Dataset Information

The Effectiveness of a Journal Club for Improving Evidence-Based Medicine Skills and Confidence in Pre-clerkship Medical Students.

ABSTRACT:

Introduction

Evidence-based medicine (EBM) refers to medical practice that uses current best evidence to inform decision-making. This requires several skills including (1) creating an answerable question, (2) searching literature, (3) critically appraising evidence, and (4) applying results. Journal clubs are known to be effective in improving searching and critical appraisal skills in graduate medical education. In pre-clerkship medical education, journal clubs are used less often, and students often do not have the opportunity to engage in all of the steps above.

Methods

We developed a journal club for pre-clerkship students and measured its effectiveness using a pre-test, post-test design. Students attended 5 journal club sessions run by rotating student leaders and facilitated by faculty. Student groups developed searchable questions from clinical cases, searched the literature, located and critically appraised an article, and applied results to the case. We measured EBM skills and confidence using two validated questionnaires.

Results

Twenty-nine students (MS-1 and MS-2) completed the study. EBM confidence significantly improved at post-test with greatest improvements in the MS-1 student cohort. Confidence in developing a searchable question from a patient case significantly improved in both cohorts. There were no changes measured on the Test of EBM Knowledge and Skills.

Discussion

Participation in a faculty-mentored, student-led journal club improved confidence across all domains of EBM, primarily in MS-1 students. Journal clubs are positively received by pre-clerkship medical students and provide effective mechanisms to teach and promote all steps of EBM in pre-clerkship curricula.

Supplementary information

The online version contains supplementary material available at 10.1007/s40670-023-01779-y.

SUBMITTER: Cahill EM

PROVIDER: S-EPMC10061358 | biostudies-literature | 2023 Apr

REPOSITORIES: biostudies-literature

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The Effectiveness of a Journal Club for Improving Evidence-Based Medicine Skills and Confidence in Pre-clerkship Medical Students.

Cahill Ellen M EM Ferreira Gabriela G Glendinning Diana D

Medical science educator 20230330 2

<h4>Introduction</h4>Evidence-based medicine (EBM) refers to medical practice that uses current best evidence to inform decision-making. This requires several skills including (1) creating an answerable question, (2) searching literature, (3) critically appraising evidence, and (4) applying results. Journal clubs are known to be effective in improving searching and critical appraisal skills in graduate medical education. In pre-clerkship medical education, journal clubs are used less often, and ...[more]

PMID: 37251208

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Project description:IntroductionAssessment of medical students' clinical skills (CS) remains a challenge. Little is known about early predictors of future CS performance. This study examines the relationship between students' pre-clerkship clinical skills (PCCS) performance and year 3 clerkship performance measures.MethodsThe authors performed a retrospective analysis of four medical student cohorts who matriculated between 2014 and 2017 and participated in a longitudinal pre-clerkship CS curriculum. A total of 440 students were included in the analyses. Students' clinical skills were assessed through a series of PCCS exams, each consisting of a single standardized patient encounter. First-year PCCS exams assessed history taking, physical examination, professionalism, and communication skills; second-year PCCS exams also assessed clinical documentation and clinical reasoning skills. Evaluators assigned a grade of "satisfactory," "borderline," or "unsatisfactory" for each skill set. Regression analyses compared year 3 performance outcomes between students with one or more "unsatisfactory" or "borderline" PCCS skill set grades and students assessed as "satisfactory" for all PCCS skill set assessments.ResultsThirty-two percent (n = 140) of the 440 students had at least one borderline or unsatisfactory (US) PCCS skill set grade. These students performed significantly worse on year 3 National Board of Medical Examiner subject exams, workplace-based clinical performance evaluations, and overall year 3 performance compared to students who passed all PCCS exam components. In addition, a higher percentage of students with PCCS performance deficiencies failed the United States Medical Licensing Examination Step 2 CS exam on the first attempt versus students who passed all PCCS exam components.ConclusionsPCCS exam performance at our institution aligned with future student performance on multiple year 3 clerkship outcome measures. This pre-clerkship performance data can be used to identify at-risk students who would benefit from additional resources to achieve competency in the clerkship environment and future medical training.Supplementary informationThe online version contains supplementary material available at 10.1007/s40670-022-01519-8.

Project description:BackgroundIn many developing countries facing medical personnel shortage, including Thailand, medical graduates are required to have enough confidence and competence to perform essential procedures by themselves. They should be competent in episiotomy and perineal repair. In the early phase of actual practice of episiotomy on real patients, new clinical students are usually unskilled and less confident. To improve medical students' competency and confidence in performing basic procedures, we developed a pig-perineum simulation-based learning program. The aim of this study is to evaluate the confidence levels of medical students as well as their perspectives regarding the effectiveness of pig-perineum simulation-based learning.MethodsMedical students participated in a pig-perineum repair workshop on identifying perineal laceration, knot-tying, and perineal laceration repair, under the instruction of skilled staff members. The workshop was meant to achieve transfer of skills from the simulated setting of our course to the actual practice on patients in the labor ward and the maternity operating room. All the participants were instructed to answer the questions on a questionnaire after the simulation. The confidence, skills, satisfaction, and learning achieved through the simulator were assessed using a 5-point Likert scale, based on the systematically validated questionnaire.ResultsSeven hundred and ninety-two medical students were enrolled in the study. The mean self-efficacy scores before and after the simulation were 3.63 and 4.16 respectively (paired t-test, p-value < 0.001). The mean satisfaction score was high (4.22), inspiring them to enhance their surgical skills in knot-tying and perineal laceration repair. The mean self-evaluation score of the participants regarding their perspectives on the closeness to reality of pig-perineum repair when compared to real clinical practice was high (4.09), making them more confident in practice in the labor room.ConclusionPig-perineum simulation-based learning improves confidence level and surgical skills in undergraduate medical students. This approach appears to enhance competency during clinical practice.

Dataset Information

The Effectiveness of a Journal Club for Improving Evidence-Based Medicine Skills and Confidence in Pre-clerkship Medical Students.

Introduction

Methods

Results

Discussion

Supplementary information

Publications

The Effectiveness of a Journal Club for Improving Evidence-Based Medicine Skills and Confidence in Pre-clerkship Medical Students.

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