PubMed Health⌕ Search
Home/Archive/PubMed

PubMed · 16450235

An interactive web-based curriculum on evidence-based medicine: design and effectiveness.

Katherine Schilling·John Wiecha·Deepika Polineni·Souad Khalil
View original source ↗Export metadata ↓

Abstract

BACKGROUND AND OBJECTIVES: Medical education experts have called for improved training in evidence-based medicine (EBM) and the increased use of e-learning technologies in medical education. In response, we developed an interactive, Web-based curriculum on key aspects of EBM in family medicine. METHODS: Students participating in a 6-week family medicine clerkship (n=238) were randomly assigned to intervention (n=134) or control (n=104) groups. Both groups participated in the traditional clerkship experience, but intervention group students received additional training via an on-line curriculum that included learning modules in MEDLINE searching skills, EBM skills, and the calculation of the number needed to treat (NNT) statistic. The on-line curriculum was evaluated using a case-control design with a test case at the clerkship's end. RESULTS: Results suggested that the on-line curriculum was effective, with experimental group students outperforming control group participants on a variety of measures, including the number of MEDLINE searches conducted during the clerkship (13 searches versus 3 searches) and the quality of literature search strategies on an evaluation patient case study (2.9 versus 2.1 on a 1=poor to 4=excellent scale). Intervention group students reported greater confidence and enjoyment in searching the biomedical journal literature via MEDLINE and were more likely to identify the best articles (randomized controlled trials or meta-analyses) for the evaluation case from among those retrieved (60% versus 34%). In addition, intervention group students' abilities to correctly calculate the NNT were significantly higher than those of control group participants (73% versus 27%). Intervention group students were more likely than control subjects to report learning from other students during the clerkship. CONCLUSIONS: This study demonstrates that an e-learning approach to educating medical students to effectively search MEDLINE for articles meeting the criteria for evidence-based practice can result in higher-quality literature search strategies, identification of higher-quality evidence, and improved confidence in information retrieval and analysis skills.

Explore related subjects

Clinical ClerkshipComputer-Assisted InstructionCurriculumEducation, DistanceEvidence-Based MedicineFamily PracticeHumansInformation Storage and RetrievalInternetMEDLINEJournal ArticleRandomized Controlled TrialResearch Support, Non-U.S. Gov'tResearch Support, U.S. Gov't, P.H.S.

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

Katherine Schilling, John Wiecha, Deepika Polineni, Souad Khalil. 2006. An interactive web-based curriculum on evidence-based medicine: design and effectiveness.. https://pubmed.ncbi.nlm.nih.gov/16450235/

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

PubMed2007

Surgical residents as medical student mentors.

BACKGROUND: Medical students' decreasing interest in surgery may be caused by the inadequate availability of role models. We believe that surgical residents show the qualities of outstanding surgical mentors and are in a key position to influence students' career choices. METHODS: In 2004-2005, 117 medical students at Mount Sinai School of Medicine completed their third-year surgery clerkship. They were asked to complete an anonymous survey regarding a career in surgery and surgical mentors. RESULTS: A total of 107 students (91%) completed the survey. Seventy-nine percent were influenced positively toward a surgical career after the clerkship. A higher fraction of these students identified a mentor or role model than the students who did not increase their interest in surgery (95% vs 52%). Residents scored higher than attendings in 12 of 14 qualities describing outstanding clinical mentors (P < .001). CONCLUSIONS: Role models are crucial in bolstering medical students' interest in surgical careers. Residents are identified as having qualities that are essential to being an outstanding mentor and residents may play a role in influencing students' career choices.

Clinical Clerkship↗
PubMed2007

A web-based system for students to document their experiences within six core competency domains during all clinical clerkships.

The authors describe the design and implementation of a new Web-based system that allows students to record important features of their clinical encounters during all 10 required clinical clerkships, document their learning experiences in six major competency domains, and generate detailed real-time reports for themselves and their clerkship directors. A new Web-based system, DMEDS (Dartmouth Medical Encounter Documentation System), accepts input from computers and PDAs. Its design permits students to describe their patients, learning sites, interactions with preceptors, and important aspects of their clinical encounters in all of our medical school's competency domains. Using a common format for all required clerkships, clerkship directors select specific items most relevant to their clerkships from a common menu and set learning targets for specific diagnoses and clinical skills. This new system was designed in the fall of 2003, tested in the spring of 2004, and implemented in all clerkships for the 2004 to 2005 academic year. During the first full academic year that DMEDS was used, students documented nearly 32,000 discrete student-patient-preceptor encounters, an average of between 21 and 120 clinical encounters per Year 3 clerkship. Highlights of the analysis of these initial data include the following: (1) insights into how educational targets are set, (2) the extent of site-to-site variation in clerkship experiences, (3) the epidemiology of patients' declining student involvement, and (4) student experiences in and understanding of the newer competency domains.DMEDS can be used in all clinical clerkships and can address student experiences in all competency domains. It provides substantial value to students, clerkship directors, preceptors, and medical school administrators. As secondary benefits, the authors found that DMEDS facilitates educational research and is readily adapted for use in residency and fellowship programs as well. Student feedback highlights the need to pay close attention to the time invested by students documenting their clinical encounters. Course directors must ensure that the benefits to students (such as knowledge of meeting learning targets and preceptors providing direct feedback to students) are transparent. Finally, for other schools contemplating the change to a competency-based curriculum with the use of a clinical encounter documentation system, the time required for both students and faculty to adopt and fully engage these major educational culture shifts seems to be at least several years.

Clinical Clerkship↗