How to choose an evidence-based medicine knowledge test for medical students? Comparison of three knowledge measures
- PMID: 30514288
- PMCID: PMC6278026
- DOI: 10.1186/s12909-018-1391-z
How to choose an evidence-based medicine knowledge test for medical students? Comparison of three knowledge measures
Abstract
Background: There are a few studies of alignment between different knowledge-indices for evidence-based medicine (EBM). The aim of this study was to investigate whether the type of test used to assess knowledge of EBM affects the estimation of this knowledge in medical students.
Methods: Medical students enrolled in 1-week EBM course were tested with the Fresno, Berlin, and ACE tests at the beginning and the end of the course. We evaluated the ability of these tests to detect a change in the acquired level of EBM knowledge and compared the estimates of change with those of the Control group that was tested with the ACE and Berlin tests before and after an unrelated non-EBM course. The distributions of test scores and average item difficulty indices were compared among the tests and the groups.
Results: Test scores improved on all three tests when compared with their pre-test results and the control. Students had on average a "good" performance on the ACE test, "sufficient" performance on the Berlin test, and "insufficient" performance or have "not passed" on the Fresno test. The post-test improvements in performance on the Fresno test (median 31% increase in percent scores, 95% confidence interval (CI) 25-42%) outperformed those on the ACE (13, 95% CI 13-20%) and Berlin tests (13, 95% CI 7-20%). Post-test score distributions demonstrated that the ACE test had less potential to discriminate between levels of EBM knowledge than other tests.
Conclusion: The use of different EBM tests resulted in different assessment of general EBM knowledge in a sample of graduate medical students, with lowest results on the Fresno and highest on the ACE test. In the light of these findings, EBM knowledge assessment should be based on the course's content and learning objectives.
Keywords: ACE test; Berlin test; Evidence-based medicine; Fresno test; Knowledge assessment; Medical students.
Conflict of interest statement
Authors’ information
Ivan Buljan, MS, is a psychologist, currently working as a doctoral student at the doctoral programme TRIBE – Translational Research in Biomedicine at the University of Split School of Medicine.
Email address: ivan.buljan@mefst.hr
Ana Jerončić, PhD, is Associate Professor at the Department of Research in Biomedicine and Health at the University of Split School of Medicine. Her research interests include applied biostatistics and epidemiology with focus on health systems research and knowledge translation in health care.
Email address: ana.jeroncic@mefst.hr
Mario Malički, MD, PhD, is currently a postdoctoral fellow at the University of Amsterdam, Netherlands. His research focuses on publication and research integrity.
Email address: mario.malicki@mefst.hr
Matko Marušić, MD, PhD, is a Professor Emeritus at the University of Split School of Medicine. His current research interests include medical education and mentoring.
Email address: matko.marusic@mefst.hr
Ana Marušić, MD, PhD, is a Full Professor at the University of Split School of Medicine, and Chair of the Department of Research in Biomedicine and health. Her research interests include knowledge translation in health care and research integrity.
Email address: ana.marusic@mefst.hr
Ethics approval and consent to participate
Testing of the intervention group was a part of the mandatory course, where it was a part of practice for the final written course examination. In the control group, the tests were offered to students attending an unrelated course. The participation was voluntary and the student consented to the study by taking the test; declining to participate in the study had no influence on the course grade. The study was approved by the Ethics Committee of the University of Split School of Medicine, under the grant “Professionalism in Health Care” funded by the Croatian Science Foundation.
Consent for publication
Not applicable
Competing interests
The authors declare that they have no competing interests.
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References
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