To learn about evidence-based medicine (EBM) during shifts in a medical school is often challenging. Medical students from Brazil have been collaborating in a learning community named the ‘Evidence-based Medicine Academic League’ (EBML). Since 2013, students have been coordinating activities to stimulate the search for and critical appraisal of the best evidence through a partnership with Cochrane Brazil. One of these activities is an internship in an intensive care unit (ICU).
To describe the methodology of evidence-based medicine practice focused on clinical questions raised during supervised rounds in an ICU at a medical school.
Members of the EBML take turns on day and night shifts in the ICU at our University hospital. The shifts are covered during weekends by two students enrolled in different years of medical graduation. In this way, students doing the Basic/Introductory Modules have the opportunity to consolidate concepts of physiopathology, while students of the Clinical Modules are challenged to acquire and train skills in medical practice. Students are supervised by both their own preceptor and the multi-professional team of the ICU, which teaches performance of a variety of medical procedures, such as arterial puncture and orotracheal intubation. At the end of a one-year period, each student is expected to have attended five 24-hour shifts. In order to answer clinical questions related to the diagnosis and treatment of medical conditions observed during shifts, all students are encouraged to search for Cochrane systematic reviews and other relevant studies. The studies are discussed and analyzed critically by all members and preceptors in weekly meetings conducted by the EBML.
Each member of EBML attended 60 hours of supervised practical activities during a one-year period. Clinical questions raised during shifts were structured into a PICO (participant, intervention, comparator, outcomes) question format and answered through the results of studies with the most appropriate design, with the participation of all EBML members.
The EBML ICU activities are a valid initiative for integrating clinical practice and EBM learning.
Patient or healthcare consumers involvement:
A method of active learning for EBM among medical students is a valid way to train future physicians about how to choose the best available evidence for clinical decision making.