Open Access Open Badges Research article

An online evidence based medicine exercise prompts reflection in third year medical students

Linda Orkin Lewin1*, Nancy J Robert2, John Raczek3, Carol Carraccio4 and Patricia J Hicks5

Author Affiliations

1 Department of Pediatrics, University of Maryland School of Medicine, 22 South Greene Street, 21201 Baltimore, MD, USA

2 American Nurses Association, 8515 Georgia Avenue, 20910 Silver Spring, MD, USA

3 Instructional Technology Group, University Of Maryland School Of Medicine, 655 West Baltimore Street, 21201 Baltimore, MD, USA

4 American Board of Pediatrics, 111 Silver Cedar Court, 27514 Chapel Hill, NC, USA

5 The Children’s Hospital of Philadelphia and the Perelman School of Medicine at the University Of Pennsylvania, 34th & 19104 Philadelphia, PA, USA

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BMC Medical Education 2014, 14:164  doi:10.1186/1472-6920-14-164

Published: 9 August 2014



Reflective practice is a desirable trait in physicians, yet there is little information about how it is taught to or learned by medical students. The purpose of this study was to determine whether an online Evidence Based Medicine (EBM) exercise with a face-to-face debriefing session would prompt third year medical students to reflect on their current skills and lead them to further reflection on clinical decision making in the future.


All third year medical students at the University Of Maryland School Of Medicine who completed their pediatrics clerkship between 7/1/09 and 2/11/11 were required to complete the EBM exercise. Following completion each student received a personal report (Learning Profile) of their responses and attended a one hour large group debriefing session. Student responses to a survey following the debriefing sessions were analyzed using a post-test survey design with a single experimental cohort.


Ninety-five percent of students completing the debriefing survey indicated that the debriefing session helped them better understand their learning profiles; 68% stated that their profiles allowed them to evaluate themselves and their decisions. Sixty-three percent noted that participating in the exercise and the debrief would lead them to either learn more about EBM and use EBM more in the future or reflect more on their own decision making.


The EBM exercise was a successful way to introduce the concept of reflective practice to third year medical students, and the graphic Learning Profiles were effective instigators of discussion and reflection.

Clinical decision making; Evidence based medicine; Medical student education; Online education; Reflection