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Student Reviews

Evidence based medicine should be taught in medical schools

BMJ 2005; 330 doi: (Published 01 February 2005) Cite this as: BMJ 2005;330:050287b
  1. Manique Wijesinghe, third year medical student1
  1. 1University of Southampton

With a click of a mouse, medical students can access thousands of research articles of variable credibility about any topic or clinical problem, using resources such as Medline, Ovid, or the Cochrane Library. But sifting through this information and coming up with a coherent, practical, and, above all, effective solution is a big challenge.

Critical appraisal skills are essential to medical students and doctors to make sense of the overwhelming volume of available information. Integrating evidence based medicine-“the judicious application of best current knowledge to the condition and values of the individual patient”1-into clinical practice is more likely to be effective at changing existing behaviour and practice than traditional methods such as workshops and stand alone courses.2

Simply applying the best current knowledge, however, is not enough: you must evaluate the information carefully before doing so. Citing her experiences of making evidence based mistakes, Hilda Bastian, a researcher in Germany, writesthat jumping to conclusions too soon, using a systematic review as a defence, can lead to serious clinical errors.3 “A promising treatment is just the larval stage of a disappointing one,” she opines.

Currently, most teaching of evidence based medicine for undergraduates takes a classroom based format-a teaching method that has been shown to have little effect.2 Information overload is a problem that will only get worse in the future. Thus it is crucial that students are guided in the prudent use of evidence based medicine from early on in their medical careers to facilitate efficient selection, evaluation, and implementation of new research findings, some of which may turn prevailing wisdom on its head.

A good point at which to begin such integrated teaching would be the beginning of a student's clinical years. Clinical medical students could be encouraged, either individually or in small groups, …

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