Development of an evaluation of medical student competence in evidence-based medicine using a computer-based OSCE station.
BACKGROUND
Instruction in evidence-based medicine (EBM) has been widely incorporated into medical school curricula with little evidence of its effectiveness. Our goal was to create, implement, and validate a computer-based assessment tool that measured medical students' EBM skills.


METHODS
As part of a required objective structured clinical examination, we developed a specific case scenario in which students (a) asked a structured clinical question using a standard framework, (b) generated effective MEDLINE search terms to answer a specific question, and (c) elected the most appropriate of 3 abstracts generated from a search justifying which best applies to the patient scenario.


RESULTS
Between the 3 blinded raters, there was very good interrater reliability with 84, 94, and 96% agreement on the scoring for each component, respectively (k = .64, .82, and .91, respectively). In addition, students found the station appropriately difficult for their level of training.


CONCLUSIONS
This computer-based tool appears to measure several EBM skills independently and combines simple administration and scoring. Its generalizability to other cases and settings requires further study.
Frohna
John G
JG
Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan 48109-0368, USA. jfrohna@umich.edu
Gruppen
Larry D
LD
Fliegel
Jonathan E
JE
Mangrulkar
Rajesh S
RS
D002983:Clinical Competence; D003201:Computers; D003479:Curriculum; D004521:Educational Measurement / Q000379:methods; D019317:Evidence-Based Medicine / Q000193:education*; D006801:Humans; D015397:Program Evaluation; D013337:Students, Medical