This is our second year of using a wiki in our session with 1st year medics ‘Finding the Evidence’. The purpose of this session is to make sure that students understand both where to find and how to use resources that support evidence based medicine. This exercise also aims to support the students as they embark on their 10,000 word dissertations where they follow a real patient for two years, looking at the the patients’ medical condition, treatment and their social context.
We set the students a clinical question, for example, they may be asked if a particular drug helps a medical condition or what evidence there is to support a particular type of treatment (I don’t want to give away of our real questions here!).
Before the training sessions the students are given an assignment which they complete in groups of 3. In the wiki there is list of resources they have to search. They have to record their search strategy (keywords and more detail if relevant), and what they find in answer to the clinical question. Then they have to write a conclusion based on all the evidence they have found, and make any observations about differences of opinion they find in the literature.
The resources they search are: Clinical Knowledge Summaries; Intute; Medline; The Cochrane Library; and the British National Formulary. This is to familiarise students with guidelines for physicians, prescribing doses, patient information, as well as the literature at the highest level of evidence and the more exploratory (but still peer reviewed) levels of research literature.
When they arrive at the session the students are given some further background to evidence based medicine and are shown some extra tips on searching these tools. We hope they actually take it in now they have used them the tools for themselves. We discuss the ‘answer’ to the clinical question they were asked and give feedback to the students on their assignments. Then the fun starts as they are asked to look at another wiki and enter comments on each others wikis, noting three things another group did differently to themselves. I think this is quite eye-opening for them – to see that another group answering the same question using the same resources finds different results and emphasises different aspects of the question. They should (and virtually all did in fact) find the same basic bottom line answer to the question, but there may be a few subtleties for example different situations where different treatments are applicable or where the evidence is unclear. We also ask the students to say what they would do differently if they were going to do this exercise again.
We are still compiling our feedback from the sessions, but so far it it mostly good, and amazingly the students say they can see the point of the exercise. I think in future we need to consider ways to focus the students’ comments more. Some have put in alot of detail and constructive comments, others are more along the lines of ’ours was better than yours’.
Overall this is a good way to focus students on particular resources. It is also very specific to a particular question and plugs straight into resources they are going to be using for their dissertations (or they should be using).
Selina has also used a wiki with the computer scientists if you want to compare notes and outcomes. Interestingly different groups of students have different characteristics as a whole. This type of exercise may be working for medics and computer sciencists, but would it work for others? Perhaps its time we tried it.
