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28 A technology-enhanced learning module in evidence-based practice for medical undergraduates
  1. Donncha O’Gradaigh1,
  2. Brendan Leen2,
  3. Miriam Bell1
  1. 1University Hospital Waterford, Waterford, Ireland
  2. 2Regional Librarian, HSE South, Kilkenny, Ireland

Abstract

Objectives Three tutors with experience and formal training in teaching evidence-based practice have been teaching a didactic programme to medical undergraduates at an Irish Medical School. In response to a shift throughout the medical school curriculum to develop technology-enhanced and blended learning formats, we revised our module content and delivery.

Method In an introductory classroom session students discussed pre-reading material on core principles. Online material was presented on a proprietary platform which stores narrated slide presentations with support materials, and can limit progression using self-test items. In phase one, students viewed presentations on ‘ask’ and ‘acquire’, before submitting a clinical query, PICO and search strategy and offering feedback on other students’ work. Over three further weeks, students viewed presentations and support materials on critical appraisal of RCTs and systematic reviews. A classroom session at this point ensured competence in these core skills before a second phase of presentations including diagnostic test studies, qualitative research, guideline development and shared decision-making. A final assignment comprised structured marking of a critical appraisal of a RCT in the context of a clinical scenario.

Course evaluation comprised (i) analysis of usage data from the delivery platform; (ii) student feedback; (iii) external evaluation of final assignments.

Results Students (n=21) accessed the first-phase course material a mean 3.2 views per presentation and 8.3 hours total (range 6–24 hours per student). Students engaged twice as long with phase 1 material versus phase 2 topics (53% versus 24% of total time). Student feedback (n=11) rated the material on a five-point scale from ‘I understand this material a little’ to ‘I fully understand and could teach this material’. Grades for first phase material ranged 3.27 to 4.36. The Advanced topics scored lower, from 2.45 to 3.09. Free-text feedback suggested having more question-based self-assessment for the advanced topics and one suggested more classroom sessions. Students also pointed out that other, more critical assignments and courses had to be prioritised at the end of the term. Eighteen of the 21 participants scored 50% or higher in the final assignment, with pass, fail and distinction grades confirmed by the external examiner.

Conclusions Evidence-based Practice can be taught in a blended learning course to medical undergraduates, with the majority demonstrating competence on both self- and summative assessments. Lower performance in advanced topics may reflect the lack of clinical experience of medical undergraduates but these topics may be less suitable for didactic online teaching and require seminar or classroom formats.

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