Evidence-Based Teaching (EBT) in Medical Education: Addressing the Challenges of Bridging Didactic Knowledge to Clinical Application


Although evidence-based teaching has been adopted in various learning disciplines, its adoption in medical education remains challenging. To graduate a full-fledged well-rounded physician equipped to face the real-world challenges of diagnosis and treating diseases is the ultimate goal of every medical institution. Medical students’ clinical competence is anchored on the approach of facilitators’ acquired teaching expertise and how they apply learned techniques to connect basic knowledge to clinical skill enhancement. Are these approaches within the realm of evidence-based teaching? The subsequent discussion will elaborate on proven effective strategies [Problem-Based Learning (PBL), Outcome-Based Education (OBE)] and how a strategic teaching and learning tool [Target-Oriented Clinical Skill Enhancement (TOCSE)] has proven to address the issue.

Key words: medical education, evidence-based teaching, student motivation, didactic knowledge, clinical application, Target-Oriented Clinical Skill Enhancement (TOCSE)

  1. Ward JP, Gordon J, Field MJ, et al. Communication and information technology in medical education. Lancet. 2001;357(9358):792-9.
  2. Ganguly P, Yaginuddin AA, Aal-Kattan, W, et al. Medical education dilemma: How can we best accommodate basic sciences in a curriculum for 21st century medical students? Can J Physiol Pharmacol. 2018;97. DOI: org/10.1139/cjpp-2018-0428
  3. Benatar S, Daneman D. Disconnections between medial education and medical practice: A neglected dilemma. Glob Public Health. 2020;15:9:1292-307, DOI: 10.1080/17441692.2020.1756376 
  4. Pelaccia T, Viau R. Motivation in medical education. Med Teach. 2017;39:136-40, DOI: 10.1080/0142159X.2016.1248924
  5. Lai NM, Sivalingam N, Ramesh JC. Medical students in their final six months of training: Progress in self-perceived clinical competence, and relationship between experience and confidence in practical skills. Singapore Med J. 2007;48:1018-27.
  6. Foong CC, Lee SS, Daniel EGS, et al. Graduating medical students’ confidence in their professional skills: A longitudinal study. Inter Med J. 2014;21:518-24.
  7. Archer JC. State of the science in health professional education: effective feedback. Med Educ. 2010;44:101-8.
  8. Stark P. Teaching and learning in the clinical setting: a qualitative study of the perceptions of students and teachers. Med Educ. 2003;37:975-82. DOI: org/10.1046/j.1365-2923.2003.01675.x
  9. Beder H, Medina P. Classroom dynamics in adult literacy education. National Center for the Study of Adult Learning and Literacy; Cambridge, Mass.;2001.
  10. Slavin RE. Perspectives on evidence-based research in education---what works? Issues in synthesizing educational program evaluations. Educ Res. 2008;37:5-14.
  11. Trainor A, Richards JB. Training medical educators to teach: bridging the gap between perception and reality. Isr J Health Policy Res. 2021;10:75-85.
  12. Steinert Y, Mann K, Anderson B, Barnett BM, Centeno A, Naismith L, et al. A systematic review of faculty development initiatives designed to enhance teaching effectiveness: A 10-year update: BEME Guide No. 40 need. Med Teach. 2016;38(8):769-86.
  13. Tekian A, Roberts T, Batty HP, et al. Preparing leaders in health professions education, Med Teach. 2014;36(3):269-71. DOI: 10.3109/0142159X.2013.849332
  14. Cheesman N. Doctors as teachers. BMJ. 2009;338. DOI: 10.1136/bmj.b1551
  15. Spencer J. Learning and teaching in the clinical environment. BMJ. 2003;326:591. DOI: 10.1136/bmj.326.7389.591
  16. Kaufman DM. Applying educational theory in practice. BMJ. 2003;326:213. DOI: 10.1136/bmj.326.7382.213
  17. Groccia JE, Buskist W. Need for evidence-based teaching. In: Evidence-Based Teaching. 2011;128:5-11. DOI: org/10.1002/tl.463
  18. Mitchell D. What really works in special and inclusive education: Using evidence-based teaching strategies. 2nd Ed. Routledge. London. 2013. DOI: 10.4324/9780203105313
  19. Ambrose S, Bridges MW, DiPietro M, et al. How learning works: Seven research-based principles for smart teaching. Jossey-Bass. 2010.
  20. Ross S, Pirraglia C, Aquilina AM, et al. Effective competency-based medical education requires learning environments that promote a mastery goal orientation: A narrative review. Med Teach. 2022;44(5):527-34. DOI: 10.1080/0142159X.2021.2004307
  21. Abdulghani HM, Al-Drees AA, Khalil MS, et al. What factors determine academic achievement in high achieving undergraduate medical students? A qualitative study. Med Teach. 2014;36(1):S43-8. DOI: 10.3109/0142159X.2014.886011.
  22. Schmidmaier R, Eiber S, Ebersbach R, Schiller M, Hege I, Holzer M, et al. Learning the facts in medical school is not enough: which factors predict successful application of procedural knowledge in a laboratory setting? BMC Med Educ. 2013;13:28. DOI:10.1186/1472-6920-13-28
  23. Dehmer JJ, Amos KD, Farrell TM, et al. Competence and confidence with basic procedural skills: The experience and opinions of fourth-year medical students at a single institution. Acad Med. 2013;88:682-7. DOI: 10.1097/ACM.0b013e31828b0007
  24. Evans DE, Wood DF, Roberts CM. The effect of an extended hospital induction on perceived confidence and assessed clinical skills of newly qualified pre-registration house officers. Med Educ. 2004;38:998-1001.
  25. Whitehouse CR, O’Neill P, Dornan T. (2002). Building confidence for work as house officers: student experience in the final year of a new problem-based curriculum. Med Educ. 2002;36:718-27.
  26. Hunt DP. (2003). The concept of knowledge and how to measure it. Intellect Cap. 2003;4:100-13.
  27. Faustinella F, Jacobs JR. The decline of clinical skills: A challenge for medical schools. Int J Educ. 2018;9:195-7. 
  28. Johnson JE, Carpenter JL. Medical house staff performance in physical examination. Arch Intern Med. 1986;146:937-41. 
  29. Wray NP, Friedland JA. Detection and correction of house staff error in physical diagnosis. JAMA. 1983;249:1035-7. 
  30. LaCombe MA. On bedside teaching. Ann Intern Med. 1997;126:217-20.  
  31. Crumlish CM, Yialamas MA, McMahon GT. Quantification of bedside teaching by an academic hospitalist group. J Hosp Med. 2009;4:304-7.
  32. Savery JR. Overview of problem-based learning: Definitions and distinctions. Interdisciplinary Journal of Problem-Based Learning. 2006;1:1. DOI: 10.7771/1541-5015.1002
  33. Blumenfield PC, Soloway E, Marx RW, et al. Motivating project-based learning: Sustaining the doing, supporting the learning. Educ Psychol. 1991;26;3-4:369-98. DOI: 10.1080/00461520.1991.9653139
  34. Burgess A, Ayton T, Mellis C. Implementation of team-based learning in 1 year of a PBL based medical program: a pilot study. BMC Med Educ (2016);16:49 DOI:10.1186/s12909-016-0550-3
  35. Davis MH. Outcome-based education. J Vet Med Educ. 2003;30(3):258-63. DOI: 10.3138/jvme.30.3.258
  36. Rao NJ. Outcome-based education: An outline. High Educ for the Future. 2020;7(1):5-21. DOI: 10.1177/2347631119886418
  37. Davis MH, Amin Z, Grande JP, O’Neill AE, Pawlina W, Viggiano TR, et al. Case-studies in outcome-based education. Med Teach.  2007:29(7), 717-22. DOI: 10.1080/01421590701691429
  38. Challa KT, Sayed A, Acharya Y. Modern techniques of teaching and learning in medical education: a descriptive literature review. Med Ed Publish. 2021;10:18.
  39. Gruppen LD. Outcome-based medical education: Implications, opportunities, and challenges. Korean J Med Educ. 2012;24(4):281-5. DOI: 10.3946/kjme.2012.24.4.281.
  40. Trullas JC, Blay C, Sarri E, et al. Effectiveness of problem-based in undergraduate medical education: a scoping review. BMC Med Educ. 2022;22:104. DOI: 10.1186/s12909-022-03154-8
  41. Thammasitboon K, Sukotjo C, Howell H, et al. Problem-based learning at the Harvard School of Dental medicine; self-assessment of performance in postdoctoral training. J Dent Educ. 2007;71(8):1080-9.
  42. Zhao W, He1 L, Deng W, et al. The effectiveness of the combined problem-based learning (PBL) and case-based learning (CBL) teaching method in the clinical practical teaching of thyroid disease. BMC Med Educ. 2020;20:381-91. DOI: 10.1186/s12909-020-02306-y
  43. Rich SK, Keim RG, Shuler CF. Problem-based learning versus traditional educational methodology: A comparison of preclinical and clinical periodontics performance. J Dent Educ. 2009;69(6):649-62.
  44. Hartling L, Spooner C, Tjosvold L, et al. Problem-based learning in pre-clinical medical education: 22 years outcome research. Med Teach. 2010;32(1):28-35. DOI: 10.3109/01421590903200789.
  45. Albanese M. Problem-based learning; why curricula are likely to show little effect on knowledge and clinical skills. Med Educ. 2000;34(9):729-38. DOI: 10.1046/j.1365-2923.2000.00753.
  46. Ramamurthy S, Er HM, Nadarajah VD, et al. Medical students’ orientation toward lifelong learning in an outcome-based curriculum and the lessons learnt. Med Teach. 2021;43:(1):S6-S11. DOI: 10.1080/0142159X.2019.1646894 
  47. Huang S, Wang D, Lu C, Yang J, Wang F, Wen Y, et al. Exploration and practice of teaching reform based on OBE concept in Internal Medicine. EC Emerg Med Crit Care. 2023;7.1:03-19
  48. Mercado-Asis LB, Garcia MVD, Balili MCV, et al. Target-Oriented Clinical Skill Enhancement (TOCSE) is an effective tool to bridge didactic to clinical learning: A randomized, controlled trial. J Med UST. 2021;5:2. DOI: 10.35460/2546-1621.2021-0160
  49. Gomez, MFAS, Zamora LD, Ablaza PJ, et al. Target-Oriented Clinical Skill Enhancement (TOCSE) builds up confidence of fourth-year medical students during first-time patient encounter: An effective bridging tool after online didactic undergraduate classes during the COVID-19 pandemic. J Med UST. 2022;6:S1. DOI: 10.35460/2546-1621.2022-SP15
  50. Daley BJ, Torre DM. Concept maps in medical education: an analytical literature review. Med Educ. 2010;44:440–8. DOI:10.1111/j.1365-2923.2010.03628.
  51. Daley BJ, Durning SJ, Torre DM. Using concept maps to create meaningful learning in medical education. Med Ed Publish. 2016;5:1. DOI:10.15694/mep.2016.000019.
  52. Boyko EJ, Alderman BW. The use of risk factors in medical diagnosis: opportunities and cautions. J Clin Epidemiol. 1990;43(9):851-8. DOI: 10.1016/0895-4356(90)90068-z.
  53. Mowafi H, Dworkis D, Bisanzo M, Hansoti B, Seidenberg P, Obermeyer Z, et al. Making recording and analysis of chief complaint a priority for global emergency care research in low-income countries. Acad Emerg Med. 2013;20(12):1241-5. DOI: 10.1111/acem.12262

Articles related to the one you are viewing

There are currently no results to show, please try again later

Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License, which permits use, share — copy and redistribute the material in any medium or format, adapt — remix, transform, and build upon the material, as long as you give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use. You may not use the material for commercial purposes. If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original. You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit https://creativecommons.org/licenses/by-nc-sa/4.0/.