October 14-17, 2006

Integrating Evidence-Based Medicine with

the Medical School Curriculum

Russell Smith, russells@usc.edu

Educational Support LibrarianNorris Medical Library

University of Southern California

Background & Setting USC – Keck School of Medicine

Approximately 160 students per class

New curriculum introduced in Fall 2001 Case-based, self-directed learning

First year students MEDLINE search project Already familiar with information retrieval

EBM Workshop & Assignment Introduced in Fall 2004

Second year medical students

One hour workshop (hands-on) Basic EBM principles Walk through resources

Online tutorial

Evidence Pyramid

SUNY Downstate Medical Center© 2006. All rights reserved

Online Tutorial

http://www.usc.edu/hsc/nml/lib-services/tutorials/ebm.html

Example question:

Is advice to stay active more effective than bed rest in the treatment of chronic low-back pain?

Resources covered National Guideline Clearinghouse

Cochrane Database of Systematic Reviews

Database of Abstracts of Reviews of Effect (DARE)

Best Evidence – ACP Journal Club

Resources covered MEDLINE

Randomized controlled trials Meta-analyses

Clinical Evidence (BMJ)

UpToDate

Final Questions Which of the above resources were

the most useful?

Did you find any answers to your question? If so, where?

State the answer, if found. Conflicting evidence?

Which resource did you find most useful?*

UpToDate (23.5%)

MEDLINE – rcts (20.8%)

N.G.C. (15.3%)

C.D.S.R. (10.6%)

*Most students listed more than one resource. Four students did not state a preference. Data was collected Spring 2006.

Inferences Ranking of MEDLINE over knowledge bases

(such as Cochrane Database of Systematic Reviews) seems to indicate:

High comfort-level for searching Benefit of first year literature search project Confidence in analytical abilities Value-added resources may be too limited in

scope

Conclusions Students are learning how to search

Project has enhanced library’s status

Student evaluations of project Very positive

Worksheet adopted by other programs

Student Evaluations*

Instructor taught effectively 4.62

Information presented was clear & concise 4.67

I learned something useful 4.32

*5 =strongly agree, 4=agree, 3=neutral, 2=disagree, 1=strongly disagree