Mumtaz Sadaf, Sabir Sohail
Medical Education and Simulation, Dental College, HITEC Institute of Medical Sciences, National University of Medical Sciences, Rawalpindi, PAK.
Transplant Nephrology, Armed Forces Institute of Urology/Army Medical College, National University of Medical Sciences, Rawalpindi, PAK.
Cureus. 2022 Nov 15;14(11):e31535. doi: 10.7759/cureus.31535. eCollection 2022 Nov.
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.
背景 针对临床前牙科学生的期刊俱乐部（JC）利用效率低下，导致缺乏对其在培养批判性推理和循证医学（EBM）实践等技能方面有效性的研究。因此，我们在本科一年级牙科学生中实施了期刊俱乐部，并使用综合循证医学能力评估（ACE）工具来衡量其有效性。
方法 我们进行了一项准实验研究，将循证医学作为一种混合模式纳入临床前学生的课程中，采用为期一年的混合学习方法。50名学生的班级被分成五组，每组10名学生，每组参加与生理学课程相关的七次期刊俱乐部活动。在自主学习环节进行批判性分析后，学生们制作交互式PowerPoint演示文稿，随后进行讨论。教师根据柯克帕特里克培训评估模型中的1 - 2个级别在每次活动后提供反馈。使用SPSS 26版（美国纽约州阿蒙克市IBM公司）对ACE工具的测试前和测试后结果进行推断统计，以进行比较分析。
结果 使用箱线图检测到中位数分数从测试前的6分线性趋势到测试后的9分。使用配对样本t检验，测试前和测试后回答之间的平均差异（95%置信区间）为 - 3.14（-2.32至 - 3.96）（p < 0.001）。就测试后回答而言，每个项目的难度指数范围为0.3至0.9。内部信度在可接受范围内，大于0.15（范围 = 0.5 - 0.18）。项目区分指数范围为0.8至大于0.2。克朗巴赫α系数为0.64，被认为是可接受的。
结论 我们的结果表明，临床前牙科学生赞赏使用期刊俱乐部来提高主动学习、批判性评价、分析和决策技能。15项ACE测量是评估巴基斯坦牙科学生循证医学能力的有用且可靠的工具。
