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Evidence-Based Medicine Training in Undergraduate Medical Education: A Review and Critique of the Literature Published 2006–2011

Maggio, Lauren A. MS(LIS), MA; Tannery, Nancy H. MLS; Chen, H. Carrie MD, MSEd; Cate, Olle ten PhD; O’Brien, Bridget PhD

doi: 10.1097/ACM.0b013e3182951959

Purpose To characterize recent evidence-based medicine (EBM) educational interventions for medical students and suggest future directions for EBM education.

Method The authors searched the MEDLINE, Scopus, Educational Resource Information Center, and Evidence-Based Medicine Reviews databases for English-language articles published between 2006 and 2011 that featured medical students and interventions addressing multiple EBM skills. They extracted data on learner and instructor characteristics, educational settings, teaching methods, and EBM skills covered.

Results The 20 included articles described interventions delivered in 12 countries in classroom (75%), clinic (25%), and/or online (20%) environments. The majority (60%) focused on clinical students, whereas 30% targeted preclinical students and 10% included both. EBM skills addressed included recognizing a knowledge gap (20%), asking a clinical question (90%), searching for information (90%), appraising information (85%), applying information (65%), and evaluating practice change (5%). Physicians were most often identified as instructors (60%); co-teachers included librarians (20%), allied health professionals (10%), and faculty from other disciplines (10%). Many studies (60%) included interventions at multiple points during one year, but none were longitudinal across students’ tenures. Teaching methods varied. Intervention efficacy could not be determined.

Conclusions Settings, learner levels and instructors, teaching methods, and covered skills differed across interventions. Authors writing about EBM interventions should include detailed descriptions and employ more rigorous research methods to allow others to draw conclusions about efficacy. When designing EBM interventions, educators should consider trends in medical education (e.g., online learning, interprofessional education) and in health care (e.g., patient-centered care, electronic health records).

Ms. Maggio is director of research and instruction, Lane Medical Library, Stanford University School of Medicine, Stanford, California.

Ms. Tannery is senior associate director, Health Sciences Library System, University of Pittsburgh, Pittsburgh, Pennsylvania.

Dr. Chen is professor of clinical pediatrics, Department of Pediatrics, University of California, San Francisco, School of Medicine, San Francisco, California.

Dr. ten Cate is professor of medical education and director, Center for Research and Development of Education, University Medical Center Utrecht, Utrecht, the Netherlands, and adjunct professor, Department of Medicine, University of California, San Francisco, School of Medicine, San Francisco, California.

Dr. O’Brien is assistant professor of medicine, Department of Medicine, University of California, San Francisco, School of Medicine, San Francisco, California.

Correspondence should be addressed to Ms. Maggio, Stanford University School of Medicine, 300 Pasteur Dr., Room L-109, Stanford, CA 94035; telephone: (650) 725-5493; e-mail:

© 2013 by the Association of American Medical Colleges