Methods to involve medical students from developing countries in Cochrane systematic reviews (CSRs): preliminary experiences from China

Article type
Authors
Sun X, Ma T, Zhang X, Tong L, Parker S, Wang L, Li Y
Abstract
Background: Medical students are one of the largest resources and the most active participants in conducting CSRs in China. Finding ways to involve them in the production of CSRs is important to produce and maintain high-quality CSRs and to promote Cochrane activities in China. For our first attempt, we utilized student reviewers in the CSR vinca alkaloid containing regimen for advanced breast cancer . Objective: To explore rational methods of participation for eligible medical students in CSRs, and to develop an optimal model for utilizing medical students to participate and promote Cochrane activities.

Methods: A model consisting of two parts was developed (figure 1).

Students were recruited through program advertisement and provided with additional information on request. All interested students were evaluated by personal interview and provisional assessment. Inclusion criteria were the level of interest, relevant education, and previous experiences in research. The remaining students received training in systematic reviews according to Cochrane Reviewer s Handbook. Students were included on the basis that they understood the methodology adequately. Students excluded from step 4 and 5 were given extra training along with the review, which aimed to develop their expertise for future review.

A staggered training system was applied at the start of each review stage (primary selection, quality appraisal, data extraction and analysis). During each stage, a problem-based training model was also applied. Problems were collected and solved by discussion with the co-coordinator or by expert lecturing. The outcomes of training were evaluated by survey and feedback by personal interview.

Results: 30 medical students were recruited. After selection, three grade IV students were finally ready to work with principle investigator and seven students were given further training (figure 1).

Seven students excluded from step 4 and 5 were given six sessions of extra training. After that, all students reported satisfaction with the program and improved understanding of CSRs. Six were assessed to meet the objectives and four ready to be reviewers. Seven required more training in data extraction and analysis, and would like to involve in future reviews.

Fourteen problem-based training sessions on three topics were available to three reviewers, of which six were related to data analysis, five to data extraction and three to quality appraisal. After training, all reported satisfaction with the program and an improved level of understanding of CSRs. On personal interview, all reported they would do more CSRs and one reported an interest in developing expertise as a lead reviewer.

At present, the review is nearing completion and will be submitted to the Breast Cancer Group for peer review and publication on The Cochrane Library.

Conclusions: Medical students are capable of conducting CSRs, however they require a standardized procedure of selection and a comprehensive method of training and mentoring. Students also need to have a high level of interest before they will conduct CSRs.