Innovation in evidence-based medicine education and assessment: an interactive class for third-and fourth-year medical students

INTRODUCTION Evidence-based medicine (EBM) is an important component of an undergraduate medical education curriculum that promotes lifelong learning and critical thinking [1]. Defined as "the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients" [2], EBM can be considered another important clinical tool, not unlike the stethoscope. The authors designed and assessed an innovative EBM course for third-year medical students to strengthen the EBM curriculum for undergraduate medical education. BACKGROUND Previous studies have advocated real-time teaching of EBM during attending rounds, in a case-based format with role playing or with standardized patients [3-5]. At the same time, brief training in literature searching and critical appraisal skills has been shown to be effective, and interactive workshops have been suggested as an ideal format for medical students [6-8]. At many academic medical centers, including the authors', constraints on resident and student duty hours and increased demands for productivity from clinical teaching faculty have made adding formal curricula to the clinical services problematic. In an effort to combine an interactive learning environment with core topics in EBM, we devised a multidisciplin-ary, case-based seminar series that is team-taught by clinicians and a librarian and is designed to be interactive, engaging, and clinically relevant. METHODS Designed by a medical librarian and a physician (Schardt and Gagliardi), the EBM course is intended to provide an interactive forum for students to develop skills in practicing EBM in the care of patients. The first version of the EBM course was offered as a noncredit elective to 8 third-year medical students in 2006 and consisted of 6 90-minute sessions conducted over the course of the spring semester. After experimenting with a 10-session format, we settled on 6 120-minute sessions conducted on consecutive Thursday evenings, from 5:00 p.m. to 7:00 p.m. After the third iteration of the course in 2008, it became a credit-bearing elective, which required opening it not only to third-year medical students, but also to fourth-year medical students. Since the 2008/09 academic year, the EBM course has attracted approximately forty students per year. The current study with pre- and post-course assessments of knowledge as well as attitudes was conducted during the 2008/09 academic year. The EBM course is designed to optimize student readiness and participation, faculty willingness to teach, and instructional strategies to maximize retention and use of EBM skills, with key features outlined below.