Practice Gives Skill: Preparing Students to Present Evidence in Clerkships
Amy C. Studer, RN, MSN, MSLIS, AHIPa and Nicole Capdarest-Arest, MA(LIS), AHIPa
aBlaisdell Medical Library, University of California – Davis, Sacramento, CA
Building an evidence-based practice module using principles of self-directed learning to prepare medical students to present evidence in clerkship.
Need & Rationale:
Our Transition to Clerkship (T2C) course occurs immediately prior to starting of clerkship rotations and includes an evidence-based medicine (EBM) module. T2C had been synchronous and in-person for all Year 3 medical students, but due to the COVID-19 pandemic, content needed to be revised to be delivered virtually. This prompted the instructors of the EBM module to re-envision the content to increase emphasis on the main module deliverable: a practice oral evidence presentation. This deliverable was also identified for increased emphasis from prior years’ students and course faculty leaders. Furthermore, it addresses Core Entrustable Professional Activities 1 and identified needs to practice oral presentation 2-4. The content was revised to be asynchronous and to further develop learner skills in finding evidence related to a clinical question, synthesizing that evidence, and then supportively practicing 5 the new skill of presenting an oral evidence synthesis for a clinical setting.
Learning objectives for the EBM module focused on: 1) identifying tools for finding evidence at the point of care, 2) using effective search strategies for finding evidence, including guidelines, 3) synthesizing evidence into a brief oral evidence presentation, 4) practicing delivery of an oral evidence presentation, including giving and receiving feedback. Instructors provided learners with frameworks and instructions to support their success with the activities, which were designed to be accomplished in 2 - 3 hours. The module consisted of pre-work and a paired activity. The pre-work focused on context for clinical oral evidence syntheses and on finding quality evidence. The paired activity consisted of selecting from a menu of topics, finding a relevant guideline and a primary study, synthesizing evidence found, recording and presenting a brief oral update to a peer, and providing peer feedback. To encourage self-direction as well as teamwork5, learners were asked to complete the pre-work and organize with their pre-assigned partner an online meeting to practice presenting the oral brief as well as providing feedback according to a rubric for one another. Learners each submitted and recorded a video of themselves delivering their brief evidence oral presentation. In this format, learners are able to deliberately practice an oral evidence presentation in a safe environment assuring a supported practice opportunity before moving into the clinical environment 2,4.
Instructors reviewed each student’s submitted video based on the peer feedback rubric and then provided aggregate feedback to the students. Instructors also reviewed all of the submitted peer feedback forms with an eye to how learners analyzed each other’s performance. Both instructors agreed that this was a more effective way to assess the quality of student work related to the activity and their ability to provide constructive peer feedback. Instructors also asked learners to provide (optional) immediate feedback about the EBM module. Students responded that the instruction was effective and that they appreciated the overall organization and structure, learning how to find guidelines, and the opportunity to practice presenting in a safe environment. The School of Medicine also solicited student feedback about the EBM module, with largely positive results. In preliminary feedback, most students who rated the module rated it as very effective (in line with or better than other sessions in T2C). There were many favorable student comments such as, “I loved the EBM project and found it especially useful specifically to 3rd year.” Instructors were impressed by the high level of engagement that students demonstrated for the activities in this module, as compared with prior years’ in-person sessions. In the future, instructors hope to seek additional feedback from learners once they are further along in clerkship rotations and integrate further goal-directed practice.
Potential Impact on the Field or Beyond:
Synthesizing and orally presenting evidence in the clinical space is a core skill 1 requiring practice and feedback. Providing measurable, skills-based learning activities immediately applicable across all clerkships will help learners more readily succeed and perform in clinic.
Keywords: third-year medical students; medical education; evidence-based practice; presentation skills; peer feedback; asynchronous learning; transition to clerkship; use of technology; online learning
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