The Effects of Evidence Based Medical Education on Learning of First Aids

Document Type: Original Article

Author

Department of Environmental Health, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Background: Teaching of theoretical and practical first aids are  important courses for medical sciences students. If these courses are  taught with Evidence Based Medicine(EBM), they will be learned better by students. The objective of this study  was the  determination of the  effect of evidence based medical education on learning of first aids.
Methods: This study had been performed inthe planning of educational course, as across-sectional study.
The cource was in accordance with the Iran’s Mininstery of Helth Carriculum for teaching first Aids to  Medical Students. The study was performed in Mashhad University of Medical Sciencesin in 2011. Medical students randomly devided to two groups. In group 1 First aids was taught in traditional style. The students’ score in final exam was compand between 2 study groups.  
Results:The  mean score of theoretical first aids in group 1 was 18.83±1.16, the minimum was 16.50 and the maximum was 20, in group 2, it was 19.28±0.40, the minimum was 18.25 and the maximum  was 20 with t=-1.563 and P=0.134 without any significant differences.  The mean theoretical first aids score of two groups were not significantly different (group1: 18.25±1.116 min 16.5 max: 20 vs. group2: 19.28±0.40 Min: 18.25 Max: 20, t: -4.52 P:0.001).
The  mean grade of practical first aids in group 1 was 18.88±0.94, the minimum  was 17 and the maximum was 20, in group 2  it was 19.92±0.23, minimum 19 and maximum  20 with t=-4.515 and P=0.001 with significant differences.
Conclusion: Evidence based medical education might  beneficial for the  learning  of practical and some  subjectof theoretical first aids.

Keywords


Introduction

The most  important task in the universities of medical sciences is students' education according to the  newest  and best references. One of  the new and beneficial educational methods in medical sciences is evidence based medical education. This method is planned  by searching about the evidences in scientific websites and journals (1,2).

Evidence based medicine is  very useful in clinical medical education specially for medical students. In some studies, this fact had been demonstrated, for example for having a better educational session such as morning report, they divided this educational session in 4 or 5 sections according to evidence based searching. Solving the problem with this method, was easier than before (3-5). One part of this session was making a question about the medical sciences subject and another part was the presentation of searching the result about previous session subject. These results were  presented by medical sciences students. First aids is  one of the main courses for medical sciences students. First aids is presented in theory and practice , but the  use of a  new scientific educational method can  make it interesting and more useful. If student can participate in teaching by answering  the questions and searching about the subject, they will have better,  more perfect learning, easier memorization and fast reaction in the real places.

Davies P. had introduced the evidence based teaching (5). Wolf F.M. had shown the effectiveness of  cumulating  of  evidence based medicine and evidence based education(8).In another study; Belfield C, Thomas H, Bullock A , Eynon R. had demonstrated measuring the effectiveness for best evidence medical education (9). MacLennan A.H,  Sturdee D.W. had determined the usefulness of evidence-based labeling for some medicine (10).

In some studies educational standards had been emphasized ,  the main items of  these standards are  curriculum, course plans and educational methods (11,12). In the curriculum of occupational health  real places  such as work places, factories and industries had been mentioned (13). By reviewing the curriculum and designing  new course plans, professors can use evidence based education in methods of teaching in the special part of course plans forms (14-16). In another study , the effect of evidence based medicine in primary care by family physicians had been demonstrated (17).

Teaching of theoretical and practical first aids is  important for medical sciences students. If these courses are taught practically and properly, they will be learned better by students .  Teaching with new educational methods such as evidence based medical education can help better learning(18).

 The objective  of this study was determining the   effect of evidence based medical education on learning  first aids.

Method

This study has been performed in a cross-sectional study from  1389 to 1390 on occupational health students. Group 1 included 18 students and group 2  , 24 students. Course plans had been written  according to the curriculum of Health Ministry website.

For group 2,the  teaching of theoretical and practical first aids was  according to evidence based care but  not for group 1. According to these, both groups had theoretical and practical first aids from 8 to 10 and 10 to 12  in a day. Each chapter had three parts theoretical, practical, and evidence based medical education by using  the educational and scientific websites and journals.A question was asked from  the students about the subject and one or two students  searched  for  the answer for the next session. At the beginning of  the next session; the students who had searched about the subject spoke what  she or he has  had found in the related journals and websites, such as Health and Safety Executive, Occupational Safety and Health Administration, International Labor Organization(19-21).

Session one: primary care ,  Session two: air ways , Session three: artificial breath, Session four: chest compression , Session five : control of bleeding , Session six: fracture, Session seven: foreign body , Session eight: burn with fire, Session nine: burn with chemicals, Session ten : heat and cold. Each session had questions asked from students  and discussions held among them  during the classes from  and also a quiz was taken at the end of the class.

Examinations of the  two groups were at the same level, these tests were  prepared by professors opinions for correction and validity and have a pilot study with 0.85 correlation for reliability in a sample of students.I can't understand this part;please ask the author for clarifying!or just send me the Persian version of just this part and I will translate.This is not comprehensible at all!

The inclusion criterion was entering university in the educational year of 1389_90 in the  field of occupational health  and exclusion criteria were  students from other entrance years or other fields.

 Data had been gathered in SPSS 11.5 and analyzed for  the calculation of means,  standard deviation, t-test and P<0.05.

 In research ethics; author got oral satisfaction from participants and told that cumulative data has  been used , without entioning the  of  the students.

Results

The total grade of theoretical first aids in group 1was 18.83±1.16, the minimum was 16.50 and the maximum was 20, in group 2  it was 19.28±0.40, the minimum  was 18.25 and the maximum  was 20 with t=-1.563 and P=0.134 without any  significant differences.

 The total grade of practical first aids in group 1 was 18.88±0.94, the minimum was 17 and the maximum was 20, in group 2 it was 19.92±0.23, the minimum was 19 and the maximum was 20 with t=-4.515 and P=0.001 with significant differences.

 Table 1 shows the comparison of grades in theoretical first aids between  the two groups .

Table 1 – The comparison of grades in theoretical first aids between the two groups (P<0.05)

P value

t-test

Grade of Theoretical first aids

 in group 2

Grade of Theoretical first aids

 in group 1

subject

number

0.052

2.054-

1.98±0.10

1.86±0.23

Primary care

1

0.177

-1.383

1.97±0.15

1.88±0.21

Air ways

2

0.009

-2.890

1.97±0.10

1.75±0.30

Artificial breath

3

0.064

1.951-

1.97±0.15

1.79±0.36

Chest compression

4

0.100

-1.696

1.88±0.29

1.69±0.38

Control of bleeding

5

0.027

-2.388

1.98±0.10

1.79±0.32

Fracture

6

0.066

1.937-

1.97±0.10

1.83±0.28

Foreign body

7

0.268

-1.123

1.94±0.16

1.87±0.27

Burn with fire

8

0.045

2.116-

1.82±0.25

0.96±0.12

Burn with chemicals

9

0.128

-1.585

1.97±0.09

1.88±0.21

Heat and cold

10

Table 2 shows the comparison of grades in practical first aids between the two groups.

Table 2 –The  comparison of grades in practical first aids between the two groups (P<0.05)

P value

t-test

Grade of Practical first aids

 in group 2

Grade of Practical first aids

 in group 2

subject

number

0.001

9.220-

2.00±0

1.66±0.38

Primary care

1

0.023

-2.500

2.00±0

1.69±0.51

Air ways

2

0.008

-2.974

1.98±0.10

1.63±0.47

Artificial breath

3

0.004

3.289-

2.00±0

1.61±0.50

Chest compression

4

0.003

-3.372

1.94±0.16

1.52±0.49

Control of bleeding

5

0.005

-3.267

2.00±0

1.62±0.48

Fracture

6

0.012

2.808-

2.00±0

1.71±0.43

Foreign body

7

0.060

-1.994

1.95±0.17

1.72±0.46

Burn with fire

8

0.006

3.117-

2.00±0

1.66±0.45

Burn with chemicals

9

0.023

2.505-

2.00±0

1.74±0.43

Heat and cold

10

In theoretical first aids, the grade of Artificial Breath, Fracture, Burn with Chemicals had significant differences between the two groups with P<0.05.

In practical first aids ,the  grade of Primary Care, Air ways, Artificial Breath, Cardiac Compression, Control of Bleeding, Fracture, Foreign Body, Burn with Chemicals, Heat and Cold had significant differences with P<0.05.

Grades of other sections of theoretical first aids such as Primary Care, Air ways, Cardiac Compression, Control of Bleeding, Foreign Body, Burn with Fire, Heat and Cold were better in group 2 but did not have any significant differences. Grades of other chapters of practical first aids such as Burn with Fire was better in group 2 but did not have any  significant differences.

Discussion

According to the results; the learning levels had been promoted  in  teaching with evidenced based medical education  specially for practical first aids with significant difference.

In group 2  of theoretical First Aids, the grades of Artificial Breath, Fracture, Burn with Chemicals were more than group 1.

In group 2 of practical First Aids ,the  grades of Primary Care, Air ways, Artificial Breath, Cardiac Compression, Control of Bleeding, Fracture, Foreign Body, Burn with Chemicals, Heat and Cold were more than group 1.

In group 2  the grades of other sections of theoretical First Aids and the  grades of other chapters of practical First Aids were better than group 1 but did not have any  significant differences.

According to the results the grade of practical first aids and many sections of theoretical had been increased with the evidence based medical education, the same as the results of the  study on students’ learning with the  use of this method.(4,17)

Evidence based medicine is  very useful in clinical medical education specially for medical students. In some studies, the use of evidence based medical education had been introduced and in other studies it had been used in holding  educational sessions such as journal clubs and morning reports (1,4,5). Evidence based medicine (17) and evidence based care had positive effects on perfection and updating clinical care . The course of first aids is one of the important courses for medical sciences students. First aids in working place is presented in theory and practice for occupational health students and  by the use of evidence based medicine education  it can become  more beneficial. In this method students participate by searching about the subject(6-8), they will have a better comprehension  of  the subject and learn more perfectly with perfect medical education method (9,10).

Also there are studies with the same results such as ; Bligh J. and Brownell A. had shown the importance of evidence in medical education(6). Mennin S.P and MCGrew M.C. had demonstrated the effectiveness of synergy for teaching and learning with evidence medical education (7).

 Gibbs T,  Durning S, Der Vleuten C.V. had shown the effectiveness of union educational practice and research traditions in medical education (18)

According to educational standards, the main items in these standards are curriculum, course plans and educational methods (11,12).

Innovation in teaching methods is  important in medical sciences education. According to the previous studies this work can elevate the learning. May be the schools need workshops for introduction these methods to members.

Health Ministry' curriculums can be helpful in teaching and learning.

By reviewing the course plans, professors can use evidence based education in methods of teaching (14-16) but it seems that introduction of new and related references is necessary such as websites, journals(17,18).

 In this study,the  students were  perfectly satisfied  with this method and could participate and  be active in classes and had experience in searching in medical sciences websites and journals. For example first aids in work places from occupational health and medicine sites such as Health and Safety Executive, Occupational Safety and Health Administration , International Labor Organization (19-21).   

This study had a few limitations; the number of students and  two entrance years of the  university, lack of  searching in journals and Internet. Another study is  recommended  with more students , from one entrance exam year, and the use of new educational journals and  scientific websites.

Conclusion

Evidence based care education was good for the learning of practical and many sections of theoretical first aids. In this study was recommended the evidence based medicine was recommended  for teaching  First Aids.

Conflict of Interests

 The author declares  no conflict of interest.

Acknowledgements

The author would like to thank  staff of Mashhad University of Medical Sciences for all their supports.

 

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