Format

Send to

Choose Destination
BMJ Open. 2019 Aug 8;9(8):e026947. doi: 10.1136/bmjopen-2018-026947.

Better evidence: prospective cohort study assessing the utility of an evidence-based clinical resource at the University of Rwanda.

Author information

1
Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
2
Better Evidence, Ariadne Labs, Boston, Massachusetts, USA.
3
Global Health Delivery Project, Harvard University, Boston, MA, USA.
4
Harvard Medical School, Boston, Massachusetts, USA.
5
Muhimbili University of Health and Allied Sciences, Dar es Salaam, Dar es Salaam, Tanzania, United Republic of.
6
College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.
7
Section on Ethnicity & Health, NIDDK, Bethesda, Maryland, USA.

Abstract

OBJECTIVE:

Evidence-based clinical resources (EBCRs) have the potential to improve diagnostic and therapeutic accuracy. The majority of US teaching medical institutions have incorporated them into clinical training. Many EBCRs are subscription based, and their cost is prohibitive for most clinicians and trainees in low-income and middle-income countries. We sought to determine the utility of EBCRs in an East African medical school.

SETTING:

The University of Rwanda (UR), a medical school located in East Africa.

PARTICIPANTS:

Medical students and faculty members at UR.

INTERVENTIONS:

We offered medical students and faculty at UR free access to UpToDate, a leading EBCR and conducted a cohort study to assess its uptake and usage. Students completed two surveys on their study habits and gave us permission to access their activity on UpToDate and their grades.

RESULTS:

Of the 980 medical students invited to enrol over 2 years, 547 did (56%). Of eligible final year students, 88% enrolled. At baseline, 92% of students reported ownership of an internet-capable device, and the majority indicated using free online resources frequently for medical education. Enrolled final year students viewed, on average, 1.24 topics per day and continued to use UpToDate frequently after graduation from medical school. Graduating class exam performance was better after introduction of UpToDate than in previous years.

CONCLUSIONS:

Removal of the cost barrier was sufficient to generate high uptake of a leading EBCR by senior medical students and habituate them to continued usage after graduation.

KEYWORDS:

EBCR, global medical education; general medicine (see internal medicine); global health; information technology

Supplemental Content

Full text links

Icon for HighWire Icon for PubMed Central
Loading ...
Support Center