A Trial of Evidence-Based Medicine in Clinical Clerkships in a Department of Hygiene and Public Health / 医学教育

ABSTRACT

Our school of medicine began a new curriculum for medical students in April of 1999. In their final year medical students are allowed to schedule a 3-month clinical clerkship. This clerkship gives the students three 4-week periods to do rotations in their areas of interest. Our clinics have had a hard time finding the time to teach students evidence-based medicine (EBM) owing to their clinical workloads. Even when the divisions want to teach EBM there are few resources available for the students. Therefore, students are sometimes unable to receive adequate training in EBM. With the introduction of the new curriculum the Department of Hygiene and Public Health thought that the clinical clerkship program offered a good opportunity to teach students EBM with a one-to-one student-teacher relationship. We report here on our preliminary program that uses a scenario approach to EBM education. We determined the students' level of development by studying the detailed progress reports written by their teachers. The students were found to understand EBM when presented with its basic concepts which are then used in multiple discussions. Students will continue to use self-directed learning throughout their careers if they learn to think using EBM early in their training and practice it during their residency. We also show here a worksheet based on the Journal of the American Medical Association User's Guide series to use systematic EBM in daily clinics. Our program is just one of several methods we hope to develop to educate medical students in EBM.