How to promote learning of evidence-based medicine among Japanese medical students

Rationale, aims, and objectives: Evidence-based medicine (EBM) has become increasingly widespread over the last 30 years. However, the ideal curriculum for undergraduate EBM education has yet to be developed. To establish an EBM curriculum suitable for the educational environment in Japan, a qualitative study was conducted to identify the elements needed to facilitate undergraduate EBM learning among Japanese medical students. Method: Participants were supervising physicians working in teaching hospitals or clinics. Six physicians who consented to participate in the study were interviewed individually from October 2019 to January 2020. In addition to basic demographics, the interviewees were asked about their own EBM learning and teaching experiences, what they kept in mind when teaching EBM to medical students and what they felt was needed to improve current undergraduate EBM education. Interview transcripts were analyzed using thematic analysis. Results: Thematic analysis extracted five themes: awareness of foreground questions in clinical practice, motivating learning through observation of role models, awareness of the role of medical students and active learning, understanding patient background as a starting point for practicing EBM, and prioritizing understanding “why” rather than “how” in EBM. Conclusions: Japanese medical students with limited clinical experience may first need to observe their supervisors practice EBM to develop the motivation to learn and grasp the bigger picture of EBM. It is important for medical students to develop an interest in their patients through conversations and to learn that EBM is a means to solve the patients’ problems. Focusing on learning the rationale rather than the skills for practicing EBM may be the key to facilitating initial interest in undergraduate EBM education for subsequent continuous learning.