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A survey study of evidence-based medicine training in US and Canadian medical schools
Maria A Blanco1, Carol F Capello1, Josephine L Dorsch1
1maria.blanco@tufts.edu , Associate Dean for Faculty Development and Associate Professor, Department of Psychiatry, Tufts University School of Medicine, Office of Educational Affairs, 136 Harrison Avenue, Sackler 321, Boston, MA 02111; cfc2002@med.cornell.edu , Associate Director, Office of Curriculum and Educational Development, and Associate Professor of Geriatric Education in Medicine, Weill Cornell Medical College, 1300 York Avenue, Room C-205 Box 243, New York, NY 10065; jod@uic.edu , Regional Head Librarian and Professor, Library of the Health Sciences-Peoria, University of Illinois at Chicago, P.O. Box 1649, Peoria, IL 61656; jerry.perry@ucdenver.edu , Director, Mail Stop A003, Health Sciences Library, Anschutz Medical Campus, University of Colorado Denver, 12950 East Montview Boulevard, Room 3101C, Aurora, CO 80045; Mary.Zanetti@umassmed.edu , Senior Director for Institutional Research, Evaluation, and Assessment; Institutional Research Officer; and Assistant Professor, Department of Quantitative Health Sciences, University of Massachusetts Medical School, 55 Lake Avenue North, S4-141, Worcester, MA 01655-0002.
Purpose:
The authors conducted a survey examining (1) the current state of evidence-based medicine (EBM) curricula in US and Canadian medical schools and corresponding learning objectives, (2) medical educators' and librarians' participation in EBM training, and (3) barriers to EBM training.
Methods:
A survey instrument with thirty-four closed and open-ended questions was sent to curricular deans at US and Canadian medical schools. The survey sought information on enrollment and class size; EBM learning objectives, curricular activities, and assessment approaches by year of training; EBM faculty; EBM tools; barriers to implementing EBM curricula and possible ways to overcome them; and innovative approaches to EBM education. Both qualitative and quantitative methods were used for data analysis. Measurable learning objectives were categorized using Bloom's taxonomy.
Results:
One hundred fifteen medical schools (77.2%) responded. Over half (53%) of the 900 reported learning objectives were measurable. Knowledge application was the predominant category from Bloom's categories. Most schools integrated EBM into other curricular activities; activities and formal assessment decreased significantly with advanced training. EBM faculty consisted primarily of clinicians, followed by basic scientists and librarians. Various EBM tools were used, with PubMed and the Cochrane database most frequently cited. Lack of time in curricula was rated the most significant barrier. National agreement on required EBM competencies was an extremely helpful factor. Few schools shared innovative approaches.
Conclusions:
Schools need help in overcoming barriers related to EBM curriculum development, implementation, and assessment.
Implications:
Findings can provide a starting point for discussion to develop a standardized competency framework.
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