Peer Education: Reviews of the Literature (PERLs)

Blanco MA, Capello CF, Dorsch JL, et al. A survey study of evidence-based medicine training in U.S. and Canadian medical schools. J Med Libr Assoc 2014;102(3):160-8. Background: Evidence-based medicine (EBM) pairs clinical judgment with the strongest research evidence. The Institute of Medicine recommended that all medical trainees and professionals should practice EBM, so it is important to determine how well medical schools are implementing that recommendation. Methods: Blanco et al. used an online survey of curricular deans at medical schools to assess the current coverage of EBM in U.S. and Canadian medical school curricula. The survey included questions concerning how each school defined, taught, and assessed EBM, which problems it faced when implementing EBM training, and how the school overcame these problems. Results: The response rate was high (77.2%). Of these respondents, 95% agreed with the definition that EBM is “the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients [which involves] integrating individual clinical expertise with the best available external clinical evidence from systematic research,” and 95% reported including EBM in their schools’ curricula. The respondents identified 482 measurable learning objectives, most taught early in the curriculum. In the first two years, there was a mixture of active and passive learning, and assessment was via written exams and observation. In the third year, active learning in clinical settings was most common, and assessment was more direct (checklists, rubrics, and/or OSCEs). These curricular deans reported no formal EBM training for fourth-year students and that clinicians usually taught EBM. Insufficient time was identified as a significant barrier for implementing an EBM curriculum for 45% of the schools, while student attitudes and problems with integrating EBM into clinical care (41%), lack of faculty knowledge (28%), and lack of faculty interest (27%) were also identified as frequent obstacles. Consensus on EBM competencies was widely agreed to be helpful (41%), as was evidence that EBM improves patient outcomes (54%). Significance for dental education: The methodology used in this study and its findings could serve as the basis for a similar survey of dental schools in the U.S. and Canada. The results concerning barriers to implementing EBM education and potential solutions for overcoming these obstacles could be helpful for educators who are implementing evidence-based dentistry (EBD) in dental schools. It is important for future clinicians to understand EBD and be able to apply EBD in their daily practice, as new techniques and materials are continuously being introduced in the dental field.