Using standardized patients to evaluate medical students' evidence-based medicine skills

Objectives To analyze the effectiveness of an Evidence Based Medicine Objective Structured Clinical Examination (EBM OSCE) with standardized patients for end of third year medical students at our institution. Methods This was a single‐center prospective cross‐sectional investigation. As part of the eight‐station OSCE exam, the authors developed and implemented a new 25‐minute EBM OSCE station with the goal of evaluating evidence based medicine skills necessary for daily clinical encounters. The OSCE case involved a highly educated patient with a history of recurrent debilitating migraines who has brought eight specific questions regarding the use of steroids for migraine headaches. Students were provided computer stations equipped to record a log of the searches performed. Results One hundred and four third‐year medical students participated in this study. The average number of search tools used by the students was 4 (SD = 2). The 104 students performed a total of 896 searches. The two most commonly used websites were uptodate.com and google.com. Sixty‐nine percent (95% CI, 60% to 78%) of students were able to find a meta‐analysis regarding the use of dexamethasone for the prevention of rebound migraines. Fifty‐two percent of students were able to explain that patients who took dexamethasone had a moderate RR (0.68 to 0.78) of having a recurrent migraine, and 71% of students were able to explain to the standardized patient that the NNT for dexamethasone was nine. Conclusion The EBM OSCE was successfully integrated into the existing eight‐station OSCE and was able to assess student EBM skills.