Evidence-based medicine skills that last: A transferable model utilizing integration, spaced learning, and repetition with a single study design among second-year medical students

Abstract

Introduction. The medical education literature lacks descriptions of evidence-based medicine (EBM) curricula with competency-based learning outcomes. The objective of this report is to describe an approach to designing, implementing, and assessing long-term learning in an integrated second-year EBM curriculum. Methods. Two complementary approaches were used. The primary deliberate approach incorporated large-group randomized controlled trial (RCT) critical appraisal sessions into existing organ system modules. The second approach added brief applications of EBM content to small-group case-based learning sessions. To assess learning, an open response written examination mapped to EBM competencies was administered at the beginning of the third year. Results. Data were available for 241 students. Using only walking knowledge, 47% of students at the beginning of the third year discussed two major weaknesses of an RCT; an additional 39% did so for only one. The ability to formulate a clinical question, describe elements of an appropriate search strategy and determine applicability to different patients was demonstrated by 84%, 87%, and 81% of examinees, respectively. Conclusion. This early work demonstrates that durable learning of EBM skills, including critical appraisal, is achievable among second-year medical students. Further work to improve learning in the second year and extend learning into subsequent years is forthcoming.

Keywords

• evidence-based medicine
• integrated curriculum
• assessment
• undergraduate medical education