Student's View of Evidence-Based Medicine: A Survey in Switzerland

Abstract

Reto Kaderli, Larissa Burghardt, Carina Hansali, Adrian Businger

Objective: Training in Evidence-based medicine (EBM) has been implemented in Swiss medical schools for the last 8 to 10 years. Still, there is little known about the undergraduates’ perception of EBM and Medical Statistics. Methods: Between February and July 2007, fifth- to sixth-year medical students during surgical clerkship at 15 adult surgical departments in German-speaking Switzerland were asked to participate in an anonymous survey. At the end of the surgical clerkship each student received a self-administered questionnaire on EBM. It included questions concerning the perception of the practical use of EBM, eight multiple-choice questions regarding the statistical literacy and 26 questions about the view of Science and Scientific Methods. Results: A total of 185/344 (53.8%) medical students participated in the study. On a seven-point Likert scale, the importance of teaching and knowledge in EBM was rated as high (5.7±1.1 and 5.9±1.0). The subjective knowledge on EBM was considered moderate on a five-point Likert scale (3.4±1.0), corresponding with the median percentage knowledge score of 33 (range 0-47). The frequency of literature research and number of publications as co-author proved to be the only significant predictors for a higher knowledge in EBM and Medical Statistics of medical students (p=0.01). The attitude toward Science was good with a total score for the value of Science and research of 80.0 ± 8.3 out of a maximum of 130. The main impediments for using EBM were lack of time (57/165, 35%), ignorance (36/165, 22%), and difficulties in integration into everyday life (32/165, 19%). Conclusions: Medical students in Switzerland were aware of their moderate knowledge in EBM and Medical Statistics and aimed for an improvement. More courses in EBM and journal clubs must be introduced and access to information resources must be ensured with an early introduction in search engines (i.e. MEDLINE, Cochrane Library, etc.). A general strengthening of the knowledge on EBM and Medical Statistics among medical students may be a good way of educating the critical number of academic physicians and establishing a foundation for their future academic environment.