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Development of an evaluation of medical student competence in evidence-based medicine using a computer-based OSCE
John G Frohna1, Larry D Gruppen, Jonathan E Fliegel
1Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan 48109-0368, USA. jfrohna@umich.edu
Background:
Instruction in evidence-based medicine (EBM) has been widely incorporated into medical school curricula with little evidence of its effectiveness. Our goal was to create, implement, and validate a computer-based assessment tool that measured medical students' EBM skills.
Description:
As part of a required objective structured clinical examination, we developed a specific case scenario in which students (a) asked a structured clinical question using a standard framework, (b) generated effective MEDLINE search terms to answer a specific question, and (c) elected the most appropriate of 3 abstracts generated from a search justifying which best applies to the patient scenario.
Evaluation:
Between the 3 blinded raters, there was very good interrater reliability with 84, 94, and 96% agreement on the scoring for each component, respectively (k = .64, .82, and .91, respectively). In addition, students found the station appropriately difficult for their level of training.
Conclusions:
This computer-based tool appears to measure several EBM skills independently and combines simple administration and scoring. Its generalizability to other cases and settings requires further study.
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