Learning by updating a Cochrane Review: teaching systematic review methods to undergraduate medical students

Tags: Poster
López-Alcalde J1, Varillas D2, Antón C2, Muriel A3, Stallings E4, Zamora J3, Monge D2
1Cochrane Associate Center of Madrid, Universidad Francisco de Vitoria, Madrid, Clinical Biostatistics Unit, Hospital Universitario Ramón y Cajal (IRYCIS), 2Universidad Francisco de Vitoria, Madrid, 3Clinical Biostatistics Unit, Hospital Universitario Ramón y Cajal (IRYCIS)/CIBER Epidemiology and Public Health (CIBERESP), 4Clinical Biostatistics Unit, Hospital Universitario Ramón y Cajal

Background: medical students must acquire research skills to deliver their end-of-degree research project. Systematic reviews (SRs) support healthcare-informed decisions and should be an essential skill obtained during a medical degree. Since 2017 medical students at Universidad Francisco de Vitoria-Madrid (UFV), which hosts Cochrane Madrid, update Cochrane Reviews for their end-of-degree research projects.

Objectives: to describe our experience in integrating the teaching of Cochrane methods in the medical degree curriculum.

Methods: we have designed a subject to guide medical students to perform a SR. The subject, starting in the 4th year and finishing in the 6th year, is distributed in three years. The subject requires theory sessions, seminars, group and individual work by each student. The teaching staff is composed of one co-ordinator, four methodologists and 15 clinical tutors. Students are evaluated by attendance, participation, a written essay, an oral presentation, and assessment by peers.

Results: 93 medical students (75.5% of women) have enrolled in the course. The class started in September 2017 and will finish in 2020. Fifteen Cochrane Reviews are under update. Their topics include psychiatry (33.3%), intensive care (20%), gynaecology (20%), endocrinology (20%) and other topics (6.6%). The students have learnt to formulate clinical questions, to search CENTRAL (Cochrane Central Register of Controlled Trials) and PubMed, to critically appraise articles, and to use Review Manager 5 and Covidence. Review publication is not the goal, but we anticipate that the students will identify new trials for the Cochrane Reviews.

Challenges:

1) the subject is demanding for students and teachers;

2) clear teaching materials are needed, and their elaboration is time-consuming;

3) new randomized controlled trials (RCTs) may not be found;

4) the free Covidence version wasn’t useful;

5) it’s uncertain if Review Manager will continue for free.

Opportunities:

1) focusing on SRs of only RCTs facilitates the process for students and teachers;

2) group work can lighten the students’ work burden;

3) the subject allows the students to acquire research skills and competencies for evidence-based medicine;

4) we are developing standardised teaching materials for each review stage, which will facilitate the work of teachers and students.

Conclusions: teaching SR methods based on the update of Cochrane Reviews is useful to acquire research skills and to promote a medical curriculum oriented to evidence-based medicine. While challenging, we expect that this course model will be successful and implemented in other universities.

Patient or healthcare consumer involvement: the integration of Cochrane methods in the undergraduate curriculum allows the medical student to learn to formulate clinical questions that are relevant for patients. This is an essential skill for an evidence-based practice that will be beneficial for patients.