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Public Science Insights: Involve Me and I Learn: Teaching Medical Students Skills to Undertake Research and Practice Evidence Based Medicine

Posted Tue, Jul, 11,2017

The term ‘evidence-based medicine’ was first used in the early 1990s. It refers to an approach to medical practice which aims to improve clinical decision making, by taking into account their clinical expertise, the patients’ values and preferences, and the evidence provided by good-quality research. To make sound clinical decisions, doctors need to have research skills which enable them to critically analyse the quality of the published evidence, including identifying study designs and reviewing how the data has been collected and analysed. They need to understand that the highest levels of evidence can be found in systematic reviews and randomised control trials.

The acceptance of ‘evidence-based medicine’ is reflected worldwide by medical councils’ recognising the importance of medical schools graduating students with well-developed research skills and the capacity to undertake research. However, it is acknowledged that engaging medical students in research skill development and training is a challenge. Based on this premise, and Benjamin Franklin’s statement “Tell me and I forget, teach me and I may remember, involve me and I learn,” the Research and Critical Analysis (RCA) program has been successfully developed and integrated within the four-year medical degree program at the University of Wollongong (UOW) in Australia.

The principles of programmatic assessment, based on the use of assessment for learning rather than simply as a means of assessing learning, were used in the design of the RCA program. The RCA program is integrated with the science, clinical and professional themes throughout the entire medical course, and involves approximately 300 hours of lectures and online learning modules. The assessment tasks for the RCA program are mapped to a competency framework, which are in turn scaffolded to different levels of Miller’s pyramid. According to Miller’s pyramid, knowledge is at the bottom level and represents a novice’s understanding, whilst action is at the top and reflects expert understanding. The competency framework was designed to support the development of the research capabilities required to critically analyse the evidence and to carry out an independent research project. 

 
In addition to scaffolding the assessment tasks to a competency framework, several strategies associated with programmatic assessment are used to implement the RCA program. These include regular and informative feedback, comprehensive marking rubrics, as well as academic mentoring and supervision. Progressive waves of student, faculty and peer feedback were used to iteratively tailor and improve the RCA program over the past 10 years.

By designing a program for learning we have encouraged students to develop their research skills by involving them in their learning. This self-determination is vital as the practice of evidence-based medicine is acknowledged as being a process of lifelong, self-directed learning which contributes to good patient outcomes. We are helping to graduate doctors who are able to embed their practice within the current evidence base due to their ability to identify, source, understand and undertake research. 
 
Judy Mullen, Pippa Burns, and Kylie Mansfield are authors of the recently published paper ‘Involve Me and I Learn’: Development of an Assessment Program for Research and Critical Analysis, available for download now in the Journal of Medical Education and Curricular Development.

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