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Cognitive levels in testing knowledge in evidence-based medicine: a cross sectional study.

Ivan Buljan1, Matko Marušić2, Ružica Tokalić2

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Evidence-based medicine (EBM) knowledge varies across cognitive levels and topics for students and experts. Assessments reveal that while experts excel in certain areas, no group demonstrated comprehensive mastery across all EBM domains.

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Evidence-based medicineLearning outcomesMedical education

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Area of Science:

  • Medical Education
  • Evidence-Based Medicine

Background:

  • Traditional knowledge assessment in Evidence-Based Medicine (EBM) often focuses on lower-level cognitive objectives like memorization and understanding.
  • This study aimed to evaluate EBM knowledge comprehensively, encompassing both higher and lower cognitive levels across various EBM topics.

Purpose of the Study:

  • To assess Evidence-Based Medicine (EBM) knowledge at multiple cognitive levels (Remembering to Creating) across diverse EBM topics.
  • To compare EBM knowledge levels between first-year students, third-year students, and EBM experts.

Main Methods:

  • Developed the Six Progressive Levels in Testing (SPLIT) instrument, a 36-item multiple-choice test covering six cognitive levels and six EBM topics.
  • Assessed the instrument's validity and EBM knowledge in first-year students (n=119), third-year students (n=70), and EBM experts (n=14).
  • Determined the minimum passing score (MPS) for the overall test through consensus among three independent assessors.

Main Results:

  • The minimum passing score (MPS) was 16/36. Experts had a significantly higher pass rate (9/14) compared to third-year (14/70) and first-year students (21/119).
  • While experts scored highest overall, no group excelled across all individual cognitive levels.
  • Experts demonstrated superior knowledge in 'Study Design' and 'Sources of Evidence,' whereas students performed better in topics aligned with their specific academic years ('Diagnostic Studies' for first-years, 'Clinical Relevance' for third-years).

Conclusions:

  • EBM knowledge differs between students and experts based on their educational and professional experiences.
  • Current assessment methods may struggle to capture the full spectrum of EBM knowledge across different cognitive levels and topics.
  • Further development of comprehensive EBM knowledge assessment tools is warranted to track learning progression effectively.