EVIDENCE BASED MEDICINE

EVIDENCE BASED MEDICINE PERCEPTIONS OF UNDERGRADUATE MEDICAL STUDENTS IN KARACHI.

Abstract

Objectives: Evaluate perception and barriers of practice of Evidence based
Medicine of first and third year medical students of Jinnah Medical and Dental College Karachi.
Study Design: Descriptive, cross sectional. Setting: Department of Medicine, Jinnah Medical and
Dental College Karachi. Period: Dec 2013 to Oct 2014. Subjects & Methods: Of 100 students,
response rate was 71% in each year, first year males were n=20 (28.2%) females n=51 (71.8%)
in third year males were n=17 (23. 9%) and females n=54 (76.1%). A student based medicine
EBM curriculum was imparted to the first and third year medical students in each of 2 semesters
of 18 and 16 weeks duration. A Questionnaire based on Likert scale comprising of 10 questions
was filled out at the end of the course of the first and third years during October 2014. Result:
Response rate was 71%, on Likert scale 4 and 5 First year students interest in EBM Classes
was n=61(89.5%) as compared to n=36(50.8%) in third year students. Importance of steps
of EBM for practicing clinical medicine was appreciated by n=60(84.5%) of first year students
versus 47(66.2 %) in third year students. EBM course helped in understanding importance of
articles in practice of medicine articles in n=44(61.9%) of first year students as compared to
39(54.9%) of third years. Barriers perceived were practice of EBM in the institution was lacking
as reported by n=35(49.3%) of first year students and n=47(66.2%) in third year students, a
longer duration of course was desired by n=41(57.8%) of first year students the respondents
agreed versus=35(49.3%) of third years, and the course was considered more theoretical than
practical n=35(48.3. %)by first years and n=48(67.6%) by third year students, p values were not
significant. Conclusion: More Pre-clinical as compared to clinical medical students recognized
EBM as an important component of undergraduate education. This positive attitude needs to
be nurtured for self-directed learning as is evident in their realization of articles being important
for clinical practice. The declining interest is due to EBM not being an examination subject,
lack of practice of EBM in the institution, and poor electronic resources and lack of vision of the
institution to embed EBM in the curriculum in to sustain interest as students moved to higher
levels and will remain a barrier till senior faculty give way to innovations in the field of medical
education.