[Preparing for patient work founded on evidence in medical school - a questionnaire study on final-year medical...

Several of the requirements for obtaining a medical degree according to the Swedish Higher Education Ordinance illustrate the scientific basis of the profession, and systematic reviews as well as health technology assessments (HTA) constitute cornerstones in evidence-based medicine. In this study, medical students' experience of scientific education related to the profession was explored, and their knowledge achieved was sampled by five multiple-choice questions (MCQ). A total of 433 out of 641 students attending the final semester in six medical schools in Sweden participated (response rate: 68%). Most of them experienced that a majority of the scientifically related learning outcomes for the medical degree had been adequately examined. Regarding the steps of a systematic review, 60% stated that they had been trained to define a specific research question, 64% to find relevant literature according to such a specific research question, 72% to assess scientific articles according to a checklist, 40% to compile results from several studies, and 35% to assess the certainty of evidence according to GRADE. Only 6% stated that they had received education regarding HTA, a factor that was strongly associated with students' perception that they had obtained adequate skills regarding how patient work is based on scientific evidence (adjusted odds ratio [OR] 14.1; 95% CI 1.80-110). Such an association was also found for credit-awarded hands-on evidence-related learning activities during clinical courses (OR 2.72; 95% CI 1.02-7.24). The median student answered 3 of 5 MCQs correctly. The results of a case/control study, a forest plot, and the concept of cost-effectiveness were frequently interpreted erroneously. In conclusion, several aspects of the scientific basis for professional life as a medical doctor seem to be well covered in the medical degree program, whereas others deserve increased attention.