Evidence-based medicine: how we teach medical undergraduates

Article type
Authors
Rocha LPDS1, Andrade LAFD1, Braga VL1, Quintella ML1, Barros EDM1, Leonel LDF1, Dittrich N1, Lima LRPD1, Pacheco RL1, Pachito DV2, Logullo P3, Atallah AN3, Gois AFT1, Riera R2
1Universidade Federal de São Paulo, Escola Paulista de Medicina
2Cochrane Brazil
3Cochrane Brazil
Abstract
Background:
Evidence-based medicine (EBM) plays an important role in taking the most appropriate conducts, therefore it should not only be considered an academic and scientific tool, but an essential skill in medical training.

Objective:
To report EBM teaching experience, integrated with the teaching of emergency medicine, in the curriculum of the fourth year of Escola Paulista de Medicina medicine course.

Methods:
The course presents fixed scheduling for each day of the week and each week a different study design is explored. On Mondays there are theoretical lectures on fundamental concepts of statistics and clinical epidemiology, as well as on study designs, then practical classes to search for studies in the literature. On Wednesdays there are clinical case discussions about subjects prevalent in emergency medicine. At the end of the class, students are asked to search for a study of that week's design that answers a question raised during the lesson, in order to do a critical review of the study and to be presented the following week. On Fridays, theoretical classes of emergency medicine are held, always arguing the evidence on that topic, and there are practical simulation classes, based on the actions usually taken, and their respective levels of evidence.

Results:
The undergraduate EBM course is an awakening to the scientific universe, being essential both for students who want and do not want to pursue a career in this area. The course teaches them that they to seek high-quality information to keep their clinical conduct up-to-date and to offer their patients the best help in an environment outside the academy. For those, most of whom are already doing scientific research, this is the foundation that helps their work to be methodologically appropriate. During the course, students come to know the main electronic databases, and learn to construct a search strategy. By the end of the course, they are able to conduct an adequate search and to make a critical analysis of the studies. The integration of teaching with emergency medicine allows the student to learn how to trace a path of searching for the best evidence from questions that certainly will arise during clinical practice.

Conclusions:
The teaching of EBM in undergraduates is beneficial both for patients and for qualification of future doctors, especially those who will not pursue an academic career.