Effects of Teaching Evidence-Based Medicine on Physician Assistant Students9 Critical Appraisal, Self-Efficacy, and Clinical Application: A Randomized Controlled Trial

Purpose To use a randomized controlled design to explore<br>the effects of evidence-based medicine (EBM) education<br>on physician assistant (PA) students’ EBM knowledge, selfefficacy,<br>and evidence-seeking behavior in a simulated<br>clinical situation and to present a model of EBM competence.<br>Methods Sixty-one didactic-year PA students from one<br>Midwestern University (2 sequential cohorts) were randomized<br>to receive the standard PA curriculum plus EBM<br>training (intervention) or the standard PA curriculum only<br>(control). Evidence-based medicine knowledge was measured<br>with a validated Fresno test. Self-efficacy was<br>measured with a validated Likert scale. Clinical application<br>of EBM skills was measured with an objective structured<br>clinical examination (OSCE).<br>Results Evidence-based medicine education led to significant<br>improvements on the Fresno and self-efficacy tests, both<br>within and between groups. On the OSCE, the intervention<br>group performed no better than the control group. Higher<br>Fresno pretest scores were significantly related to decreasing<br>improvements in the posttest scores: R = 20.634.<br>Conclusion Teaching EBM to PA students improved their<br>EBM knowledge and self-efficacy but not their clinical<br>application. Future research should focus on enhancing<br>EBM evaluation and application in the clinical setting.