Citation

Title:

Using Self-Determination Theory to Drive an Evidence-Based Medicine Curriculum for Pediatric Residents: A Mixed Methods Study.

Authors:

Dasgupta, Minnie N.; ¹Kirkey, Danielle C.; ¹Weatherly, Jake A.; ¹Kuo, Kevin W.; ¹Rassbach, Caroline E.¹

Affiliation:

¹Department of Pediatrics, Stanford University School of Medicine, Palo Alto, Calif

Source:

Academic Pediatrics (ACAD PEDIATR), Apr2022; 22(3): 486-494. (9p)

Publication Type:

Journal Article - research, tables/charts

Language:

English

Major Subjects:

Motivation
Autonomy
Internship and Residency
Medical Practice, Evidence-Based -- Utilization
Curriculum
Pediatrics
Interns and Residents -- Psychosocial Factors
Attitude of Health Personnel

Minor Subjects:

Human; Accreditation; Multimethod Studies; Prevalence; Audiorecording; Content Analysis; Prospective Studies; Descriptive Statistics

Abstract:

OBJECTIVE: The ability to incorporate evidence-based medicine (EBM) into clinical practice is an Accreditation Council for Graduate Medical Education competency, yet many pediatric residents have limited knowledge in this area. The objective of this study is to describe the effect of an EBM curriculum on resident attitudes and clinical use of EBM. METHODS: We implemented a longitudinal EBM curriculum to review key literature and guidelines and teach EBM principles. In this Institutional Review Board-exempt mixed methods study, we surveyed residents, fellows, and faculty about resident use of EBM at baseline, 6 months, and 12 months after the beginning of the intervention. We conducted point prevalence surveys of faculty about residents' EBM use on rounds. Residents participated in focus groups, which were audio-recorded, transcribed, and coded using conventional content analysis to develop themes. RESULTS: Residents (N = 61 pre- and 70 post-curriculum) reported an increased appreciation for the importance of EBM and comfort generating a search question. Faculty reported that residents cited EBM on rounds, with an average of 2.4 citations/week. Cited evidence reinforced faculty's plans 79% of the time, taught faculty something new 57% of the time, and changed management 21% of the time. Focus groups with 22 trainees yielded 4 themes: 1) increased competence in under-standing methodology and evidence quality; 2) greater autonomy in application of EBM; 3) a call for relatcdncss from faculty role models and a culture that promotes EBM; and 4) several barriers to successful use of EBM. CONCLUSIONS: After implementation of a longitudinal EBM curriculum, trainees described increased use of EBM in clinical practice.

Journal Subset:

Biomedical; Peer Reviewed; USA

ISSN:

1876-2859

MEDLINE Info:

NLM UID: 101499145

Entry Date:

20220509

Revision Date:

20220928

DOI:

10.1016/j.acap.2021.12.018 

Accession Number:

156309857

Database:

CINAHL Complete