Teaching trainees how to critically evaluate the literature - a crossover study at two pediatric residency programs

Abstract

ObjectivesThe purpose of this study was to assess the efficacy of a concise, evidence based medicine curriculum in improving the knowledge of pediatric residents at two institutions. MethodsSixty first and second year pediatric residents at MassGeneral Hospital for Children and MedStar Georgetown University Hospital participated in a crossover study. The evidence based medicine curriculum, consisting of 4 ninety minute sessions grounded in adult learning theory principles, was developed using the methodology described in the book ‘Studying a Study’. A validated 20 question evidence based medicine multiple choice test was administered on three separate occasions to measure baseline knowledge, efficacy of the curriculum in improving knowledge, and long term retention of that knowledge. Results Post curriculum, the fall group’s scores improved 23% from baseline (M=10.3, SD=2.4) to (M=12.7, SD=3.0) students (t(26)=-3.29, p=0.0018) while the spring group improved by 41% (M=10.0, SD=2.8) to (M=14.1, SD=2.2) students (t(32)=-6.46, p<0.0001). When re-tested 4-6 months later, the fall group’s scores did not significantly decline from their immediate post curriculum scores (M=12.7, SD=3.0) to (M=11.7, SD=3.0) students (t(32) =1.33, p=0.190). There was an association between number of sessions attended and increase in post curriculum score (χ2(3, N=60) =11.75, p=0.0083). ConclusionsFindings demonstrate our curriculum was effective in teaching evidence based medicine to pediatric residents, and fostered long term retention of knowledge. Based on these results, we believe this curriculum could be implemented at any institution.

Assessing the impact of Medical Microbiology classes using active strategies on short- and long-term retention on medical students: an innovative study

“…Questions QA-B were personal (gender, age), and the remaining questions are depicted in Supplementary Tables 2 and 3 and include the following topics: examination by light microscopy [1], selection of biological samples to be taken and how to be harvested [2,9], distinction between Gram-negative and Gram-positive bacteria [3], culture media composition and sterilization methods [4,5,21], microbial identification techniques, methods of direct diagnosis and antimicrobial susceptibility testing [6,8,20], criteria for antimicrobial therapeutic selection [7], agents related to gastroenteritis [10], microbial agents related to sexually transmissible infections [11], etiological agent of stomach cancer [12], microbial agent transmitted through air conditioning ducts [13], Grampositive bacteria characterization [14,22], etiology of Vibrio cholera infection [15], Escherichia coli phenotypic characterization [16], tuberculosis in Portugal [17], fungi characterization [18], virus characteristics [19], definition of metabolism [23], kinetics of microbial growth [24], transmission of genetic material in bacteria [25], and microbial genomes [26].…”

“…It was described that incorporating an active learning strategy in a Pharmacology course concerning antimicrobial compounds leads to a significant increase in long-term performance comparatively to traditional lectures [17]. A study performed by Nelson and coworkers also demonstrates that an active curriculum implemented in pediatric residents was effective in teaching evidence-based medicine and promote long-term retention [18].…”

Evidence-based medicine curricula and barriers for physicians in training: a scoping review

“…Out of the 14 abstracts, 5 used the validated Fresno 25 , 31 , 36 , 56 , 57 and 1 used the validated Berlin questionnaire. 26 Nelson and colleagues 58 reported the usage of a 20 question previously validated questionnaire. The rest of the studies used unvalidated surveys and questionnaires to assess their outcomes.…”

“…57 The curricular structure has been reported to be developed on the adult learning theory principles in 3 articles. 10,46,58 Most curricula contained more than 2 teaching methods, with only 9 curricula reporting on a single intervention repeated for multiple times: interactive workshops, 59 EBM teaching rounds, 53 Journal Club, 29,60 one-on-one meetings, 55 self-paced modules, 45 modules, 24 and small group sessions. 26,36,54…”

Medical resident training in China

“…Training of the residents is thus crucial to the quality and development of medical services. 2 - 4 In China, the resident training program has experienced necessary changes in the past few decades to cope with the drastic increase in people's needs of high-quality medical services as well as the rapid development of medical science and technology. Given the fact that the world today is increasingly globalized and local health care resources have to address the needs of not only residents but also immigrants and visitors from other parts of the world, it is valuable to introduce medical resident training in China to an international audience.…”