Article type
Abstract
"Background
Physicians have a major role in evidence-based medicine (EBM). As health technology assessment (HTA) constitutes a means to support EBM in healthcare, insights in HTA, including evidence synthesis, are essential.
Objectives
To explore education related to EBM in medical school including HTA/evidence synthesis.
Methods
Final-year medical students at the University of Gothenburg were invited to participate in a questionnaire study. The students were asked to state their agreement to the statement “During medical school, I have been adequately prepared regarding how to use evidence in patient work” (1=Disagree completely; 5=Agree completely). Scoring 4/5 was interpreted as agreement. The received education on HTA as well as training on key parts of a systematic review was similarly queried about. Students’ knowledge was evaluated by five multiple-choice questions (MCQs) regarding the interpretation of a case/control study, a diagnostic study, a meta-analysis with certainty of evidence expressed according to Grading of Recommendations, Assessment, Development, and Evaluations (GRADE), a forest plot, and a health economics statement regarding cost-effectiveness.
Results
A total of 107 out of 134 students participated (response rate: 80%; 60% women; median age: 26). In all, 78% experienced that they had been adequately prepared regarding how to use evidence in patient work while 5% stated that they had received education on HTA. The correlation coefficient between these responses was 0.29 (P-value: 0.002). Regarding key parts in evidence synthesis, 17% reported that they had had training to define a question according to the PICO model (patients, intervention, comparison, outcomes), 26% to identify relevant literature according to a PICO, 76% to assess scientific articles using checklists, 23% to synthesize results from several studies, and 8% to assess evidence according to GRADE. The students scored in median 3 correct answers on the MCQs (range 0‒5).
Conclusions
Education on HTA during medical school is correlated to perceived preparation for EBM but few medical students reported having received such education. Critical appraisal of individual articles seems largely integrated but other key parts of systematic reviews need further attention, as well as interpretation of research results – such proficiency is imperative for physicians.
"
Physicians have a major role in evidence-based medicine (EBM). As health technology assessment (HTA) constitutes a means to support EBM in healthcare, insights in HTA, including evidence synthesis, are essential.
Objectives
To explore education related to EBM in medical school including HTA/evidence synthesis.
Methods
Final-year medical students at the University of Gothenburg were invited to participate in a questionnaire study. The students were asked to state their agreement to the statement “During medical school, I have been adequately prepared regarding how to use evidence in patient work” (1=Disagree completely; 5=Agree completely). Scoring 4/5 was interpreted as agreement. The received education on HTA as well as training on key parts of a systematic review was similarly queried about. Students’ knowledge was evaluated by five multiple-choice questions (MCQs) regarding the interpretation of a case/control study, a diagnostic study, a meta-analysis with certainty of evidence expressed according to Grading of Recommendations, Assessment, Development, and Evaluations (GRADE), a forest plot, and a health economics statement regarding cost-effectiveness.
Results
A total of 107 out of 134 students participated (response rate: 80%; 60% women; median age: 26). In all, 78% experienced that they had been adequately prepared regarding how to use evidence in patient work while 5% stated that they had received education on HTA. The correlation coefficient between these responses was 0.29 (P-value: 0.002). Regarding key parts in evidence synthesis, 17% reported that they had had training to define a question according to the PICO model (patients, intervention, comparison, outcomes), 26% to identify relevant literature according to a PICO, 76% to assess scientific articles using checklists, 23% to synthesize results from several studies, and 8% to assess evidence according to GRADE. The students scored in median 3 correct answers on the MCQs (range 0‒5).
Conclusions
Education on HTA during medical school is correlated to perceived preparation for EBM but few medical students reported having received such education. Critical appraisal of individual articles seems largely integrated but other key parts of systematic reviews need further attention, as well as interpretation of research results – such proficiency is imperative for physicians.
"