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Integrating EBM into Medical School

Integrating EBM into Medical School



Result of study re: medical student usage of online resources to find evidence-based information based on real-life clinical questions.

Result of study re: medical student usage of online resources to find evidence-based information based on real-life clinical questions.



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    Integrating EBM into Medical School Integrating EBM into Medical School Presentation Transcript

    • Integrating Evidence-Based Medicine with the Medical School Curriculum Russell Smith, russells@usc.edu Educational Support Librarian Norris Medical Library University of Southern California
    • 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.
    • 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.
    • 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
    • EBM Workshop & Assignment
      • Introduced in Fall 2004
      • Second year medical students
      • One hour workshop (hands-on)
        • Basic EBM principles
        • Walk through resources
      • Online tutorial
    • Evidence Pyramid SUNY Downstate Medical Center© 2006. All rights reserved
    • Online Tutorial http://www.usc.edu/hsc/nml/lib-services/tutorials/ebm.html
    • Example question:
      • Is advice to stay active more effective than bed rest in the treatment of chronic low-back pain?
    • Resources covered
      • National Guideline Clearinghouse
      • Cochrane Database of Systematic Reviews
      • Database of Abstracts of Reviews of Effect (DARE)
      • Best Evidence – ACP Journal Club
    • Resources covered
      • MEDLINE
        • Randomized controlled trials
        • Meta-analyses
      • Clinical Evidence (BMJ)
      • UpToDate
    • 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?
    • 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.
    • 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
    • Conclusions
      • Students are learning how to search
      • Project has enhanced library’s status
      • Student evaluations of project
        • Very positive
      • Worksheet adopted by other programs
    • 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