Using Evidence to Inform Prognosis Decisions

Abstract

Abstract Introduction Numerous studies have demonstrated that many physicians lack fundamental skills of interpreting and using clinical care evidence. We propose that building a foundation for evidence-based medicine (EBM) will provide an initial scaffold that can be integrated during later clinical training. We built this module as a two-session experience to provide first− or second-year medical students the opportunity to build fundamental knowledge about prognosis clinical research and how to appraise trials of prognosis. Methods The first session of the module consists of a didactic or prerecorded online didactic to review basic concepts and principles about prognosis research. The second session is an in-class exercise where students may take preparatory quizzes to assess readiness followed by an application exercise where students in teams of seven or eight appraise a prognosis trial. The module design uses several team-based learning (TBL) principles, and the module can be slightly modified to use the traditional TBL method if time permits. The module also includes two practice exercises and several supplementary learning resources. Results We have been teaching this module to first− and second-year medical students for 9 years and have made several iterative improvements. No students have failed the courses that have integrated this module. The module's individual quizzes have averaged 60%-100%, the group quizzes more than 80%, and the application exercises more than 80%. Besides the peer reviewed references provided, we performed a pre-/post-assessment of alternative multiple-choice question items (nine pre, nine post) covering the same objectives. The mean premodule score was 40.8%, and the mean postmodule score was 80.7%. Discussion We have used this module successfully for 9 years to teach prognosis evidence, and this submission represents the culmination of our collective experience with this topic. This module can be taught as a stand-alone session but is better integrated with other EBM modules (risk trials, randomized trials, searching, etc.) to provide comprehensive knowledge about how to acquire and understand all the variables that are considered for clinical decisions.

Keywords

• Prognosis
• Evidence-Based Medicine
• Active Learning
• Undergraduate Medical Education