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Logo of bmcmeduBioMed Centralsearchsubmit a manuscriptregisterthis articleBMC Medical Education
BMC Med Educ. 2004; 4: 20.
Published online Oct 13, 2004. doi:  10.1186/1472-6920-4-20
PMCID: PMC526196
Appraising and applying evidence about a diagnostic test during a performance-based assessment
George Bergus,corresponding author1 Scott Vogelgesang,2 Janeta Tansey,3 Ellen Franklin,4 and Ronald Feld5
1Department of Family Medicine, The University of Iowa, Iowa City, IA, 52242, USA
2Department of Internal Medicine, The University of Iowa, Iowa City, IA, 52242, USA
3Department of Psychiatry, The University of Iowa, Iowa City, IA, 52242, USA
4The Office of Student Affairs and Curriculum, Carver College of Medicine, The University of Iowa, Iowa City, IA, 52242, USA
5Department of Pathology, The University of Iowa, Iowa City, IA, 52242, USA
corresponding authorCorresponding author.
George Bergus: george-bergus/at/; Scott Vogelgesang: scott-vogelgesang/at/; Janeta Tansey: janeta-tansey/at/; Ellen Franklin: ellen-franklin/at/; Ronald Feld: ronald-feld/at/
Received August 9, 2004; Accepted October 13, 2004.
The practice of Evidence-based Medicine requires that clinicians assess the validity of published research and then apply the results to patient care. We wanted to assess whether our soon-to-graduate medical students could appraise and apply research about a diagnostic test within a clinical context and to compare our students with peers trained at other institutions.
4th year medical students who previously had demonstrated competency at probability revision and just starting first-year Internal Medicine residents were used for this research. Following an encounter with a simulated patient, subjects critically appraised a paper about an applicable diagnostic test and revised the patient's pretest probability given the test result.
The medical students and residents demonstrated similar skills at critical appraisal, correctly answering 4.7 and 4.9, respectively, of 6 questions (p = 0.67). Only one out of 28 (3%) medical students and none of the 15 residents were able to correctly complete the probability revision task (p = 1.00).
This study found that most students completing medical school are able to appraise an article about a diagnostic test but few are able to apply the information from the article to a patient. These findings raise questions about the clinical usefulness of the EBM skills possessed by graduating medical students within the area of diagnostic testing.
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