Integrating EBM into Medical School

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

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

Integrating EBM into Medical School

by russkie69

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