Showcase Higher Education Research and Development Society of Australasia 2015

The impact of clinical maturity in evidence based medicine (#167)

Dragan Ilic , Basia Diug

Abstract Content (up to 300 words recommended)


Evidence-based medicine (EBM) involves making clinical decisions informed by the most relevant and valid evidence available, integrated with clinical experience and patient values. With many medical schools moving toward a graduate entry model, it has been suggested that the outcomes of teaching EBM skills may differ between undergraduates and graduate-entry students. Previous research has suggested that greater previous clinical experience and refined learning/study techniques may favour graduate-entry medical trainees. This study aimed to provide robust empirical evidence to determine the effect of clinical maturity on medical trainees’ competency in EBM.


The objective of this study was to identify whether the clinical maturity of medical trainees impacts upon their competency in EBM.


Undergraduate and graduate-entry medical trainees entering their first year of training in the clinical environment were recruited for this study. All participants completed an online assessment of their competency in EBM via a psychometrically validated instrument to discriminate between learners at novice and advanced levels of EBM. Scores were analysed using student t-tests to differentiate between potential differences between cohorts.


Data on a total of 674 medical trainees was collected over a four year period. Differences in EBM competency was identified in two, out of the four, data collection periods. In both years undergraduate medical trainees had a significantly higher level of competency in EBM.


Clinical maturity does not impact upon medical trainee’s competency in EBM. Competency in EBM relies on an integration of clinical expertise, along with patient values and evidence. Clinical maturity may only be one factor that may influence competency in EBM. Other predicators of EBM competency may include previous training and exposure to epidemiology, biostatistics and information literacy. Whilst graduate-entry medical students may have more ‘life’ experience/maturity, it does not translate into clinical maturity and integration into the clinical environment.

Addressing the theme/s of the Conference (up to 200 words recommended)

This presentation aligns with the conference’s theme of ‘assessing, evidencing and evaluating graduate capabilities’. Medical trainees are expected to have the capabilities of being life-long learners upon graduation. Evidence based medicine (EBM) provides trainees with the knowledge and skills to achieve this goal. It has been postulated greater clinical maturity may be associated with a better ability of medical trainees to achieve these graduate capabilities. Our study evaluated the hypothesis that clinical maturity is associated with better graduate capabilities, specifically with respect to EBM. Performance on EBM competency tasks between graduate and undergraduate medical trainees was performed across four cohorts. Results did not suggest a clear association with clinical maturity and performance in EBM. Our study provides novel evidence on the assessment and evaluation of these important graduate capabilities in the field of medical education.