Taking stock of evidence-based healthcare in the undergraduate medical curriculum at Stellenbosch University: Combining a review of curriculum documents and input from recent graduates

Abstract

Background. The Stellenbosch University Rural Medical Educational Partnership Initiative (SURMEPI) aims to increase the quality and retention of medical doctors, and regionally relevant research. Strengthening evidence-based healthcare (EBHC) knowledge and skills at an undergraduate level is important within this context. Objectives. To assess and describe the current undergraduate medical EBHC curriculum in order to identify opportunities to enhance EBHC teaching, and to explore challenges related to EBHC experienced by recently graduated doctors. Methods. We used methodological triangulation to assess current EBHC teaching and learning through a document review and a survey of recent graduates. We extracted learning outcomes from module guides that related to prespecified EBHC competencies. Our electronic survey collected quantitative data, which were analysed with SPSS, and qualitative data, which were coded with ATLAS.ti and grouped into emerging themes. Results. EBHC teaching was fragmented and concentrated in the first and last phase of the medical curriculum. Most survey respondents agreed that it was important to learn EBHC at undergraduate level, and that there was a need for increased teaching of certain EBHC competencies. Recently graduated doctors identified lack of access to literature as the main challenge when practising EBHC. Other challenges included time constraints, work overload, lack of EBHC skills, lack of self-motivation, applicability of the evidence and the work environment. Conclusion. Recent graduates felt that they needed more EBHC learning opportunities within the undergraduate medical curriculum. Existing EBHC teaching and learning for undergraduate medical students need to be enhanced by integrating EBHC into clinical modules and scaffolding it throughout all the phases of the curriculum.