Evidence-based Medicine Course Research Articles

Online education isn’t the best choice: evidence-based medical education in the post-epidemic era—a cross-sectional study

BackgroundThe COVID-19 pandemic led many educational institutions to shift to online courses, making blended education a significant trend in teaching. We examined the effectiveness of blended learning in an evidence-based medicine course.MethodsWe compared the examination scores of a blended learning group, an online only group, and a traditional offline group and conducted a questionnaire survey on students’ preferences for different learning modes and the reasons for their preferences. A total of 2100 undergraduate students in clinical medicine were included in this cross-sectional study. Examination results were collected, and questionnaires were administered to the study participants. We compared the mean scores and exam pass rates of the three teaching groups using ANOVA and c2test for multiple comparisons.ResultsThe blended group’s exam scores and pass rate were significantly higher than those of the offline and online groups. Furthermore, 71.6% preferred the blended teaching mode. In the survey on " learning effectiveness”, the majority of the students believed that blended education could better enhance the initiative of learning, the interest of the course, the pertinence of the learning content, the comprehension of evidence-based medical thinking, and the basic skills of evidence-based practice. Subsequently, in a questionnaire administered to a blended group of students, their foremost reason for liking online instruction was ‘flexible in time and space’ (99%), followed by ‘can be viewed repeatedly, facilitating a better understanding of knowledge points’ (98%). Their foremost reason for liking offline teaching was ‘helps to create a good learning atmosphere’ (97%), followed by ‘teachers can control students’ learning status in real time’ (89%).ConclusionsThis study explored the effectiveness of learning in evidence-based medicine courses by comparing the learning outcomes and personal perceptions of three different teaching modes. This is the first cross-sectional study in which three different teaching models are compared and discussed in an evidence-based medicine course. We also elaborate on the specific instructional protocols for each model. This study shows that using a blended education approach in evidence-based medicine courses can improve students’ learning motivation, autonomy, and satisfaction. It also enhances instructional efficiency, thereby improving students’ understanding of the course content.

Use of simulation scenarios and vote cards in teaching critical appraisal concepts in evidence-based medicine

BackgroundThe most effective method of teaching critical appraisal concepts remains unclear. We used simulation scenarios in a Risk-of-Bias (RoB) 2.0 framework to teach the various biases that may affect randomized controlled trials and assessed whether including this interactive session in an evidence-based medicine (EBM) course for third-year preclinical medical students can optimize their understanding of critical appraisal concepts.MethodsThe session had 13 modules, each corresponding to a particular risk of bias in RoB 2.0. Each module included a simulated scenario, followed by data presentation and a generalized conclusion. The students were subsequently asked to use colored vote cards to indicate whether they agreed, had some concern, or disagreed with the conclusion and to justify their answers. On the basis of the students’ answers, the facilitator debriefed the scenario and addressed the specific bias. In each module, the students were required to demonstrate critical thinking in analyzing the claims and quality of the supporting evidence and in justifying their decisions, thus conceptualizing their understanding of research biases.ResultsWe included 306 students across two pilot sessions in spring 2020 and 2021, and the response rate was 97.4%. The students were least able to discern the following problems: baseline imbalances when assessing allocation bias (correct answers: 9.06%), missing outcome data when assessing attrition bias (correct answers: 11.65%), and balanced nonprotocol interventions when assessing performance bias (correct answers: 14.88%). The postcourse survey revealed several aspects of the interactive session that the students appreciated or found challenging.ConclusionPreclinical medical students generally appreciated the inclusion of simulation scenarios and vote cards in an EBM course. The use of vote cards facilitated medical students’ understanding of critical appraisal concepts, uncovered areas that they found challenging to understand, and encouraged their active participation. Such interactive sessions should be increasingly included in medical education.

Evidence-Based Medicine and Pharmacotherapy Content Alignment

ObjectiveWhen effectively executed, content alignment can aid student performance in associated courses. Limited research exists for content alignment of evidence-based medicine (EBM) and pharmacotherapy courses. This study assesses the impact of EBM and pharmacotherapy course alignment on student performance. MethodsContent alignment included assignment of 6 landmark trials in EBM coursework. The articles were identified by pharmacotherapy instructors as “landmark” to management of associated diseases in the aligned pharmacotherapy semester. Articles were the basis for quizzes over skills taught in the EBM course and were referenced during pharmacotherapy lectures. ResultsDuring the alignment semester, students were more likely to cite specific guidelines and/or primary literature to rationalize pharmacotherapeutic plans on examinations compared with the prealignment period (54% vs 34%). Overall, pharmacotherapy case performance and plan rationale scores were significantly higher in the alignment semester compared with prealignment. Student performance on the Assessing Competency in Evidence-Based Medicine tool improved from the start of the semester (8.64, SD 1.66) to the end (9.5, SD 1.49; mean score +0.86). Comfort in applying EBM analysis to primary literature increased significantly between the first and final assignments, with 6.7% and 71.7% of students self-reporting a high degree of confidence, respectively. Students (73%) reported an enhanced understanding of pharmacotherapy due to alignment compared with a previous semester of pharmacotherapy without alignment. ConclusionThe use of landmark trial assignments to align EBM and pharmacotherapy coursework demonstrated a positive impact on student rationale for clinical decision-making and student confidence in evaluating primary literature.

Evidence-Based Medicine Course in Combination With Journal Clubs to Promote Evidence-Based Surgery.

Introduction To provide high-quality surgical care, surgeons must critically appraise medical literature to adapt their clinical practice whenever convincing evidence emerges. This will promote evidence-based surgery (EBS). Over the last decade, we have organized monthly journal clubs (JCs) and more extensive quarterly EBS courses for surgical residents and PhD students, supervised by surgical staff. We evaluated the participation, satisfaction, and knowledge gained by this EBS program, to make the program future-proof and aid other educators. Materials and methods An anonymous digital survey was distributed via email among residents, PhD students, and surgeons of the Amsterdam University Medical Centers' (UMC) surgical department in April 2022. The survey included general questions on EBS education, specific course-oriented questions for the residents and PhD students, and questions about supervision for surgeons. Results The survey was completed by 47 respondents from the surgery department of the Amsterdam UMC University Hospital, of whom 63.8% (n=30) were residents or PhD students and 36.2% (n=17) were surgeons. During one year of the combined EBS course and JCs, the EBS course was attended by 40.0% (n=12) of PhD students and was rated with a mean score of 7.6/10. JCs were attended by 86.6% (n=26) of residents or PhD students and received a mean score of 7.4/10. Reported strengths of the JCs were their easy accessibility and the acquisition of critical appraisal skills and scientific knowledge. A reported point of improvement was to focus more deeply on specific epidemiological topics per meeting. Of the surgeons, 64.7% (n=11) had supervised at least one JC and gave a mean score of 8.5/10. The main reasons to supervise JCs were the distribution of knowledge (45.5%), scientific discussion (36.3%), and contact with PhD students (18.1%). Conclusion Our EBS educational program, including JCs and EBS courses, was well appreciated by residents, PhD students, and staff. This format is advocated for other centers aiming to better implement EBS in surgical practice.

The dissemination of holistic health care and evidence-based medicine courses from institution-based to department-based via a course management system

ABSTRACT This prospective longitudinal study assessed the effects of the course management system, EDU3, on the effectiveness of the dissemination of holistic health care and evidence-based medicine (EBM) courses. Between January 2014 and December 2021, delinked data (n = 354,229) from EDU3 were analyzed. In addition to analyzing the main educational team or seed teachers responsible for opening the courses, yearly changing trends in the number and teaching styles of courses, main participants, and the diversity of teaching activities were evaluated. EDU3 precisely announced the courses opened by non-doctor major departments, including departments of medical education, nursing, and medical research, for non-doctor medical personnel. Meanwhile, the system smoothly announced doctor major departments which opened courses for doctors. A 2 times/4.5 times parallel increase in holistic health care/EBM courses from institution to department and the yearly increasing trends in the number of these courses indicated the success of this system. This study revealed that centralized training of seed teachers motivated them to open diverse department-oriented teaching activities for holistic health care and EBM. The parallel increasing trends of the number of courses opened by the institution and departments indicated the effective dissemination of holistic health care and EBM from institution to department.

Undergraduate courses of evidence-based medicine in Peruvian medical schools: Characteristics and addressed topics

BackgroundMedical schools are increasingly including evidence-based medicine (EBM) courses in their curricula. However, little is known about the characteristics of these courses in Peru. Therefore, the present study aimed to describe the characteristics and topics addressed by undergraduate courses on EBM in Peruvian medical schools, and to compare the content of these courses with predefined EBM competencies. MethodsWe conducted a cross-sectional study. We obtained the syllabi of undergraduate EBM courses from all medical schools for the latest year available. We extracted their characteristics and categorized the topics they included according to the five steps necessary to apply EBM, divided into 22 competencies. ResultsIn 2021, Peru had 47 universities with active undergraduate medical schools, of which 9 (19.1%) had EBM courses. These courses were not mandatory in three of the universities, and were typically offered between the 2nd and 5th year of the degree program. When analysing the topics covered in the syllabi, we found that they addressed 7 to 13 of the 22 core competencies evaluated. The least addressed topics belonged to steps 4 (apply) and 5 (evaluate) of the EBM process. ConclusionWe found that few Peruvian universities offer EBM courses, and that these courses have heterogeneous characteristics, with syllabi that do not include all essential topics for applying the five steps of EBM.

Evidence-based medicine needs patient and public involvement to remain relevant: A proposal for a new curriculum

IntroductionPublic partnerships, a route to sharing expertise, networks and resources anchored in the United Nations Sustainable Development Goals, has been championed by multiple stakeholders. ObjectiveTo propose a new evidence-based medicine (EBM) curriculum for harnessing patient and public expertise to ensure that EBM teaching and learning can become more relevant and impactful. MethodsA curriculum development group comprising of EBM teachers, patient and public involvement representatives, clinicians, clinical epidemiologists, public health experts and educationalists, with experience of delivering and evaluating face-to-face and online EBM courses across many countries and continents, prepared a new EBM course. ResultsA student-centred, problem-based and clinically integrated course for teaching and learning EBM was developed. In the spirit of shared decision-making, practitioners can learn to support patients, articulate their perspectives, recognise the need for their contribution and ensure community involvement when generating and applying evidence. With end users in mind, the application of research findings, delivery of care and EBM effectiveness in the workplace would carry increased priority. ConclusionsEmbracing patients as EBM collaborators can help deliver cognitive diversity and inspire different ways of thinking and working. Adopting the proposed approach in EBM education lays the foundations for a joint practitioner–patient partnership to ask, acquire, appraise and apply EBM in a more holistic context which will strengthen the EBM proposition.

The First Asynchronous Online Evidence-Based Medicine Course for Syrian Health Workforce: Effectiveness and Feasibility Pilot Study.

Evidence-based medicine (EBM) is critical for providing the best scientifically proven patient health care, and it is implemented worldwide in order to improve the quality of the delivered health care. However, not all Syrian health professionals are knowledgeable about the importance, methodology, and implementation of EBM. Providing web-based learning courses on EBM might be effective in improving the EBM knowledge of health care professionals. This study was performed to test the effectiveness and the feasibility of an asynchronous web-based course on EBM in improving the competencies of Syrian health care professionals in terms of EBM. A web-based course on EBM was developed in Arabic and uploaded onto the Syrian Virtual University platform. An electronic registration form was designed and distributed to medical groups on social media for registration to this web-based course. Both the pretest and posttest had the same 3 sections to measure the impact of this web-based EBM program on the knowledge, skills, and attitudes of the Syrian health care professionals. The posttest had an additional section for measuring the efficacy and ease of use of this program. Student paired 1-tailed t test was used to analyze the differences in the different assessment sections among the participants. Nineteen participants filled the electronic registration form, but 8 participants did not meet the inclusion criteria. Therefore, the pretest was sent to the remaining 11 participants (7 men and 4 women) who graduated from Syrian universities. Ten of them completed the pretest, while 7 of them completed the posttest. The web-based course was found to be effective in improving the participants' EBM knowledge, skills, and attitudes at P>.05. Further, the web-based EBM course was feasible and easy-to-use. In order for EBM to be implemented in Syria, continuous medical education training programs should be designed for clinical practitioners. Our study shows that asynchronous web-based medical education is an effective and a feasible means for introducing the concept of EBM, improving practitioners' skills, and promoting the positive attitudes of Syrian clinical practitioners toward EBM.

Didactic Physician Assistant Students’ Perceptions of Evidence-Based Medicine Resources: A Preliminary Investigation

Evidence-Based Medicine (EBM) instruction is required for physician Assistant (PA) students. This pilot study surveyed didactic PA students at three geographically diverse PA programs at the end of their didactic EBM course to understand which attributes of EBM resources they find most and least useful, and their self-efficacy in searching and appraising medical literature. Thematic analysis identified the most important student-reported attributes of a resource. PA students in this sample preferred UpToDate and PubMed as their top EBM tools based on attribute ratings. However, each database included in this pilot study received positive feedback, despite a low usage rate across institutions. The most important attributes were ease of use/search, information presentation, and conclusion/critical appraisal skill. After one EBM course, on average, students rated their self-efficacy searching the literature and appraising the literature as “moderately confident.” This suggests that instructors and librarians have an opportunity to expose students to more tools as well as encourage “the right tool for the right job.”

Active learning for an evidence-based veterinary medicine course during COVID-19.

Epidemiology is often a challenging course that is not well appreciated by many students learning veterinary medicine. The curriculum for this topic can sometimes be dry, difficult for students to contextualize, and heavy with statistics and mathematical concepts. We incorporated the concepts of epidemiology that are most important for practicing veterinarians and combined these with evidence-based veterinary medicine principles to create a practical course for second-year undergraduate veterinary students. We share the structure of our course and the different learning components, which also included incorporating graduate student mentors for journal clubs and an assignment that culminated in some students publishing their review findings. Anecdotal responses from students suggest they enjoyed the course and learned skills they felt would be useful in veterinary practice to help them make evidence-based clinical decisions.

Teaching evidence-based medicine in Mexico: a systematic review of medical doctor curriculums at a national level

ObjectivesTo assess the teaching of evidence-based medicine (EBM) in medical curriculums. As a secondary objective, we assessed the representativeness of science courses related to EBM.Design and settingSystematic review. Accredited curriculums...

Links between evidence-based medicine and shared decision-making in courses for doctors in training: a scoping review

ObjectivesThis scoping review aims to synthesise the current evidence on the inclusion and effectiveness of integrating evidence-based medicine (EBM) and shared decision-making (SDM) into training courses for doctors in training...

Self-perceived competencies on evidence-based medicine in medical students and physicians registered in a virtual course: a cross-sectional study

ABSTRACT Background Evidence-based medicine (EBM) is defined as the integration of the best available evidence from scientific studies with clinical experience (and context) and with patients’ values and preferences. The objective of the present study was to describe self-perceived EBM competencies in physicians and medical students enrolled in a massive virtual EBM course. Methods Analytical cross-sectional study. People interested in a free virtual EBM course fulfilled their data in a virtual form for their registration in September 2020. In this form, 22 competencies related to four dimensions of EBM were evaluated: asking a clinical question, search, analysis, and application; using a 5-option Likert scale. The resulting database was analyzed, selecting people who claimed to be physicians or medical students of 18 years or more. Results 1793 participants were included: 1130 medical students and 663 physicians; more than 80% lived in Peru. The frequency of participants who agreed or strongly agreed with feeling qualified in each competence ranged: from 39.2% to 57.8% for the competencies of the ‘Asking a clinical question’ dimension, from 39.2% to 56.1% for ‘Search,’ from 19.9% to 32.0% for ‘Analysis,’ and from 19.6% to 29.9% for ‘Application.’ Both in physicians and students, the lowest frequencies were for the competencies of interpretation of impact measures, graphs, and results of systematic reviews; as well as shared decision making and calculation of expected benefit. Physicians who graduated more recently scored better on competencies from search and analysis dimensions. Conclusion Among physicians and medical students enrolled in the course, self-perception of competencies was lower in the dimensions of analysis and application. More recently graduated physicians seem to have a greater self-perception of their research and analysis skills, probably due to curricular updates. List of abbreviations: EBM: Evidence-based medicine; CIMBE, for its acronym in Spanish: International Course on Evidence-Based Medicine; SOCIMEP, for its acronym in Spanish: Peruvian Medical Student Scientific Society

Formal evidence-based medicine instruction in Turkish undergraduate medical education: an initial evaluation

BackgroundGlobal and national undergraduate medical education accreditation organizations recommend the inclusion of Evidence-Based Medicine (EBM) instructions into the medical schools’ curricula. Accordingly, some Turkish medical schools have individually developed and implemented EBM training programs, but there is no data of current programs’ effectiveness and students’ learning achievements due to the lack of a validated Turkish language EBM assessment tool.This study evaluates the effect of a newly introduced formal EBM instruction to the curriculum on students’ knowledge and skills by using the recently published Turkish adaptation of the Fresno Test.MethodsThe study is an experimental investigation using pre- and post-test evaluations. A five-week EBM course was developed according to Kern’s six-step curriculum development approach. A total of 78 students from the third (n = 30), fourth (n = 19) and fifth (n = 29) year of medical school voluntarily consented and were enrolled into the course. Overall, the Cerrahpaşa Medical Faculty had a total of 555, 461, and 400 students enrolled in the third, fourth, and fifth year, respectively.The program has been evaluated based on students’ learning achievements and survey responses.ResultsThe students’ mean pre-test Fresno Test score improved from 49.9 ± 18.2 to 118.9 ± 26.3 post-training. The Cohen’s effect size was 3.04 (95% CI, 2.6–3.5). The overall students’ satisfaction score was 8.66 ± 1.09 on a 1 to 10 scale.ConclusionsThe program was effective in improving students’ knowledge and skills on EBM. We propose to offer the program as an elective course during the third year of the medical school curriculum based on all data obtained during the program evaluation.

Auswirkungen eines Wahlfachs zur evidenzbasierten klinischen Entscheidungsfindung auf die Kompetenzen und Einstellungen von Medizinstudierenden: Eine Pilotstudie

Evidence-based medicine (EbM) as a teaching subject is increasingly taken into account in the Master Plan 2020. To date, neither theoretical requirements nor practical applications of EbM have been consistently implemented in the clinical curriculum. To fill this gap, a digital and tutor-based EbM course has been developed. The aim is to identify the student characteristics (statistical competence, Need for Cognition (NFC), work and experience patterns (AVEM), diagnostic uncertainty) of the first cohort in order to ensure successful course implementation and to prepare future doctors for their role as mediators of health literacy using EbM methods. The long-term study started in the summer term 2019 with 10 medical students during their clinical training. The measurements were conducted before (t0) and after course attendance (t1). Socio-demographic variables were taken at t0, the Quick Risk Test, PRU questionnaire, the NFC scale and the AVEM were collected at t0 and t1. Half of the students started their doctoral thesis before attending the course. The first test results of the Quick Risk Test (t0) were between 50% and 90% and at t1 between 60% and 100%. The students showed high scores on the NFC scale (X¯=4.6, SD=0.52, Δ X¯ t0 - t1=0.1) and medium scores on the Perfectionism scale (X¯=3.8, SD=0.51, Δ X¯ t0 - t1=0.1), Resignation Tendency (X¯=3.8, SD=1.17, Δ X¯ t0 - t1=0.1) and on the scale Aggressive Problem Solving (X¯=3.9, SD=1.06, Δ X¯ t0 - t1=0.2). They achieved high levels of Anxiety Due to Diagnostic Uncertainty (X¯=4.8, SD=0.69, Δ X¯ t0 - t1=0.4) and on the scale Concern about Poor Outcomes (X¯=3.9, SD=1.54, Δ X¯ t0 - t1=0.6). The scale Restraint in Disclosing Uncertainty to Patients was more pronounced than the scale Restraint in Disclosing Errors to Physicians (X¯=3.5, SD=0.93, Δ X¯ t0 - t1=-0.3 compared to X¯=2.3, SD=1.20, Δ X¯ t0 - t1=0.1). Statistical competence improved with course attendance, with only one student being able to correctly answer all items at t1. NFC and AVEM were strongly expressed and were not very sensitive to change in the sample. The greatest changes were observed on the scales of concern about poor results and fear of diagnostic uncertainty, both of which decreased with course participation. In the long term, the development of a new measuring instrument to assess EbM competencies instead of the Quick Risk Test is conceivable. The longitudinal design will also enable us to make causal interpretations and to track changes in students' competence feelings, behaviour and attitudes.

Integrating an evidence-based medicine curriculum into physician assistant education: Teaching skills for lifelong decision-making!

Background: Medical knowledge continuously evolves and to help health care providers to stay up to date, the evidence-based medicine (EBM) model has emerged. The practice of EBM requires new skills of the health care provider, including directed literature searches, the critical evaluation of research studies and the direct application of the findings to patient care. Methods: This paper describes the integration and evaluation of an evidence-based medicine course sequence into a Physician Assistant curriculum utilizing the expertise from faculty trained in basic science, nursing and primary care practice. Results: Collaboration of faculty with different educational backgrounds resulted in a course series that was equally strong in all aspects of EBM. This new course sequence teaches students to manage and use the best clinical research evidence to competently practice medicine. To assess the effectiveness of the EBM sequence a survey was developed and administered at the beginning and end of the sequence. Conclusion: EBM knowledge gained is essential to effective clinical decision making and this newly developed tool specifically helps to identify student competencies within the defined course objectives. Contributing to the uniqueness of the tool are case-based questions requiring integration of EBM knowledge by the student.

Evidence-Based Medicine Approaches of Students in a Medical School

Aim: To define knowledge and attitudes of Cumhuriyet University Medical School (CUMS) students about Evidence-Based Medicine (EBM) and to determine opinions about the 1-week EBM education given to fourth-year students. Material and Methods: This was a descriptive study on third, fourth, and fifth-year students of CUMS. The 1-week EBM education given in 4th-year is an internship, they can take theoretically and practice lectures. The data collection tool used in research has questioned descriptive features of students, knowledge and attitudes about EBM, and their views on the internship. Results: 165 students volunteered to participate. The most common answers for investigation research question; for 3rd-year students' was general web sites, for 4th-year students' and 5th-year students' was electronic EBM database. While 3rd-year students valued to easy access for searching data, reliability was important for 4th and 5th-year students. The frequency of students' use of electronic databases (p<0.001), the rate of know the keyword as “good” (p=0.021), Medline usage frequency (p=0.003) and mean scores obtained from the pyramid of evidence (p<0.001) have differed significantly between students' years. There was a significant difference between students' English levels and electronic EBM database selection (p=0.034). Students', have upper-intermediate and upper English levels, 72.7%(8) chose the Electronic EBM database source to investigate. The most difficult parts for students when reading an article are their English insufficiency, statistics, and academic language. Students’ opinions about the EBM course; 77.2%(88) found that the course was beneficial, 7.0%(8) said course were not helpful, and 15.8%(18) were undecided. Conclusion: Improving students' English levels could increase their frequency of EBM database usage. It was observed knowledge and attitude of EBM were quite low in 3rd-year students, and general knowledge and attitude of 4th-year students, have received just new internship, were better than the other years. These findings show us that internship is beneficial.

Evidence-Based Medicine Course for Pre-Clinical Medical Students and Evaluation of Their Self-Efficacy Perceptions

Objective This study aims to share the results of the two-year implementation phase of the Evidence-Based Medicine (EBM) course, which was restructured and updated at Manisa Celal Bayar University Faculty of Medicine (MCBUFoM). Materials and Method All (N = 514) students enrolled in Year-1 at MCBUFoM in the academic years of 2018-2019 and 2019-2020 were included in this cross-sectional study. Course goal, competencies and learning objectives were determined and sessions were developed accordingly. This restructured 12-hour course was given in six sessions, four of which were theoretical and two were practical. Lectures, practical exercises using mobile devices in small groups and case-based problem-solving activities were used as instruction methods. Students’ self-efficacy perceptions and their feedback regarding the EBM course were collected via two separate online questionnaire forms containing structured and semi-structured items. The responses of the students who attended the EBM course sessions were analyzed and reported. ResultsA total of 195 Year-1 students (37.7%) responded to the survey questionnaires. One hundred seventy-two of these students (88.2%) reported that they attended EBM course sessions. Based on their participation, 68 (39.5%) students have not attended any practical sessions, and 104 (60.5%) students have attended at least one practical session. Ninety-one (65.0%) of the students stated that the time allocated to the course was sufficient. It was revealed that the mean total score of students' self-efficacy perceptions regarding the learning objectives of the EBM course was 3.41 ± 0.85, and the highest mean value was found in application dimension (3.49 ± 1.06). Students' self-efficacy perceptions were found to be significantly higher for the students who attended the practical sessions. Students’ level of satisfaction regarding the course was high for all evaluation domains. “The scope of the course” was most frequently (n = 86, 56.2%) reported response as the “most beneficial aspect of the course” by the students. ConclusionsThe findings obtained in this study were found to be compatible with the data reported in the literature. Starting the EBM training early, and continuing them throughout the medical education will increase the permanence of the knowledge acquired. Utilizing case-based clinical problems and mobile devices will have a significant positive impact on students' perception of self-efficacy concerning EBM.

A cross-sectional survey on academic librarian involvement in evidence-based medicine instruction within undergraduate medical education programs in Canada

Introduction: The purpose of this study was to determine the range of involvement of Canadian academic medical librarians in teaching evidence-based medicine (EBM) within the undergraduate medical education (UME) curriculum. This study articulates the various roles that Canadian librarians play in teaching EBM within the UME curriculum, and also highlights their teaching practices. Methods: An electronic survey was distributed to a targeted sample of academic librarians currently involved in UME programs in Canadian medical schools. Results: 12 respondents (including one duplicate response) representing ten schools responded to this survey. 7 of 10 respondents were involved in EBM instruction, 3 of 10 institutions had a dedicated EBM course. Librarians were involved in a variety of roles, and often co-created and co-delivered content along with medical school faculty, and were present on course committees. They used a variety of educational strategies, incorporated active learning, as well as online modules. Discussion/Conclusion: The data highlighted the embedded nature of EBM instruction in undergraduate medical education programs in Canada. It also showed that librarians are involved in EBM instruction beyond the second step of EBM; acquiring or searching the literature.

Practical Evidence-Based Medicine at the Student-to-Physician Transition: Effectiveness of an Undergraduate Medical Education Capstone Course.

Medical information is expanding at exponential rates. Practicing physicians must acquire skills to efficiently navigate large bodies of evidence to answer clinical questions daily. How best to prepare medical students to meet this challenge remains unknown. The authors sought to design, implement, and assess a pragmatic evidence-based medicine (EBM) course engaging students at the transition from undergraduate to graduate medical education. An elective course was offered during the required 1-month Capstone medical school curriculum. Participants included one hundred sixty-eight graduating fourth-year medical students at Emory University School of Medicine who completed the course from 2012 to 2018. Through interactive didactics, small groups, and independent work, students actively employed various electronic tools to navigate medical literature and engaged in structured critical appraisal of guidelines and meta-analyses to answer clinical questions. Assessment data was available for 161 of the 168 participants (95.8%). Pre- and post-assessments demonstrated students' significant improvement in perceived and demonstrated EBM knowledge and skills (p < 0.001), consistent across gender and specialty subgroups. The Capstone EBM course empowered graduating medical students to comfortably navigate electronic medical resources and accurately appraise summary literature. The objective improvement in knowledge, the perceived improvement in skill, and the subjective comments support this curricular approach to effectively prepare graduating students for pragmatic practice-based learning as resident physicians.