The effect of an evidence-based medicine course on medical student critical thinking

Examination of learning ability development through the implementation of the "autonomy-collaboration" learning mode grounded in evidence-based medicine practice

OBJECTIVE

Currently, there are still some shortcomings in EBM education in China.The study aimed to investigate the effectiveness of the novel evidence-based medicine (EBM) learning model of "autonomy-collaboration."

METHODS

A total of 91 undergraduate students majoring in clinical medicine at Zhongshan Clinical College of Dalian University from the 2019 batch were selected as the participants in this study. They were instructed to follow the EBM learning model of "autonomy-collaboration." Upon completion of the course, questionnaires, records of participants' sentiments and insights, and evidence-based clinical practice reports were used as indicators to evaluate the effectiveness of the training.

RESULTS

This learning modality effectively enhanced independent learning ability of the students, stimulated their interest in learning, and strengthened the communication between students and teachers, thereby improving the quality of teaching.

CONCLUSION

The novel EBM learning model of "autonomy-collaboration," exhibited robust effectiveness in instruction and facilitated the seamless integration of theoretical knowledge with clinical practice. Consequently, its widespread adoption is strongly recommended.

Evidence-Based Medicine: Feminist Criticisms and Implications for Women's Health

Evidence-based medicine (EBM) dates back to 19th-century Paris and started out as a new paradigm for practicing medicine, with the aim of replacing anecdote with high-quality evidence from positivist-style research. Despite the clear logic underpinning EBM, there have been numerous criticisms, including maintenance of an archaic view of evidence as "facts," failure to acknowledge that all research is underpinned by the beliefs of the researcher, and the simple fact that medical research has historically been androcentric and results generalized to female patients. In this essay, we discuss the criticisms of EBM, with a focus on feminist critiques based on three central feminist epistemologies: feminist empiricism, standpoint theory, and social constructivism. We argue that EBM potentially perpetuates gaps in women's health and advocate for incorporating feminist epistemologies into future medical research to garner further understanding of social influences on women's health. In addition, we argue that EBM may degrade the clinical acumen and that critical thinking should become a key component of medical school curricula.

Students 4 Best Evidence as a digital Problem-Based Learning method to improve Evidence-Based Practice competencies in undergraduate physiotherapy students: an observational study

BACKGROUND

Evidence-based practice (EBP) is an essential element in the delivery of high-quality care and healthcare professionals make clinical decisions based on the best available research. Experts and international organisations have emphasised the need for healthcare professionals to possess adequate competencies for EBP. An EBP learning laboratory has been established at an Italian university to educate medical and other health professional students in the use of evidence in clinical practice and research. Students 4 Best Evidence (S4BE) is an online community of students from around the world, from school age to university, who are interested in learning more about EBP. As well as featuring a library of learning resources, the site also provides a platform for students to write their own blogs.

OBJECTIVES

The aim of this study is to evaluate the effectiveness of an EBP laboratory, using S4BE as an educational tool, to teach EBP competencies to undergraduate physiotherapy students.

DESIGN

We ran an observational pretest and post-test study.

PARTICIPANTS AND SETTING

The sample included 121 students completing a bachelor's degree in Physiotherapy at an Italian University.

INTERVENTION

The intervention consisted of using the S4BE platform as the digital Problem-Based Learning (DPBL) method to teach EBP competencies.

MAIN OUTCOME MEASURES

RESULTS: The students showed a significant improvement in all domains (p<0.001), except in the sympathy domain, where the percentage score decreased from 71% to 60%. The best improvements were reached in terminology (54% to 65%) and in practice (41% to 55%) domains.

CONCLUSION

This study proposed an effective educational protocol, based on a DPBL approach, using S4BE as a digital technology tool. Further research is needed to test the effectiveness of this educational protocol compared with traditional learning methods for physiotherapy students.

TRIAL REGISTRATION NUMBER

NCT03707119.

Chinese medical students' disposition for critical thinking: a mixed methods exploration

BACKGROUND

Critical thinking (CT) is an essential competency for medical students. This study's aim was to evaluate Chinese medical students' disposition for CT and to explore the impact of current trends in medical education on students' CT development.

METHODS

We used multistage stratified cluster sampling to recruit a total of 1241 medical students among five different years of training and from three medical institutions in China. The Critical Thinking Disposition Inventory-Chinese Version (CTDI-CV) and self-reported information were used to collect cross-sectional data. Based on the data from the CTDI-CV, 112 medical students in clinical course training from a single institution continued one-year follow-up. Their one-year CTDI-CV score changes were collected regarding various medical education variables.

RESULTS

The mean CTDI-CV score of the 1241 medical students was 287.04 with 729 (58.7%) students receiving a score of 280 or higher. There were statistically significant differences in schools attended(F = 3.84, P < 0.05), year of school attended(F = 10.32, P < 0.001), GPA(F = 6.32, P < 0.01), weekly time spent learning after class(F = 14.14, P < 0.001), attitude toward medicine(F = 28.93, P < 0.001), desire to be a doctor after graduation(t = - 3.35, P < 0.001), familiarity with CT(F = 20.40, P < 0.001), and perception of importance of CT(F = 22.25, P < 0.001). The participants scored the highest on the CTDI-CV subscales of "inquisitiveness" and the lowest on "truth seeking." The 112 students in the longitudinal study had significantly lower total CT scores after one academic year follow-up.

CONCLUSIONS

Chinese medical students generally exhibited positive CT dispositions. The cross-sectional survey and one-year longitudinal study indicated that students' CT disposition diminished as they progressed through traditional medical training. Our study contributes to understanding the status of Chinese medical education of and influential factors on medical students' CT disposition.

Question formulation skills training using a novel rubric with first-year medical students

Objective:

The authors used an assessment rubric to measure medical students' improvement in question formulation skills following a brief evidence-based practice (EBP) training session conducted by a health sciences librarian.

Method:

In a quasi-experimental designed study, students were assessed using a rubric on their pre-instructional skills in formulating answerable EBP questions, based on a clinical scenario. Following their training, they were assessed using the same scenario and rubric. Student pre- and post-test scores were compared using a paired t-test.

Results:

Students demonstrated statistically significant improvement in their question formulation skills on their post-instructional assessments. The average score for students on the pre-test was 45.5 (SD 11.1) and the average score on the post-test was 65.6 (SD 5.4) with an average increase of 20.1 points on the 70-point scale, p<0.001.

Conclusion:

The brief instructional session aided by the rubric improved students' performance in question formulation skills.

A multi-dimensional EBP educational program to improve evidence-based practice and critical thinking of hospital-based nurses: Development, implementation, and preliminary outcomes

Improving outcomes and quality of care through evidence-based practice (EBP) is a priority globally. But most nurses have insufficient competence in EBP. How to conduct Educational interventions to enhance clinical nurses' EBP competencies and critical thinking disposition (CTD) requires more evidence. One hundred eleven clinical nurses from a Chinese four-campus hospital were enrolled in our EBP education program. The Johns Hopkins Nursing Evidence-Based Practice Model was used to develop and guide the educational and practical sessions. Multi-dimensional learning strategies -including online self-learning, on-site lectures, workshops, and social media-facilitated group discussions-were used to facilitate the implementation of the education sessions. After education, nurses embedded evidence into practice. The Chinese versions of the EBP Believe scale (EBPB), EBP Implementation scale (EBPI), and the Simplified Chinese Version of the Critical Thinking Disposition Inventory (CTDI-SCV) were applied to assess the relevant competencies among clinical nurses before and after the education program. Clinical nurses' EBPB, EBPI, and CTDI-SCV scores improved. But only EBPB and EBP skills and attitudes were enhanced with a statistical difference (t = -2.980, -4.141, and -2.695, with all p < 0.01). There was a small positive association between EBPB and CTDI-SCV (r = 0.396, p < 0.01). Fifteen EBP programs were successfully accomplished.

Impact of a Journal Club Elective Course on Student Learning Measures

Objective. To assess the impact of a journal club elective course on measures of student's longitudinal performance throughout an accelerated three-year Doctor of Pharmacy (PharmD) curriculum. Methods. Students were separated into two groups (those who did and did not complete a journal club elective). The following primary and secondary student outcomes were assessed using hierarchical linear regression analysis: score on the Pharmacy Curriculum Outcomes Assessment (PCOA), overall course grade in the Pharmacotherapeutics IV course, overall course grade in the Research Design and Literature Evaluation II course, and average grade on acute/ambulatory care advanced pharmacy practice experiences (APPEs). Results. One hundred ninety-seven students were included in the study (73 students who completed the journal club elective and 124 students who did not). After controlling for baseline confounders, enrollment in the journal club elective was associated with students scoring 24.5 points higher on their overall scaled score on the PCOA. Enrollment in the journal club elective also appeared to add 2% to a student's overall grade in each of the courses and APPEs. All results were statistically significant. Conclusion. An elective journal club course can significantly improve multiple objective measures of pharmacy student learning. Components of this course, such as reading primary literature, presenting a journal club, learning from peers, and scaffolding of pharmacotherapeutic concepts are important elements to consider when designing a journal club curriculum.