Evaluating Critical Appraisal Skills by Introducing Journal Clubs to Preclinical Dental Students Using the Assessing Competency in Evidence-Based Medicine (ACE) Tool Through Pre and Post-testing

Oct 4, 2026

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Implementing journal clubs for pre-clinical dental students addresses the limited development of critical reasoning and evidence-based medicine (EBM) practice skills. A quasi-experimental hybrid model integrated EBM into the curriculum with blended learning across a year. The 50-student cohort was split into five groups, each completing seven journal-club sessions tied to physiology, followed by discussion and instructor feedback using Kirkpatrick’s evaluation levels. Pre- and post-testing with the ACE tool showed higher scores after intervention, supported by paired t-test findings and acceptable reliability metrics, with overall evidence of improved appraisal, analytical thinking, and decision-making competencies.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages8

Reading Time20 min

AccessFree to download

Abstract

Background

Methodology

Results

Conclusions

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Open Access Original Article DOI: 10.7759/cureus.31535 Review began 11/02/2022 Review ended 11/12/2022 Published 11/15/2022 © Copyright 2022 Mumtaz et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited. Evaluating Critical Appraisal Skills by Introducing Journal Clubs to Preclinical Dental Students Using the Assessing Competency in EvidenceBased Medicine (ACE) Tool Through Pre and Posttesting Sadaf Mumtaz 1 , Sohail Sabir 2 1. Medical Education and Simulation, Dental College, HITEC Institute of Medical Sciences, National University of Medical Sciences, Rawalpindi, PAK 2. Transplant Nephrology, Armed Forces Institute of Urology/Army Medical College, National University of Medical Sciences, Rawalpindi, PAK Corresponding author: Sadaf Mumtaz, [dr_sadaf_mumtaz@yahoo.com](dr_sadaf_mumtaz@yahoo.com) Abstract Background The ineffective utilization of journal clubs (JCs) for pre-clinical dental students has led to a lack of research into their effectiveness in developing skills such as critical reasoning and evidence-based medicine (EBM) practice. Therefore, we have implemented JCs in first-year undergraduate dental students and measured their effectiveness using the integrated Assessing Competency in Evidence-Based Medicine (ACE) tool. Methodology We conducted a quasi-experimental study where EBM was included in the curriculum for pre-clinical students as a hybrid model with a year-long blended learning approach. The 50-student class was divided into five groups of 10 students, with each group participating in seven JCs related to the physiology curriculum. After conducting critical analysis in self-directed learning sessions, students created interactive PowerPoint presentations followed by discussion. Instructors offered feedback after each session based on 1-2 levels in Kirkpatrick’s training evaluation model. Inferential statistics were used for comparative analysis of the ACE tool pre-and post-test using SPSS version 26 (IBM Corp., Armonk, NY, USA) . Results A linear trend in median score from 6 in the pre-test to 9 in the post-test was detected using the box and whisker plot. Using paired sample t-test, the mean difference (95% confidence interval) between the pre-test and post-test responses was-3 .14 (-2 .32 to-3 .96) (p < 0 .001) . In terms of the post-test responses, each item’s difficulty index ranged from 0.3 to 0.9. Internal reliability was in the acceptable range of >0 .15 (range = 0 .5-0. 18) . The item discriminatory index was in the range of 0 .8 to >0 .2. Cronbach’s alpha was 0.64, which was deemed acceptable. Conclusions Our results show that pre-clinical dentistry students appreciated the use of JCs to improve active learning, critical appraisal, analytical, and decision-making skills. The 15-item ACE measure is a useful and reliable tool for assessing dentistry students’ EBM proficiency in Pakistan. Categories: Medical Education, Dentistry, Health Policy Keywords: communication skills, decision making, active learning, critical appraisal, journal clubs Introduction Evidence-based medicine (EBM) is critical for the advancement of healthcare professionals in today’s complex healthcare system [1] . EBM follows a five-step approach that involves (i) posing a question that can be answered, (ii) searching the literature, (iii) critical assessment, (iv) applying the evidence, and (v) performance evaluation [1,2] . EBM is incomplete without critical appraisal. It is a self-directed process that is frequently hampered by a lack of instruction and a lack of research time during the pre-clinical and clinical years [3] . The appraisal and critique of evidence is a critical thinking skill described by Bloom’s taxonomy [4] . The use of questioning, class discussions, debates, and

FAQs

What problem does the study address in preclinical dental education?

Ineffective use of journal clubs for pre-clinical dental students limits research on how they develop critical reasoning and evidence-based medicine (EBM) practice skills.

How was the journal club intervention implemented?

EBM was integrated into the curriculum using a year-long blended learning hybrid model. The cohort was divided into five groups, and each group participated in seven journal clubs linked to the physiology curriculum, including self-directed analysis, interactive presentations, and discussion with instructor feedback.

What were the key findings from the ACE tool pre- and post-tests?

Scores increased from a median of 6 in pre-test to 9 in post-test. Paired sample t-test showed a significant mean difference (p < 0.001), and reliability and item statistics indicated the ACE measure was acceptable for assessing EBM proficiency.

Oct 4, 2026

Uploaded by dabgoudw