Medical students poor at searching for evidence based answers

Kay Seong Ngoo, Aberdeen

Senior medical and nursing students are not efficient enough in retrieving relevant evidence based information to answer clinical questions. Nevertheless, medical students improve on their ability to answer questions after using an information retrieval system.

Information retrieval systems such as medical databases and the techniques of evidence based medicine are widely adopted by healthcare providers for research and practical purposes. This ensures that the best clinical decision and care are delivered to patients. Previous studies have focused on the user's ability to retrieve information in an educational setting. None were applied to students' ability to answer clinical questions, however. Other studies tend to focus on the ability of retrieval systems to benefit users.

Medical and nursing researchers from the United States attempted to gauge the abilities of a mixed group of 45 medical and 21 nurse practitioner students in using Medline to answer five clinical questions, after a brief orientation on the information retrieval system. The researchers also aimed to identify factors associated with successful use of an information retrieval system to obtain correct answers to clinical questions.

The search for information using evidence based techniques was a challenging task for students (WR Hersh et al, J Am Med Inform Assoc 2002;9:283-93). The researchers found that students do best with questions of prognosis and worst with those of diagnosis and harm; students with experience of literature searching using Medline are more likely to be successful. Medical and nurse practitioners are similar in their ability to locate the most relevant information, as this bears no relation with their abilities to answer questions correctly.

The researchers recommended that information finding and management should be a core skill in medical education. One of the key researchers, William Hersh, of the Oregon Health and Science University, commented, “It is important in all the hype about access to online information that we actually figure out how effective these systems are with users.” He added, “It amazes me that we ask students to spend time memorising information they will never use after medical school, yet we do not teach them how to find and manage information, which every physician needs to do every day no matter what his or her specialty.” He alluded that background knowledge of information technology may be advantageous.