Evaluating Critical Appraisal Skills by Introducing Journal Clubs to Preclinical Dental Students Using the Assessing Competency in Evidence-Based Medicine (ACE) Tool Through Pre and Post-testing

Abstract

BackgroundThe ineffective utilization of journal clubs (JCs) for pre-clinical dental students has led to a lack of research into their effectiveness in developing skills such as critical reasoning and evidence-based medicine (EBM) practice. Therefore, we have implemented JCs in first-year undergraduate dental students and measured their effectiveness using the integrated Assessing Competency in Evidence-Based Medicine (ACE) tool. MethodologyWe conducted a quasi-experimental study where EBM was included in the curriculum for pre-clinical students as a hybrid model with a year-long blended learning approach. The 50-student class was divided into five groups of 10 students, with each group participating in seven JCs related to the physiology curriculum. After conducting critical analysis in self-directed learning sessions, students created interactive PowerPoint presentations followed by discussion. Instructors offered feedback after each session based on 1-2 levels in Kirkpatrick's training evaluation model. Inferential statistics were used for comparative analysis of the ACE tool pre-and post-test using SPSS version 26 (IBM Corp., Armonk, NY, USA). ResultsA linear trend in median score from 6 in the pre-test to 9 in the post-test was detected using the box and whisker plot. Using paired sample t-test, the mean difference (95% confidence interval) between the pre-test and post-test responses was -3.14 (-2.32 to -3.96) (p < 0.001). In terms of the post-test responses, each item's difficulty index ranged from 0.3 to 0.9. Internal reliability was in the acceptable range of >0.15 (range = 0.5-0.18). The item discriminatory index was in the range of 0.8 to >0.2. Cronbach's alpha was 0.64, which was deemed acceptable. ConclusionsOur results show that pre-clinical dentistry students appreciated the use of JCs to improve active learning, critical appraisal, analytical, and decision-making skills. The 15-item ACE measure is a useful and reliable tool for assessing dentistry students' EBM proficiency in Pakistan.

Knowledge changes after applying evidence‐based dentistry educational interventions to dental students: A systematic review

“…Most of the selected studies originated from North America, 27–30,33,38,40,41 followed by Middle‐Eastern universities 6,35,36,39,46 . Fourteen studies evaluated changes observed in a single group of participants after the implementation of an educational intervention, with no comparative analyses 6,27–30,32,37,39–44,46 .…”

“…Most of the selected studies originated from North America, 27–30,33,38,40,41 followed by Middle‐Eastern universities 6,35,36,39,46 . Fourteen studies evaluated changes observed in a single group of participants after the implementation of an educational intervention, with no comparative analyses 6,27–30,32,37,39–44,46 . Alternatively, five studies compared parallel cohorts, 31,34–36,38,45 wherein either different educational interventions were comparatively evaluated, 31,34,38 or trained were compared with untrained students 35,36,45 …”

“…The intervention formats were diverse, utilized numerous resources, and were conducted for variable periods. Most of the educational interventions reported in the included studies covered the knowledge contained in the EBD domain “ask”, 6,28,31,33–36,38,40–42,44,46 “acquire”, 27,34–36,39,41,43 and “appraise” 6,27,28,30–37,39,41–46 . Fewer educational interventions covered the EBD domain “apply”, 27,28,31,33,36 while none considered the domain “audit”.…”

“…Despite the format variability, the educational interventions could be essentially categorized into three modalities, according to how the EBD subject was approached, as described below. Regular disciplines or courses, such as Community Dentistry, 27,36 Oral Immunology, 30 Treatment Planning, 33 Integrated Clinical Science, 38 Conservative Dentistry, 39 and Epidemiology, 45 incorporating one or more of the EBD principles, methods and/ or practices; EBD‐focused disciplines or courses, including one or more of the EBD principles, methods, and/or practices 6,28,31,34,35,40–43 ; Other educational interventions, including journal clubs, 32,37,46 short training sessions with librarians, 29 and a Wikipedia collaboration, 44 including one or more of the EBD principles, methods, and/or practices. …”

“…The teaching of EBD has been recommended by leading educational organizations, 15–18 and multiple experiences aimed at comprehensively reorganizing and updating curricula have been successfully implemented worldwide 10,19–26 . Minor yet important educational initiatives have also been conceived, and several designs have been tested thus far 6,27–46 . The teaching of EBD to dental students has been generally associated with enjoyable learning experiences, 27,32,43,47 the establishment of positive attitudes toward EBD, 32,42,45 and enhanced performance in other essential skills, 32,47 such as communication and interaction 27 .…”