44 Teaching of evidence-based medicine in italian medical schools: a systematic analysis of courses and syllabi

Abstract

Objectives Medical schools worldwide have increasingly included EBM principles in undergraduate curriculum either in different courses or in one specific course. In Italy complete and systematic data on EBM teaching in medical schools are lacking. Indirect information comes from a survey conducted by GIMBE Foundation on more than 600 students who applied for a scholarship to acquire Evidence-based Practice core curriculum. Most of respondents outlined that EBM is mainly taught in occasional lectures or seminars, without any searching and/or critical appraising of literature. In 2017 GIMBE Foundation assigned a research grant to the Italian Secretariat of Medical Students (SISM) to evaluate teaching of EBM in medical schools and assess the real implementation of syllabi through structured surveys among students. Method The first phase of the study has been developed in 4 steps. Step 1: identification and inclusion of all Italian medical degree courses, excluding English taught ones. Step 2: detection of information sources to analyse, namely the core curriculum designed by the Italian Council of Medical Deans, the core curriculum of each medical school, medical schools’ annual return (‘Scheda Unica Annuale – SUA’) and syllabi of single courses. Step 3: keywords identification. A high sensitive strategy has been used, searching each document for the following keywords: ‘medicina basata’, ‘evidenza’, ‘evidenze’, ‘evidence’, ‘letteratura’, ‘prove di efficacia’, ‘EBM’. Step 4: data entry. Occurrences have been recorded in a database including the following fields: medical school and degree course, keyword (present, absent, not relevant, SUA section where keyword occurred, SUA page number where keyword occurred, sentence where keyword occurred, specific EBM course (yes/no). Duplicate and not relevant records have been excluded. Results 40 eligible medical schools were identified, with a total of 46 medical degree courses. At this stage of the study only the core curriculum of both the Italian Council of Medical Deans and single Medical Schools as well as SUA have been analysed. Syllabi of single courses will be examined in the next months. The core curriculum of the Italian Council of Medical Deans includes all components of EBM core curriculum in its elementary teaching units (even if not structured). As for the single medical schools, only 4 ore curricula have been retrieved and therefore they have been excluded from further assessment and analyses. In medical schools’ annual return (SUA) only 8 degree courses with a specific EBM course were identified; there is a variable keywords’ occurrence in SUA of different degree courses (mean 3.8±SD 2.6, range 1–11). Conclusions Although educational aims reported in the elementary teaching units of core curriculum of the Italian Council of Medical Deans are coherent with EBM core curriculum, SUA only occasionally include EBM. The 8 EBM specific courses identified in SUA seem to be due more to local initiatives rather than resulting from a systematic introduction of EBM in the Italian undergraduate medical education. Theme Tools and concepts that are basic and central to the teaching and practising of evidence-based medicine.