Evidence-based Medicine Group Research Articles

A comparison of learning in traditional and evidence based journal clubs

Introduction: Journal clubs are known as the teaching methods in most of the medical training centers. In journal club (JC) participants discuss about articles in recent medical papers and finally, written scientific results are accepted or rejected. The aim of this study was to compare the traditional and evidence based medicine (EBM) type of JCs.Methods: The present study was conducted in Imam Reza Hospital, Tabriz University of medical sciences from January to March 2010. Forty participants were enrolled in our study: 16 stagers, 11 interns and 13 internal medicine residents. We held 3 journal clubs with 14 participants in the first session and 13 participants in the other sessions. Journal club was held at the end of each week. The first paper was presented by one of the attending physicians of rheumatology ward. The second paper was presented by another attendant of rheumatology ward who was a member of EBM group of Tabriz University of Medical Sciences. Then the results were compared. Results:The comparison of the sums of participants’ scores didn’t show any meaningful difference between traditional and EBM journal club in topic, purpose, and methods and material part of papers, but in the results section of the papers, the difference was remarkable. Conclusions: Our study showed that in the EBM journal clubs, participants learnt more about the results part of the papers. but in the results section of the papers.

Teaching of evidence-based medicine to medical students in Mexico: a randomized controlled trial

BackgroundEvidence-Based Medicine (EBM) is an important competency for the healthcare professional. Experimental evidence of EBM educational interventions from rigorous research studies is limited. The main objective of this study was to assess EBM learning (knowledge, attitudes and self-reported skills) in undergraduate medical students with a randomized controlled trial.MethodsThe educational intervention was a one-semester EBM course in the 5th year of a public medical school in Mexico. The study design was an experimental parallel group randomized controlled trial for the main outcome measures in the 5th year class (M5 EBM vs. M5 non-EBM groups), and quasi-experimental with static-groups comparisons for the 4th year (M4, not yet exposed) and 6th year (M6, exposed 6 months to a year earlier) groups. EBM attitudes, knowledge and self-reported skills were measured using Taylor’s questionnaire and a summative exam which comprised of a 100-item multiple-choice question (MCQ) test.Results289 Medical students were assessed: M5 EBM=48, M5 non-EBM=47, M4=87, and M6=107. There was a higher reported use of the Cochrane Library and secondary journals in the intervention group (M5 vs. M5 non-EBM). Critical appraisal skills and attitude scores were higher in the intervention group (M5) and in the group of students exposed to EBM instruction during the previous year (M6). The knowledge level was higher after the intervention in the M5 EBM group compared to the M5 non-EBM group (p<0.001, Cohen's d=0.88 with Taylor's instrument and 3.54 with the 100-item MCQ test). M6 Students that received the intervention in the previous year had a knowledge score higher than the M4 and M5 non-EBM groups, but lower than the M5 EBM group.ConclusionsFormal medical student training in EBM produced higher scores in attitudes, knowledge and self-reported critical appraisal skills compared with a randomized control group. Data from the concurrent groups add validity evidence to the study, but rigorous follow-up needs to be done to document retention of EBM abilities.

Impact of an evidence-based medicine curriculum on resident use of electronic resources: a randomized controlled study.

Evidence-based medicine (EBM) is widely taught in residency, but evidence for effectiveness of EBM teaching on changing residents' behavior is limited. To investigate the impact of an EBM curriculum on residents' use of evidence-based resources in a simulated clinical experience. Fifty medicine residents randomized to an EBM teaching or control group. A validated test of EBM knowledge (Fresno test) was administered before and after intervention. Post intervention, residents twice completed a Web-based, multiple-choice instrument (15 items) comprised of clinical vignettes, first without then with access to electronic resources. Use of electronic resources was tracked using ProxyPlus software. Within group pre-post differences and between group post-test differences were examined. There was more improvement in EBM knowledge (100-point scale) for the intervention group compared to the control group (mean score increase 22 vs. 12, p = 0.012). In the simulated clinical experience, the most commonly accessed resources were Ovid (71% of residents accessed) and InfoPOEMs (62%) for the EBM group and UptoDate (67%) and MDConsult (58%) for the control group. Residents in the EBM group were more likely to use evidence-based resources than the control group. Performance on clinical vignettes was similar between the groups both at baseline (p = 0.19) and with access to information resources (p = 0.89). EBM teaching improved EBM knowledge and increased use of evidence-based resources by residents, but did not improve performance on Web-based clinical vignettes. Future studies will need to examine impact of EBM teaching on clinical outcomes.

Evidence-based medicine teaching in the Mexican army medical school

Training of medical students must include the skills necessary to use advances in scientific research. Evidence-based medicine (EBM) has been incorporated in undergraduate programs in several countries, a process that has not been well studied in developing countries’ medical schools. An EBM course was incorporated into the curriculum of the Mexican Army Medical School. In the first year of its implementation it was given to half the fifth- and sixth-year groups. At the end of the semester, a previously validated questionnaire designed to evaluate the effectiveness of EBM teaching was administered. In total, 67 students took the course and 64 did not. A significant increase in the self-assessment of critical appraisal skills and the self-reported use of the Cochrane Library were found. There was a significant increase in the attitudes score, 22.9 ± 5.9 (mean ± SD) in the non-EBM group vs. 28.8 ± 3.2 in the EBM group (p < 0.001), and a trend towards higher scores in the knowledge domain, 1.89 ± 3.3 in the non-EBM group vs. 2.56 ± 3.6 in the EBM group (p > 0.05). EBM concepts can be taught in a developing country medical school, with a short-term gain in attitude and probably in knowledge.