Integrating evidence based medicine into undergraduate medical education: combining online instruction with clinical clerkships.
BACKGROUND
Incorporation of evidence based medicine into the undergraduate curriculum varies from school to school. The purpose of this study was to determine if an online course in evidence based medicine run concurrently with the clinical clerkships in the 3rd year of undergraduate medical education provided effective instruction in evidence based medicine (EBM).


METHODS
During the first 18 weeks of the 3rd year, students completed 6 online, didactic modules. Over the next 24 weeks, students developed questions independently from patients seen during clerkships and then retrieved and appraised relevant evidence. Online, faculty mentors reviewed student assignments submitted throughout the course to monitor progress. Mastery of the skills of EBM was assessed prior to and at the conclusion of the course using the Fresno test of competency.


RESULTS
Paired data were available from 139 students. Postcourse test scores (M= 77.7; 95% CI = 59-96.4) were significantly higher than precourse scores (M= 66.6; 95% CI = 46.5-86.7), p< .001. Paired evaluations demonstrated an average improvement of 11.1 +/- 20.0 points. All of the students submitted 4 independently derived questions and successfully retrieved and appraised evidence.


CONCLUSIONS
Medical students successfully acquired and independently applied EBM skills following extended, online, faculty mentored instruction. This method of instruction provided uniform instruction across geographic sites and medical specialties and permitted efficient use of faculty time.
Aronoff
Stephen C
SC
Department of Pediatrics, Temple University School of Medicine, Philadelphia, PA, USA. Aronoff@temple.edu
Evans
Barry
B
Fleece
David
D
Lyons
Paul
P
Kaplan
Lawrence
L
Rojas
Roberto
R
D002982:Clinical Clerkship / Q000379:methods / Q000458:organization & administration*; D002983:Clinical Competence; D003194:Computer-Assisted Instruction / Q000379:methods*; D016001:Confidence Intervals; D003479:Curriculum; D004504:Education, Medical, Undergraduate / Q000379:methods / Q000458:organization & administration*; D004521:Educational Measurement; D004522:Educational Status; D019317:Evidence-Based Medicine / Q000458:organization & administration*; D005180:Faculty, Medical; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D009862:Online Systems; D012577:Schools, Medical / Q000458:organization & administration; D013337:Students, Medical; D057170:Translational Research, Biomedical