Evaluation of an "evidence-based medicine" training given to medical students utilizing the fresno test

Evidence-based medicine is the conscientious explicit and judicious use of current best evidence in combination with clinical experience in making decisions about the care of individual patients. Training on asking clinical questions, effective database searches and critical appraisal of scientific research is necessary to practice evidence-based medicine. The lack of knowledge and skills is one of the important factors that hinder the practice of evidence-based medicine. For this reason, national and international educational organizations and boards emphasize that evidence-based medicine training should be included in the medical school curriculum. The aim of this study is to develop an evidence-based medicine education program in accordance with the curriculum of Cerrahpaşa Medical School. We aimed to adapt the Fresno Test to the Turkish language and based on the evaluation results to determine which phase of medical school is the most appropriate for program implementation. Method This study is an experimental investigation using pre- and post-test evaluations. An evidence-based medicine education program has been prepared and carried out to be included in the curriculum of Cerrahpaşa Medical School. The program has been prepared to cover the basic steps of evidence-based medicine. The Fresno test which is commonly used was adapted to Turkish to evaluate students' performance. Results A total of 76 volunteer students from the 3rd, 4th and 5th year participated in this educational program that was applied for the first time at Cerrahpaşa Medical School. Information from students who wanted to participate in the education program was collected for needs assessment and the program was developed accordingly. The students' score of the Turkish Fresno Test was 49.9 ±18.2 pre-training and 118.9 ±26.3 post-training (p <0.0001). There was no difference in the total scores of pre-test and post-test results between years (pre-test p = 0.37, post-test p = 0.63). The Cronbach α coefficient was 78.4% on the post-test results. The intraclass correlation (ICC) coefficient for continuous variables and the kappa analysis for categorical variables were calculated to evaluate interrater reliability. The ICC coefficients ranged from 0.66 to 0.95 for the pre-test and 0.83 to 0.97 for post-test results. The Kappa coefficients were 1.00 for all pre-test and post-test questions except one post-test question which was 0.89. The content validity of the test was evaluated by experienced physicians in the field of evidence-based medicine, and the content validity index was 1.00. The overall students' satisfaction of the education program was high. Qualitative and quantitative data obtained in the program were used to identify strengths and weaknesses which will be used for program improvement. Based on all study data, we suggest that the program might be best suited for the third year of Cerrahpaşa Medical School's curriculum. Conclusion An educational program called "Evidence-Based Medicine School" was developed at University of Istanbul Cerrahpasa Medical School to improve students' knowledge and skills on evidence-based medicine. The Turkish adapted Fresno Test used to evaluate students' success and program effectiveness is valid and reliable measurement tool. Program evaluation results indicate that the program was effective in improving students' knowledge and skills on evidence-based medicine. Although there was not any difference in Fresno test scores between the years of medical school we propose to implement the program as an elective course during the third year of the medical school curriculum based on all data obtained during the program evaluation. Keywords: Evidence-Based Medicine, Fresno Test, Medical Education