Evaluation of Evidence Based Medicine Knowledge and Skills among a Sample of Medical Students in King Abdul Aziz University: A Follow up Study

Abstract

Background: Evidence-based medicine (EBM) is an essential method of teaching that represents the integration of clinical expertise, patient values, and high-quality evidence in the process of decision making concerning healthcare. The current study aims to evaluate the EBM skills of medical students four years after having taken this course. In order to evaluate the effectiveness of this course, students who took the course are compared with students who did not take the course. Materials and Methods: The current study was conducted at the Faculty of Medicine of King Abdulaziz University in Saudi Arabia between 2009 and 2013. Fifteen students out of 165 in the fourth year selected this course as one of their student-selected components (SSC), and this was their first experience in learning about EBM. Immediately after the end of the course, faculty members asked the first student cohort to evaluate the effectiveness of the course and rate the EBM project, the material taught, and the instructional handouts using a five-point Likert scale questionnaire. Out of the 15 who enrolled in the course, 14 were surveyed four years after taking the EBM course, in addition to another 14 medical students who did not take the EBM course. The students self-assessed their confidence with EBM skills in the following areas: formulation of clinical questions in the “PICO” format (patient population, intervention [or exposure], comparison, outcomes), literature searches, evaluation of articles, and ability to apply this process to other clinical situations. In addition, student performance was evaluated with regard to the five steps applied in their learning experiences during the course. A five-point Likert-type scale was used in the questionnaires, with “strongly disagree” coded as 1 and “strongly agree” coded as 5. The collected data were analyzed in terms of descriptive statistics using SPSS. Results: The results indicate that the overall scores from the four-year prospective study were lower than those collected immediately after the EBM course. Students who took the course (EBM group) has better skills in critiquing articles and linking EBM with clinical skills than those who did not (non-EBM group). Moreover, subjects from the EBM group had more interest in medical updates and research and were more familiar with the medical database library. Conclusion: EBM teaching should be integrated as an initial course and applied early, followed by continuous EBM-based practice with clinical activities throughout the clinical years. Moreover, smartphone based E-learning has become an efficient way to handle medical knowledge and deliberation among medical students and healthcare providers.