The impact of evidence-based medicine curricula on information literacy among clinical medical undergraduates and postgraduates in China.

BACKGROUND

Information literacy (IL) is vital in health education, yet studies indicate medical students' IL might be insufficient or deficient. This study aims to evaluate the impact of an integrated Evidence-based Medicine (EBM) course in improving information literacy (IL) skills among Chinese undergraduate and postgraduate medical students.

METHODS

This study included 5-year and 7-year undergraduate students as well as postgraduate students majoring in clinical medicine from West China School of Clinical Medicine at Sichuan University who took the EBM course for the first time between January 2010 and December 2010 and participated in all sessions of the course. This study would employ a pre-and post-course comparison method to assess the impact of the integrated EBM course on the IL across different academic stages of Chinese medical students, in order to offer new and reliable strategies for the improvement of medical education of IL. The study incorporated an Evidence-Based Medicine (EBM) course intervention, followed by a comprehensive assessment of its impact. The course impact is defined as the alterations in students' self-perceived Information Literacy (IL) competencies, measured by the differences between pre-and post-course self-evaluations, along with the objectively demonstrated evidence application skills as reflected in the teacher-graded reports. Specifically, the evaluation of impact contains two parts: 1) subjective assessment, which was students' self-assessments of IL (information acquiring competency, information processing competency and information utilizing competency), conducted before and after the EBM course; 2) objective assessment, which was a teacher's assessment, conducted by having each student submit an evidence-based medical record report after the EBM course, and then the teacher assigning grades based on the records.

RESULTS

A total of 288 medical students participated in the intervention course, including 5-year undergraduates (n = 106), 7-year undergraduates (n = 57) and postgraduates (n = 125). 1) Information acquiring ability: after the course, students demonstrate a more proactive and enthusiastic inclination towards acquiring information. Their capabilities and expertise in information gathering have notably improved. 2) Information processing ability, exhibited by a 9.7% increase in the number of students who can differentiate types of information (p < 0.05), and a 9.8% decrease in students who are unable to evaluate the accuracy of information (p < 0.05) after EBM course; 3) Information utilizing ability, with the percentage of medical students who can cite references in a standard format and synthesize information effectively increased by 18% (p < 0.05) and 10.1% (p < 0.05) respectively after EBM course. And multiple aspects of the three dimensions of IL showed significant improvement in the postgraduate students. 4)Post-course evaluations of the evidence-based medical record indicate that students have demonstrated commendable proficiency in constructing PICO-based questions and applying evidence to formulate clinical decisions rooted in actual clinical scenarios. Notably, over half of the students attained an A grade in this assessment; However, students exhibit relatively weaker skills in acquiring evidence and critical appraisal, particularly among the 5-year undergraduates and postgraduates; In terms of after-effect evaluation, only 10% of the students evaluated both self-evaluation and clinical effect, while most students evaluated the clinical effect alone.

CONCLUSIONS

The integrated Evidence-based Medicine (EBM) course contributes to the improvement of information literacy (IL) skills among Chinese medical students, as is evidenced by the preliminary pre-and post-course comparative analysis. Further randomized controlled trials (RCTs) are needed for a more comprehensive and in-depth evaluation of the impact of EBM on IL. In the future, there should be a reinforced emphasis on the skills related to acquiring information and critical appraisal specifically tailored to clinical questions. Moreover, it is essential to provide differentiated curricula to meet the specific needs of students in different grade levels.