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Development, implementation, and outcomes of an initiative to integrate evidence-based medicine into an osteopathic curriculum.

ABSTRACT: In response to the American Osteopathic Association's Commission on Osteopathic College Accreditation (COCA) standards set forth in 2008, osteopathic medical schools are restructuring curricula to demonstrate they are teaching the seven core competencies and integrating evidence-based medicine (EBM) throughout all 4 years of training.To describe and evaluate the efforts of a college of osteopathic medicine to integrate EBM concepts into its curriculum while maintaining existing course content and faculty contact hours.One-group pre- and posttest study.Kirksville College of Osteopathic Medicine-A.T. Still University (KCOM) in Missouri.KCOM course directors in workshop series I (n=20) and KCOM faculty workshop series II (n=14).A faculty development workshop series based on the diffusion of innovations model was instituted to facilitate cultural change, gain faculty support, and accelerate the implementation of EBM throughout KCOM's curriculum.Faculty attitudes, confidence levels, and the number of courses that included instruction of EBM concepts were measured in August 2007 and May 2008.Faculty attitudes about integrating EBM into the curriculum and confidence levels measured pre- and postworkshop series found that 21 of 26 participants believed they improved their ability to locate primary EBM resources using the Internet; 21 of 28 improved their ability to teach EBM concepts to students. Fifteen of 16 faculty course directors agreed to find ways to incorporate EBM into their classes. Review of KCOM's course syllabi in April 2009 demonstrated a statistically significant difference (P<.001) in the number of faculty teaching EBM concepts after the faculty development workshop series concluded in March 2008 compared to before the series commenced in March 2006. An unexpected outcome was the implementation of a faculty-conceived, standalone EBM course in fall 2007.A workshop series based on the diffusion of innovations model is effective in garnering faculty support for the implementation of a change in curriculum that emphasizes EBM content without increasing faculty contact hours or eliminating existing curricular content. A faculty development model emphasizing a "bottom-to-top" approach is effective in achieving workplace culture changes and seamless curricular transitions. Results have shown that a consensus building model is conducive to engaging faculty and garnering its support to effect curricular change, which, ultimately, ensures success.

SUBMITTER: Laird S

PROVIDER: S-EPMC3142697 | biostudies-literature | 2010 Oct

REPOSITORIES: biostudies-literature

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Development, implementation, and outcomes of an initiative to integrate evidence-based medicine into an osteopathic curriculum.

Laird Stephen S George John J Sanford Sondra M SM Coon Susan S

The Journal of the American Osteopathic Association 20101001 10

<h4>Context</h4>In response to the American Osteopathic Association's Commission on Osteopathic College Accreditation (COCA) standards set forth in 2008, osteopathic medical schools are restructuring curricula to demonstrate they are teaching the seven core competencies and integrating evidence-based medicine (EBM) throughout all 4 years of training.<h4>Objective</h4>To describe and evaluate the efforts of a college of osteopathic medicine to integrate EBM concepts into its curriculum while main ...[more]

PMID: 21068224

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Project description:BackgroundEvidence-based medicine (EBM) is an important element of medical education. However, limited information is available on effective curricula.ObjectiveTo evaluate a longitudinal medical school EBM curriculum using validated instruments.Design, participants, measurementsWe evaluated EBM attitudes and knowledge of medical students as they progressed through an EBM curriculum. The first component of the curriculum was an EBM "short course" with didactic and small-group sessions occurring at the end of the second year. The second component integrated EBM assignments with third-year clinical rotations. The 15-point Berlin Questionnaire was administered before the course in 2006 and 2007, after the short course, and at the end of the third year. The 212-point Fresno Test was administered before the course in 2007 and 2008, after the short course, and at the end of the third year. Self-reported knowledge and attitudes were also assessed in all three classes of medical students.ResultsEBM knowledge scores on the 15-point Berlin Questionnaire increased from baseline by 3.0 points (20.0%) at the end of the second year portion of the course (p < 001) and by 3.4 points (22.7%) at the end of the third year (p < 001). EBM knowledge scores on the 212-point Fresno Test increased from baseline by 39.7 points (18.7%) at the end of the second year portion of the course (p < 001) and by 54.6 points (25.8%) at the end of the third year (p < 001). On a 5-point scale, self-rated EBM knowledge increased from baseline by 1.0 and 1.4 points, respectively (both p < 001). EBM was felt to be of high importance for medical education and clinical practice at all time points, with increases noted after both components of the curriculum.ConclusionsA longitudinal medical school EBM was associated with markedly increased EBM knowledge on two validated instruments. Both components of the curriculum were associated with gains in knowledge. The curriculum was also associated with increased perceptions of the importance of EBM for medical education and clinical practice.

Project description:BackgroundEvidence-Based Medicine (EBM) integrates best available evidence from literature and patients' values, which then informs clinical decision making. However, there is a lack of validated instruments to assess the knowledge, practice and barriers of primary care physicians in the implementation of EBM. This study aimed to develop and validate an Evidence-Based Medicine Questionnaire (EBMQ) in Malaysia.MethodsThe EBMQ was developed based on a qualitative study, literature review and an expert panel. Face and content validity was verified by the expert panel and piloted among 10 participants. Primary care physicians with or without EBM training who could understand English were recruited from December 2015 to January 2016. The EBMQ was administered at baseline and two weeks later. A higher score indicates better knowledge, better practice of EBM and less barriers towards the implementation of EBM. We hypothesized that the EBMQ would have three domains: knowledge, practice and barriers.ResultsThe final version of the EBMQ consists of 80 items: 62 items were measured on a nominal scale, 22 items were measured on a 5 point Likert-scale. Flesch reading ease was 61.2. A total of 343 participants were approached; of whom 320 agreed to participate (response rate?=?93.2%). Factor analysis revealed that the EBMQ had eight domains after 13 items were removed: "EBM websites", "evidence-based journals", "types of studies", "terms related to EBM", "practice", "access", "patient preferences" and "support". Cronbach alpha for the overall EBMQ was 0.909, whilst the Cronbach alpha for the individual domain ranged from 0.657-0.940. The EBMQ was able to discriminate between doctors with and without EBM training for 24 out of 42 items. At test-retest, kappa values ranged from 0.155 to 0.620.ConclusionsThe EBMQ was found to be a valid and reliable instrument to assess the knowledge, practice and barriers towards the implementation of EBM among primary care physicians in Malaysia.

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Development, implementation, and outcomes of an initiative to integrate evidence-based medicine into an osteopathic curriculum.

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Development, implementation, and outcomes of an initiative to integrate evidence-based medicine into an osteopathic curriculum.

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