The Effectiveness of a Journal Club for Improving Evidence-Based Medicine Skills and Confidence in Pre-clerkship Medical Students

Abstract

Introduction: Evidence-based medicine (EBM) refers to medical practice that uses current best evidence to inform decision-making. This requires several skills including (1) creating an answerable question, (2) searching literature, (3) critically appraising evidence, and (4) applying results. Journal clubs are known to be effective in improving searching and critical appraisal skills in graduate medical education. In pre-clerkship medical education, journal clubs are used less often, and students often do not have the opportunity to engage in all of the steps above. Methods: We developed a journal club for pre-clerkship students and measured its effectiveness using a pre-test, post-test design. Students attended 5 journal club sessions run by rotating student leaders and facilitated by faculty. Student groups developed searchable questions from clinical cases, searched the literature, located and critically appraised an article, and applied results to the case. We measured EBM skills and confidence using two validated questionnaires. Results: Twenty-nine students (MS-1 and MS-2) completed the study. EBM confidence significantly improved at post-test with greatest improvements in the MS-1 student cohort. Confidence in developing a searchable question from a patient case significantly improved in both cohorts. There were no changes measured on the Test of EBM Knowledge and Skills. Discussion: Participation in a faculty-mentored, student-led journal club improved confidence across all domains of EBM, primarily in MS-1 students. Journal clubs are positively received by pre-clerkship medical students and provide effective mechanisms to teach and promote all steps of EBM in pre-clerkship curricula.