MedEdPORTAL (Oct 2014)
Evidence-based Medicine Subcourse to the Pediatric Clerkship
Abstract
Abstract Introduction According to the Council on Medical Education in Pediatrics, evidence-based medicine (EBM) skills are necessary for all medical students regardless of specialty career plans. Our EBM subcourse, which is embedded in the 6-week pediatric clerkship, provides an efficient and effective method to train over 160 third-year medical students per year in the use of medical literature. It also encourages these students to develop active learning skills. Methods Our subcourse is built on the premise that the students have some background in EBM. At the beginning of the pediatric clerkship, students test their skills with a scripted scenario (EBM Review). The emphasis is on the students' demonstration of their skills in order to benefit their patients. The conclusion of the subcourse (EBM Finale) is the students' sharing of the clinical scenario of their choice, the clinical question that arose, the literature search, their evaluation of the literature, and how it applies to their patient. The audience for the EBM Finale is their peers and faculty. We provide a comprehensive manual (Instructor's Guide) with an orientation slide for the students, student instruction sheets for the EBM Review and EBM Finale, a sample of a student EBM Finale presentation, and an EBM Finale evaluation form. Results In the fall of 2013, all 167 fourth-year students were sent a 12-question survey to elicit their perspective on this subcourse; 160 students (95%) returned the survey. Of these students, 68% agreed that the subcourse prepared them for their residency/career, 71% had applied what they had learned in other settings, and 90% felt that EBM was valuable. Subcourse aspects rated as most useful were EBM Review, EBM Finale, ward rounds with the EBM preceptor present, and resident EBM conferences. Discussion We have evolved our EBM curriculum over 7 years, adjusting it based on student feedback and our observations. This past year (2013-14), we started having the students provide peer feedback on the EBM presentations. We are still looking for ways to encourage better peer-to-peer feedback. We hope to further explore how and where the students subsequently use their EBM skills. Recently, we have added the requirement for the students to explain one statistical method/test used in their article. We would like to standardize the critical appraisal aspect of our EBM Finale. We are considering having each team of students complete an appraisal worksheet, as appropriate for their chosen article.
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