Evidence Based Medicine Teaching in Undergraduate Medical Education: A Literature Review

Abstract

Objectives – To determine the year when evidence based medicine (EBM) was introduced and the extent to which medical students were exposed to EBM in undergraduate medical education and to investigate how EBM interventions were designed, developed, implemented, and evaluated in the medical curriculum. Methods – A qualitative review of the literature on EBM interventions was conducted to synthesize results of studies published from January 1997 to December 2011. A comprehensive search was performed on PubMed, CINAHL, Web of Science, Cochrane Library, ProQuest Dissertations & Theses, PsycINFO, and ERIC. Articles were selected if the studies involved some form of quantitative and qualitative research design. Articles were excluded if they studied EBM interventions in medical schools outside the United States or if they examined EBM interventions for allied health profession education or at the levels of graduate medical education and continuing medical education. Thirteen studies which met the selection criteria were identified and reviewed. Information was abstracted including study design, year and setting of EBM intervention, instructional method, instruction delivery format, outcome measured, and evaluation method. Results – EBM was introduced to preclinical years in three studies, integrated into clinical clerkship rotations in primary care settings in eight studies, and spanned preclinical and clinical curricula in two studies. The duration of EBM interventions differed, ranging from a workshop of three student contact hours to a curriculum of 30 student contact hours. Five studies incorporated interactive and clinically integrated teaching and learning activities to support student learning. Diverse research designs, EBM interventions, and evaluation methods resulted in heterogeneity in results across the 13 studies. Conclusions – The review reveals wide variations in duration of EBM interventions, instructional methods, delivery formats for EBM instruction, implementation of an EBM intervention, outcomes measured, and evaluation methods, all of which remain relevant issues for further research. It is important for medical educators and health sciences librarians to attend to these issues in designing and delivering a successful EBM intervention in the undergraduate medical curriculum.