TEACHING STRATEGIES TO IMPROVE EVIDENCE-BASED MEDICINE LEARNING IN UNDERGRADUATE MEDICAL STUDENTS
Evidence-based Medicine; Medical Education; Medical Students; Validation Study
Background: The incorporation of Evidence-based Medicine (EBM) in medical school curriculum is challenging. There are few comparative studies on teaching methods, and assessment methods need national adaptation and validation. Aims: To compare the competencies development for EBM among the strategies Journal Club (JC), Clinical Case Sessions (CCS) and Expositive Class (EC), using a Brazilian version of the ACE Tool questionnaire. Methods: The study was conducted in two steps: translation for Brazilian Portuguese, adaptation and validation of the ACE Tool with students and professionals; and assessment of competencies development for EBM through comparison of mean pre and post-test scores on ACE Tool. Results: We recruited 88 participants: 20 students in JC group; 20 students in CCS; 36 students in EC and 12 invited professors/preceptors. The Brazilian version of ACE Tool has adequate internal consistency (Cronbach’s alfa 0.610) and reliability (item-to-total correlation ≥ 0.15 in 14 of 15 itens). Professors/preceptors mean scores were significantly higher than students’ on pre-test (10.25±1.71 vs 8.73±1.80, mean difference 1.52, 95% CI 0.47-2.57, p=0.005). There was significant difference between pre- and post-test mean scores on EC group (8.39±1.71 vs 9.11±1.58, mean difference 0.72, 95% CI 0.17,1.27, p=0.012), but not on JC group (8.70±1.65 vs 9.15±1.42, mean difference 0.45, 95% CI -1.32,0.40, p=0.28) or CCS group (9.40±2.01 vs 9.40±1.93, mean difference 0.0, 95% CI -1.03,1.03, p=1). Conclusion: The Brazilian version of ACE Tool had discriminatory capacity for different levels of expertise and adequate internal consistency and reliability. In EBM-novice students, EC strategy has better results on competencies assessment.