Council on Medical Student Education in Pediatrics


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Evidence-Based Solutions for Evidence-Based Medicine

Challenges to Learning Evidence-Based Medicine and Educational Approaches to

Meet These Challenges: A Qualitative Study of Selected EBM Curricula in U.S. and Canadian Medical Schools.   Maggio LA et al.  Academic Medicine. 2016; 91:101–106.


Reviewed by Nick Potisek


What was the study question?

What barriers hinder medical students from learning EBM skills and what strategies are successfully used to address these barriers?

How was the study done?

Twenty-two medical schools were selected from 2012 Medical School Graduation Questionnaire data based on graduating students’ high self-reported confidence in their EBM abilities.  EBM faculty at each institution were identified and interviewed.  Interviews were transcribed then analyzed using an inductive approach. 

What were the results?

Thirty-one EBM faculty with varying clinical and educational roles were interviewed from 17 of the 22 selected medical schools. Four EBM learning challenges were identified: (1) suboptimal role models, (2) students’ lack of willingness to admit uncertainty, (3) lack of clinical context, and (4) difficulty mastering EBM skills.  Common approaches used by these institutions to overcome these EBM learning challenges include integrating EBM with other courses, integrating clinical content into EBM, faculty development, EBM whole-task exercises, and longitudinal integration of EBM across the curriculum. 

What are the Implications of these findings?

This study attempts to understand the challenges medical students face in learning EBM skills and serves as a starting place to understanding the barriers students encounter in EBM.  Medical schools who graduate students with perceived confidence in their EBM skills use a variety of integrated, longitudinal, and clinical EBM approaches.  Gaining familiarity with these EBM curricular designs can help educators enhance EBM at their respective institutions.  Further understanding student barriers through student focused interviews and true evaluation of student EBM skills vs. perception of their skills are important next steps to evaluate. 


Editor’s Note:   It’s nice to know what successful schools are doing about EBM education.  When pilfering educational strategies, it generally makes sense to steal from the best. (JG)

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