title: Evidence-based medicine: discrepancy between perceived competence and actual performance among graduating medical students.
abstract: Since at the time of graduation from medical school physicians are expected to demonstrate adequate professional competence including mastery of critical appraisal skills, we conducted a preliminary, cross-sectional, web-based study to examine the extent to which fourth year medical students in the US are competent in core areas of evidence-based medicine (EBM). Using self-assessment instruments, subjects (n = 150) were asked to demonstrate their ability to understand the practical meaning of key methodological and data analysis constructs as they relate to patient care, to rate their perceived competence in core areas of EBM and to disclose their attitudes toward critical appraisal of the literature and EBM. The mean score in our cohort was 55% suggesting that students may have knowledge gaps that interfere with their ability to critically appraise the medical literature. There was an apparent chasm between subjects' perceived competence and their actual performance on the assessment instrument. These findings, if corroborated in larger studies, (1) suggest that better education in EBM is needed so as to avoid the possibility that patient care may inadvertently be jeopardized; and (2) cast doubt on the use of self-assessed knowledge as a proxy for actual skills with respect to EBM and medical decision-making.
authors.affiliation: Rabin Medical Center, Petah Tikva, Israel. ocaspi@ahsc.arizona.edu
authors.forename: Opher
authors.initials: O
authors.lastname: Caspi
authors.forename: Patrick
authors.initials: P
authors.lastname: McKnight
authors.forename: Lillian
authors.initials: L
authors.lastname: Kruse
authors.forename: Victoria
authors.initials: V
authors.lastname: Cunningham
authors.forename: Aurelio Jose
authors.initials: AJ
authors.lastname: Figueredo
authors.forename: Lee
authors.initials: L
authors.lastname: Sechrest
mesh_terms: D001290:Attitude; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D004521:Educational Measurement / Q000379:methods; D019317:Evidence-Based Medicine / Q000193:education*; D006801:Humans; D012649:Self Concept; D013337:Students, Medical / Q000523:psychology*; D011795:Surveys and Questionnaires; D014481:United States