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Appraising and applying evidence about a diagnostic test during a performance-based assessment
George Bergus1, Scott Vogelgesang, Janeta Tansey
1Department of Family Medicine, The University of Iowa, Iowa City 52242, USA. george-bergus@uiowa.edu
BMC Medical Education
|October 16, 2004
Summary
Medical students can appraise research on diagnostic tests but struggle to apply it clinically. This highlights a gap in translating evidence-based medicine skills into patient care for graduating physicians.
Area of Science:
- Medical Education
- Evidence-Based Medicine
- Diagnostic Testing
Background:
- Evidence-based Medicine (EBM) necessitates clinicians evaluating research validity and applying findings to patient care.
- Assessing the ability of medical students to appraise and apply diagnostic test research in clinical scenarios is crucial.
- Comparison with peers from other institutions was included to benchmark performance.
Purpose of the Study:
- To evaluate the proficiency of soon-to-graduate medical students in critically appraising research on diagnostic tests.
- To assess the ability of these students to apply research findings to patient management, specifically in probability revision.
- To compare the skills of medical students with those of first-year Internal Medicine residents.
Main Methods:
- Fourth-year medical students and first-year Internal Medicine residents participated in the study.
- Participants encountered a simulated patient scenario.
- Following the encounter, subjects appraised a relevant diagnostic test research paper and revised patient pretest probability based on test results.
Main Results:
- Medical students and residents showed comparable critical appraisal skills, answering 4.7/6 and 4.9/6 questions correctly, respectively (p=0.67).
- Probability revision skills were significantly lacking, with only 3% of medical students and 0% of residents successfully completing the task (p=1.00).
Conclusions:
- Most graduating medical students can critically appraise diagnostic test research but struggle with clinical application.
- The findings raise concerns about the practical clinical utility of Evidence-based Medicine skills in graduating medical students concerning diagnostic testing.
- Further improvements in medical education are needed to bridge the gap between research appraisal and clinical application.
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