Ensino-aprendizagem de medicina baseada em evidências: ensaio comparativo entre clube de revista, sessão de casos clínicos e aula expositiva

Abstract

Background: The incorporation of Evidence-based Medicine (EBM) in medical school curriculum is challenging. There are few comparative studies on teaching methods, and assessment methods need national adaptation and validation. Aims: To compare the competencies development for EBM among the strategies Journal Club (JC), Clinical Case Sessions (CCS) and Expositive Class (EC), using a Brazilian version of the ACE Tool questionnaire. Methods: The study was conducted in two steps: translation for Brazilian Portuguese, adaptation and validation of the ACE Tool with students and professionals, according to psychometric properties of validity, internal consistency and reliability; and assessment of competencies development for EBM through comparison among groups of mean post-test scores on ACE Tool. Results: We recruited 88 participants: 20 students in JC group; 20 students in CCS; 36 students in EC and 12 invited professors/preceptors. The Brazilian version of ACE Tool has adequate internal consistency (Cronbach’s alfa 0.610) and reliability (item-to-total correlation ≥ 0.15 in 14 of 15 itens). Professors/preceptors mean scores were significantly higher than students’ on pre-test (10.25±1.71 vs 8.73±1.80, mean difference 1.52, 95% CI 0.47 to 2.57, p=0.005). There was no difference between JC and CCS scores compared to EC (JC vs EC: 9.15 ± 1.42 vs 9.11 ± 1.58, 95% CI -0.77 to 0.85, p=0.92; CCS vs EC: 9.4 ± 1.93 vs 9.11 ± 1.58, 95% CI -0.7 to 1.28, p=0.57). Conclusion: The Brazilian version of ACE Tool had discriminatory capacity for different levels of expertise and adequate internal consistency and reliability. In EBM-novice students, post-test results were equivalent among JC, CCS e EC groups.