Randomised controlled trial of clinical decision support tools to improve learning of evidence based medicine in medical students.
OBJECTIVE
To assess the educational effectiveness on learning evidence based medicine of a handheld computer clinical decision support tool compared with a pocket card containing guidelines and a control.


METHODS
Randomised controlled trial.


METHODS
University of Hong Kong, 2001.


METHODS
169 fourth year medical students.


METHODS
Factor and individual item scores from a validated questionnaire on five key self reported measures: personal application and current use of evidence based medicine; future use of evidence based medicine; use of evidence during and after clerking patients; frequency of discussing the role of evidence during teaching rounds; and self perceived confidence in clinical decision making.


RESULTS
The handheld computer improved participants' educational experience with evidence based medicine the most, with significant improvements in all outcome scores. More modest improvements were found with the pocket card, whereas the control group showed no appreciable changes in any of the key outcomes. No significant deterioration was observed in the improvements even after withdrawal of the handheld computer during an eight week washout period, suggesting at least short term sustainability of effects.


CONCLUSIONS
Rapid and convenient access to valid and relevant evidence on a portable computing device can improve learning in evidence based medicine, increase current and future use of evidence, and boost students' confidence in clinical decision making.
Leung
Gabriel M
GM
Department of Community Medicine, University of Hong Kong, Faculty of Medicine Building, 21 Sassoon Road, Pokfulam, Hong Kong, China.
Johnston
Janice M
JM
Tin
Keith Y K
KY
Wong
Irene O L
IO
Ho
Lai-Ming
LM
Lam
Wendy W T
WW
Lam
Tai-Hing
TH
D000328:Adult; D002982:Clinical Clerkship; D034201:Computers, Handheld; D018592:Cross-Over Studies; D003658:Decision Making, Computer-Assisted; D020000:Decision Support Systems, Clinical / Q000295:instrumentation*; D019317:Evidence-Based Medicine / Q000193:education*; D005260:Female; D006723:Hong Kong; D006801:Humans; D008297:Male; D013663:Teaching / Q000379:methods