EBM trained students underline the importance of targeted EBM education, while parallel increase of knowledge and skills with increasing number of education years highlight the importance of integrating EBM terminology and concepts also into the thematic of other courses.

Information seeking and evaluation: a multi-institutional survey of veterinary students

Objective

To practice evidence-based medicine, clinicians must be competent in information literacy (IL). Few studies acknowledge the critical role that reading strategies play in IL instruction and assessment of health professional students. The purpose of this study was to understand the information-seeking and evaluation behaviors of doctor of veterinary medicine (DVM) students in regard to scientific papers.

Methods

The authors studied DVM student behaviors across eight programs in North America using a web-based survey of closed- and open-ended questions about finding and evaluating scientific papers, including a task to read a linked scientific paper and answer questions about it.

Results

A total of 226 individuals responded to the survey. The sections of a scientific paper that were most commonly read were the abstract, introduction, and conclusions. Students who reported reading a higher proportion of scientific papers were more likely to feel confident in their abilities to interpret them. A third of respondents answered open-ended questions after the paper reading task. Respondents felt the least amount of confidence with one of the final steps of evidence-based medicine, that of interpreting the significance of the paper to apply it in veterinary medicine.

Conclusions

DVM students may lack the skills needed to evaluate scientific literature and need more practice and feedback in evaluating and interpreting scientific papers. Librarians who support DVM students can (1) help DVM students to efficiently evaluate scientific literature, (2) seek training opportunities in alternative modes of teaching and learning IL skills, and (3) partner with veterinary faculty and clinicians to provide students with practice and feedback in information evaluation.