Integrating EBM into Medical School
- 1. Integrating Evidence-Based Medicine with the Medical School Curriculum Russell Smith, russells@usc.edu Educational Support Librarian Norris Medical Library University of Southern California
- 2. Integrating EBM - Abstract TITLE: Integrating Evidence-Based Medicine in the Medical School Curriculum OBJECTIVE: To describe an evidence-based educational module for second-year medical students. METHODS: Second-year medical students received one-hour instruction on basic principles of evidence-based medicine as well as searching techniques for selected evidence-based medicine resources. After instruction, worksheets were distributed to the students. Students were required to describe a patient encountered during clinical rounds, formulate a PICO-based question and then look for answers in designated resources. The worksheet also contained a checklist of resources and boxes for the students to record the number of hits in each resource. Worksheets were evaluated by librarians and individual feedback was given to the students.
- 3. Abstract (continued) Results: Based on student evaluation, the majority of workshop attendees found EBM instruction to be a positive experience. Of the resources presented, students found UpToDate to be the most helpful. Interestingly MEDLINE ranked second among students in terms of usefulness. Conclusion: Medical students can benefit from library instruction on searching evidence-based medical resources. Additionally, integrating EBM instruction with the curriculum of medical students effectively promotes the library as an active partner in learning with the School of Medicine.
- 4. Background & Setting USC – Keck School of Medicine Approximately 160 students per class New curriculum introduced in Fall 2001 Case-based, self-directed learning First year students MEDLINE search project Already familiar with information retrieval
- 5. EBM Workshop & Assignment Introduced in Fall 2004 Second year medical students One hour workshop (hands-on) Basic EBM principles Walk through resources Online tutorial
- 6. Evidence Pyramid SUNY Downstate Medical Center© 2006. All rights reserved
- 8. Example question: Is advice to stay active more effective than bed rest in the treatment of chronic low-back pain?
- 9. Resources covered National Guideline Clearinghouse Cochrane Database of Systematic Reviews Database of Abstracts of Reviews of Effect (DARE) Best Evidence – ACP Journal Club
- 10. Resources covered MEDLINE Randomized controlled trials Meta-analyses Clinical Evidence (BMJ) UpToDate
- 13. Final Questions Which of the above resources were the most useful? Did you find any answers to your question? If so, where? State the answer, if found. Conflicting evidence?
- 14. Which resource did you find most useful? * UpToDate (23.5%) MEDLINE – rcts (20.8%) N.G.C. (15.3%) C.D.S.R. (10.6%) *Most students listed more than one resource. Four students did not state a preference. Data was collected Spring 2006.
- 15. Inferences Ranking of MEDLINE over knowledge bases (such as Cochrane Database of Systematic Reviews) seems to indicate: High comfort-level for searching Benefit of first year literature search project Confidence in analytical abilities Value-added resources may be too limited in scope
- 16. Conclusions Students are learning how to search Project has enhanced library’s status Student evaluations of project Very positive Worksheet adopted by other programs
- 17. Student Evaluations * Instructor taught effectively 4.62 Information presented was clear & concise 4.67 I learned something useful 4.32 *5 =strongly agree, 4=agree, 3=neutral, 2=disagree, 1=strongly disagree