Abstracts
Abstract
Background: Training future doctors in the skills of evidence-based medicine (EBM) is clearly important. Journal club (JCs) are well-recognized educational interventions for teaching EBM. In contrast to postgraduate medical education, JCs use in undergraduate medical education (UME) has not been adequately explored. We conducted a realist review of the effectiveness of JCs in UME to unpack the underlying mechanisms by which the intervention works (or fails) in teaching EBM.
Methods: The scope of review was the evaluation of the effectiveness of JCs in UME settings. We searched major bibliographic databases - MEDLINE, Embase, ERIC, PSYCInfo, CINAHL, Scopus, and Web of Science and found fifteen articles eligible for inclusion. Data was extracted aided by a modified Kirkpatrick framework and presented in evidence tables. Themes and chains of inference were identified, and finally, we formulated new hypotheses on how and why JC intervention works.
Results: Mandatory vs. voluntary JC did not differentially impact attendance of JC in UME settings though JC duration beyond two hours decreased attendees’ self-reported satisfaction. Coupling lectures to JCs positively impacts knowledge gain and retention. Coupled Mentorship or using critical appraisal worksheets helped the achievement of manuscript writing skills and a positive attitude towards EBM.
Conclusions: Journal clubs are effective interventions to teach EBM in UME settings and are well-received by learners. They improve specific learning outcomes of knowledge gain and retention, skills of manuscript writing and critical appraisal. However, we found no evidence that these translates to the practice of EBM nor impacts patient outcomes.
Résumé
Contexte : Il est important que les compétences enseignées aux futurs médecins soient conformes à l’approche de la médecine fondée sur les données probantes (MFDP) et les clubs de lecture (CL) sont reconnus comme une intervention pédagogique en ce sens. Le recours aux CL dans la formation prédoctorale a été peu étudié, contrairement à la place qu’ils occupent au postdoctorat. Nous avons effectué une revue réaliste de l’efficacité des CL dans la formation de premier cycle pour décortiquer les mécanismes sous-jacents qui déterminent la réussite ou l’échec de cette méthode pédagogique en ce qui a trait à l’enseignement de la MFDP.
Méthodes : La revue visait l’évaluation de l’efficacité des CL dans la formation médicale prédoctroale. Nous avons effectué des recherches dans les principales banques de données bibliographiques – MEDLINE, Embase, ERIC, PSYCInfo, CINAHL, Scopus et Web of Science – et avons trouvé quinze articles répondant à nos critères d’inclusion. Nous avons utilisé le modèle modifié de Kirkpatrick pour la collecte de données, que nous avons présentées sous forme de tableaux de preuves. Nous avons dégagé des thèmes et élaboré des chaînes d’inférences, puis formulé de nouvelles hypothèses sur le comment et le pourquoi de l’efficacité des CL.
Résultats : Le caractère obligatoire ou facultatif de l’activité n’a pas eu d’effet différentiel sur la participation des étudiants de premier cycle aux CL, mais leur satisfaction autodéclarée diminuait lorsque la durée de la séance dépassait deux heures. En revanche, le fait de conjuguer les CL à des conférences a eu un effet positif sur l’acquisition et la rétention des connaissances et le fait de les conjuguer au mentorat ou à l’utilisation de feuilles d’évaluation critique a contribué à l’acquisition de compétences en rédaction et à l’adoption par les étudiants d’une attitude positive à l’égard de la MFDP.
Conclusions : Les clubs de lecture constituent un moyen efficace et bien accueilli par les apprenants pour enseigner la MFDP au prédoctorat. Ils améliorent les résultats d’apprentissage spécifiques sur le plan de l’acquisition et de la rétention des connaissances, ainsi que les compétences en matière de rédaction et d’évaluation critique. Toutefois, nous n’avons trouvé aucune indication que ces effets puissent se répercuter dans la pratique de la MFDP ou dans les résultats pour les patients
Appendices
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