A controlled trial of a seminar to improve medical student attitudes toward, knowledge about, and use of the medical literature

Objective: To determine whether an interactive seminar could affect medical student knowledge of research design, basic critical appraisal skills, and attitudes toward and clinical use of the medical literature. Design: Controlled, nonrandomized clinical trial Participants: Third-year clinical clerks (n=146) during their core medicine clerkship. Interventions: Two 90 minute interactive seminars. Measurements and main results: Pre- and postquestionnaires were used to assess knowledge and attitudes regarding the use of the medical literature among 65 study and 81 control students. Blinded review of write-ups assessed actual use of the medical literature. Overall, 80% of the students subscribed to one or more journals and reported reading three or more journal articles per month. After the intervention, the study students were more likely than the control students to consider: 1) study design important in article selection and 2) use of medical literature critical to patient care decisions. Knowledge scores were significantly improved in the study group (p=0.0001). The intervention yielded no increase in the actual use of medical literature in patient write-ups over that encouraged by usual clerkship goals. 51% of the study and 48% of the control students cited literature at baseline, and 53% of all the students did so after the intervention. Of these citations, 50% were for journal articles and the remainder were for textbooks. The students infrequently mentioned the quality of the cited literature. Conclusions: An interactive seminar designed to introduce medical students to critical appraisal improved student knowledge and attitudes but did not increase the actual use of literature in patient writeups.