Medical students and tutors experiences of directed and self-directed learning programmes in evidence-based medicine: a qualitative evaluation accompanying a randomised controlled trial .

Abstract

Medical students and tutors experiences of directed and self-directed learning programmes in evidence-based medicine: a qualitative evaluation accompanying a randomised controlled trial .

This qualitative study aimed to interpret the results of a randomised controlled trial comparing two educational programmes in evidence-based medicine (EBM) for medical students at the University of Oslo, 2002/2003. In the trial, no statistically significant differences between the study groups were shown for any outcomes considered (EBM knowledge, skills and attitudes). One teaching programme was based on computer-assisted self-directed learning. The other was organised as directed learning based on workshops. Students from the first two of the three cohorts evaluated in the RCT, participated in this qualitative study (n =192). Educational theory and findings from an extensive systematic literature review of quantitative and qualitative literature were used to develop initial research questions and study methods. In addition, conceptual frameworks were created to show how factors impacting on learning might interact and differ in the two groups. Data collection began with participant observation and continued with semi-structured interviews, focus groups and a written questionnaire. Overall 98% of self-directed and 97% of directed learning students described the courses as useful or very useful. Participant observation and student interviews suggested the programmes were sufficiently distinct to allow a true comparison. Students unanimously stated that EBM should be taught earlier in their studies. Most students felt that neither course organisation nor being a research participant had adversely affected learning. Tutors and a majority of students suggested that personality, learning style and previous learning experience determined preference for learning method. Despite this, the majority of students felt the programme they had been allocated to was best for them. Nonetheless, many students were unsure about on their ability to translate their new EBM skills to clinical practice.