Understanding medical student evidence-based medicine information seeking in an authentic clinical simulation.

Joey Nicholson,Anique De Bruin,Cees Van Der Vleuten,Adina Kalet

doi:10.5195/jmla.2020.875

Abstract

ObjectiveEvidence-based medicine practices of medical students in clinical scenarios are not well understood. Optimal foraging theory (OFT) is one framework that could be useful in breaking apart information-seeking patterns to determine effectiveness and efficiency of different methods of information seeking. The aims of this study were to use OFT to determine the number and type of resources used in information seeking when medical students answer a clinical question, to describe common information-seeking patterns, and identify patterns associated with higher quality answers to a clinical question.MethodsMedical students were observed via screen recordings while they sought evidence related to a clinical question and provided a written response for what they would do for that patient based on the evidence that they found.ResultsHalf (51%) of study participants used only 1 source before answering the clinical question. While the participants were able to successfully and efficiently navigate point-of-care tools and search engines, searching PubMed was not favored, with only half (48%) of PubMed searches being successful. There were no associations between information-seeking patterns and the quality of answers to the clinical question.ConclusionClinically experienced medical students most frequently relied on point-of-care tools alone or in combination with PubMed to answer a clinical question. OFT can be used as a framework to understand the information-seeking practices of medical students in clinical scenarios. This has implications for both teaching and assessment of evidence-based medicine in medical students.

Highlights

Evidence-based medicine (EBM) is widely accepted as the best practice in integrating research evidence into clinical decisions for the best possible patient care [1]
Time management and lack of technical expertise are two of the most common challenges that medical students face when they seek research evidence to support their clinical decisions in the clinical context [6]
Understanding modern information-seeking behaviors of medical students in the context of their EBM training is a first step toward addressing these significant barriers

Summary

Introduction

Evidence-based medicine (EBM) is widely accepted as the best practice in integrating research evidence into clinical decisions for the best possible patient care [1]. For medical students to become excellent physicians, educators must ensure that the students learn how to manage and apply the voluminous information available through searching and navigating the information landscape efficiently and appropriately Studies in this area have the potential to improve the quality of EBM education and, as a consequence, clinical care. Time management and lack of technical expertise are two of the most common challenges that medical students face when they seek research evidence to support their clinical decisions in the clinical context [6]. These studies do not give any insight into medical students’ abilities to successfully navigate through preferred resources in a limited time. Understanding how our students approach EBM will inform and refine our EBM curriculum and enable us to audit relevant EBM behaviors and provide structured, actionable feedback in clinical settings to enhance their learning

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Discussion

Conclusion