Evaluating Critical Appraisal Skills by Introducing Journal Clubs to Preclinical Dental Students Using the Assessing Competency in Evidence-Based Medicine (ACE) Tool Through Pre and Post-testing.

Background The ineffective utilization of journal clubs (JCs) for pre-clinical dental students has led to a lack of research into their effectiveness in developing skills such as critical reasoning and evidence-based medicine (EBM) practice. Therefore, we have implemented JCs in first-year undergraduate dental students and measured their effectiveness using the integrated Assessing Competency in Evidence-Based Medicine (ACE) tool. Methodology We conducted a quasi-experimental study where EBM was included in the curriculum for pre-clinical students as a hybrid model with a year-long blended learning approach. The 50-student class was divided into five groups of 10 students, with each group participating in seven JCs related to the physiology curriculum. After conducting critical analysis in self-directed learning sessions, students created interactive PowerPoint presentations followed by discussion. Instructors offered feedback after each session based on 1-2 levels in Kirkpatrick's training evaluation model. Inferential statistics were used for comparative analysis of the ACE tool pre- and post-test using SPSS version 26 (IBM Corp., Armonk, NY, USA). Results A linear trend in median score from 6 in the pre-test to 9 in the post-test was detected using the box and whisker plot. Using paired sample t-test, the mean difference (95% confidence interval) between the pre-test and post-test responses was -3.14 (-2.32 to -3.96) (p < 0.001). In terms of the post-test responses, each item's difficulty index ranged from 0.3 to 0.9. Internal reliability was in the acceptable range of >0.15 (range = 0.5-0.18). The item discriminatory index was in the range of 0.8 to >0.2. Cronbach's alpha was 0.64, which was deemed acceptable. Conclusions Our results show that pre-clinical dentistry students appreciated the use of JCs to improve active learning, critical appraisal, analytical, and decision-making skills. The 15-item ACE measure is a useful and reliable tool for assessing dentistry students' EBM proficiency in Pakistan.