Hong Kong Med J 2009;15:332-8 | Number 5, October 2009
Competence in evidence-based medicine of senior medical students following a clinically integrated training programme
NM Lai, CL Teng
Department of Paediatrics, School of Medicine and Health Sciences, Monash University Malaysia, JKR 1235, Bukit Azah, 80100, Johor Bahru, Johor Darul Takzim, Malaysia
OBJECTIVE. To assess the impact of a structured, clinically integrated evidence-based undergraduate medicine training programme using a validated tool.
DESIGN. Before and after study with no control group.
SETTING. A medical school in Malaysia with an affiliated district clinical training hospital.
PARTICIPANTS. Seventy-two medical students in their final 6 months of training (senior clerkship) encountered between March and August 2006.
INTERVENTION. Our educational intervention included two plenary lectures at the beginning of the clerkship, small-group bedside question-generating sessions, and a journal club in the paediatric posting.
MAIN OUTCOME MEASURES. Our primary outcome was evidence-based medicine knowledge, measured using the adapted Fresno test (score range, 0-212) administered before and after the intervention. We evaluated the performance of the whole cohort, as well as the scores of different subgroups that received separate small-group interventions in their paediatric posting. We also measured the correlation between the students' evidence-based medicine test scores and overall academic performances in the senior clerkship.
RESULTS. Fifty-five paired scripts were analysed. Evidence-based medicine knowledge improved significantly post-intervention (means: pre-test, 84 [standard deviation, 24]; post-test, 122 [22]; P<0.001). Post-test scores were significantly correlated with overall senior clerkship performance (r=0.329, P=0.014). Lower post-test scores were observed in subgroups that received their small-group training earlier as opposed to later in the clerkship.
CONCLUSIONS. Clinically integrated undergraduate evidence-based medicine training produced an educationally important improvement in evidence-based medicine knowledge. Student performance in the adapted Fresno test to some extent reflected their overall academic performance in the senior clerkship. Loss of evidence-based medicine knowledge, which might have occurred soon after small-group training, is a concern that warrants future assessment.
Key words: Education, medical, undergraduate; Evidence-based medicine
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