From Questions to Answers: Teaching Evidence-Based Medicine Question Formulation and Literature Searching Skills to First-Year Medical Students.

Abstract

Introduction: Medical students may arrive at medical school with some research background but not necessarily evidence-based medicine (EBM) skills. First-year preclinical medical students require foundational skills for EBM (formulating background and foreground questions, navigating information sources, and conducting database searches) before critically appraising evidence and applying it to clinical scenarios.

Methods: We developed a flipped classroom EBM workshop for preclinical students combining prework modules and a 60-minute in-person session. After completing the online modules on foundational EBM skills, students participated in an in-person activity based on patient cases. In small groups, students formulated background and foreground questions based on a case and looked for evidence in resources assigned to each group. Small groups reported back to the whole group how they searched for information for their patient cases. A total of 105 first-year medical students were required to complete this workshop after concluding their basic sciences courses.

Results: Because current EBM assessment tools do not assess the early steps of EBM, we developed an assessment tool for foundational EBM tools. Before the modules, students completed a pretest on formulating questions and searching for information. After the workshop, students completed a posttest. Students showed improvement in differentiating background and foreground questions (p < .001), formulating answerable clinical questions (p < .001), and developing appropriate database searches (p < .001 and p = .002).

Discussion: This flipped classroom approach to teaching foundational EBM skills may be adapted for different contexts, but educators should consider time limitations, group size, and tools for interactivity.