gms | German Medical Science

Introduction: An essential aim of courses in evidence-based medicine is to improve the skills for reading and interpreting medical literature adequately. Regarding the conceptual framework, it is important to consider different educational levels.

Methods: We conducted four short courses in EbM of 90 minutes each for health care management and medical students focused on critical appraisal of the literature. At the end, the students assessed five publications about randomised controlled trials using five different instruments; the results were compared to expert assessments.

Results: In total, 169 students participated in our EbM courses. The students’ assessments were affected by arbitrariness without a positive or negative tendency. 16% of the medical students stated that their command of English was weak or low. Across studies, evidence was found that the choice of instrument had an impact on agreement rates between expert and student assessments (p=0.0158) Three studies showed an influence of the instrument on the agreement rate (p<0.05 each).

Discussion: Our results contrast sharply with those of many other comparable evaluations. Reasons may be a lack of students’ motivation due to the compulsory courses, and the comparison to a reference standard in addition to self-ratings causing objectivity.

Conclusion: Undergraduates should become familiar with the principles of EbM, including research methods, and the reading of scientific papers as soon as possible. For a deeper understanding, clinical experience seems to be an indispensable precondition. Based on our results, we would recommend an integration of lectures about EbM and critical appraisal into medical curricula at least twice and with greater intensity shortly before graduation.