Successful teaching in evidence-based medicine

Objectives Several published articles have described the importance of expo sing medical trainees to the 'new paradigm' of evidence-based medicine (EBM ). Recognizing this, we sought to develop and objectively evaluate a mini-c ourse in EBM for third-year medical students. Design We developed a mini-course consisting of four sessions in which stud ents learn to derive sequentially focused questions, search MEDLINE, review articles critically and apply information from the literature to specific clinical questions. To evaluate the teaching intervention, we performed a c ontrolled educational study. Students at the intervention site (n=34) atten ded the EBM mini-course, while students at the control site (n=26) received more 'traditional' didactic teaching on various clinical topics. Intervent ion and control students were surveyed immediately before and after the min i-course to assess changes in reading and literature searching skills, as w ell as a tendency to use the literature to answer clinical questions. Setting Boston University School of Medicine. Subjects Third-year medical students. Results The intervention was associated with significant changes in student s' self-assessed skills and attitudes. MEDLINE and critical appraisal skill s increased significantly in the intervention group relative to the control group (significance of between group differences: P=0.002 for MEDLINE and P=0.0002 for critical appraisal), as did students' tendency to use MEDLINE and original research articles to solve clinical problems (significance of between group differences: P=0.002 and P=0.0008, respectively). Conclusions We conclude that this brief teaching intervention in EBM has ha d a positive impact on student skills and attitudes at our medical school. We believe that the key elements of this intervention are (1) active studen t involvement, (2), clinical relevance of exercises and (3) integrated teac hing targeting each of the component skills of EBM.