Experiences with a clinical reasoning and evidence-based medicine course.

BACKGROUND: Although clinical reasoning (CR) and evidence-based medicine (EBM) are taught in some medical schools, the curricular details and students' clinical use of these skills are unknown. A detailed description of, and student experiences with, a practical CR and EBM curriculum delivering recommended content and pedagogy in an emerging academic environment may be broadly informative.

PURPOSE: To describe and characterise student experiences with a CR and EBM curriculum at a newly formed Academic Medical Centre (AMC).

METHODS: Applying expert recommended content and pedagogy, we developed a CR and EBM curriculum for final-year medical students delivered by existing clinical faculty members. We evaluated the course content by delineating the CR elements and EBM steps taught, and characterised student CR and EBM classroom and clinical experiences using a self-reported survey (1, strongly disagree; 5, strongly agree).

RESULTS: Clinical faculty members, presenting real cases using active learning techniques, delivered all six recommended CR elements and three EBM steps throughout the course. Thirty-nine (89%) students completed a survey and agreed that the course added value to their clinical practice (3.90). Students agreed that they practised CR in the classroom (3.93) and in the clinical setting (3.78) similarly (p = 0.21). Their agreement differed for EBM practice (classroom 3.78, clinical 3.35; p = 0.002). Exploring factors that inhibit the application of EBM in a clinical setting [is] important

CONCLUSIONS: Our curriculum addressed recommended CR and EBM elements, used clinical faculty members efficiently and was valued by students. Although our students practised these skills in the classroom and the clinical setting, exploring factors that inhibit the application of EBM in a clinical setting will be important in optimising both student learning and patient care.