Training medical students in evidence-based medicine: a community campus approach.
OBJECTIVE
Clinicians need skills in critical appraisal of medical literature to improve quality of care. This report on evidence-based medicine (EBM) curricula describes 1) the role of family medicine educators, 2) timing, 3) value of a standard format across multiple communities, and 4) outcomes in attitudes and skills.


METHODS
In 1992, a nine-session curriculum delivered across six community campuses was introduced during the third year of medical school in the College of Human Medicine at Michigan State University. Evaluation compared 1) responses on the Association of American Medical Colleges graduation questionnaires from classes who received the curriculum with the 1994 class who did not (424 students), 2) responses to questions on group process performance, and 3) focused surveys of two classes.


RESULTS
Trained classes reported higher levels of confidence in critical appraisal and research skills than the 1994 class and other schools. Respondents reported the small-group process as effective, greater appreciation of the training after 1 year of residency than at graduation, and no change in research activity.


CONCLUSIONS
Family medicine educators can lead a new curriculum in EBM and maintain consistent standards across multiple communities. Many questions remain concerning the ideal curricular design to help clinicians apply the best research to patient care.
Wadland
W C
WC
Department of Family Practice, Michigan State University, USA. william.wadland@ht.msu.edu
Barry
H C
HC
Farquhar
L
L
Holzman
C
C
White
A
A
D003479:Curriculum; D004504:Education, Medical, Undergraduate / Q000379:methods* / Q000458:organization & administration; D019317:Evidence-Based Medicine / Q000193:education*; D005180:Faculty, Medical; D005194:Family Practice; D006801:Humans; D008824:Michigan; D015397:Program Evaluation