Work files as learning tools in knowledge management.

BACKGROUND Modern medicine requires doctors to be able to identify, assess and use best current research evidence in their own practice. We have developed an educational programme in knowledge management integrated in clinical practice with the aid of specially designed work files and an online training course. A work file is an electronic form that documents the process from clinical questions to answers. MATERIAL AND METHOD A cohort of medical students in their 10th semester at the University of Oslo completed two work files based on their own clinical questions identified during a 10 week clinical placement period in hospitals. Submitted work files were assessed and the answers in each field were categorised. We present results from one work file from each student. RESULTS We received 91 work files from a total of 107 students. Answers to clinical questions were most frequently drawn from recommendations in evidence-based textbooks (n = 43), followed by primary studies (n = 30), systematic reviews (n = 15) and non-disclosed sources (n = 3). The students' critical appraisal of the articles revealed a varying degree of understanding of methods, interpretation of results and applicability. We nevertheless assessed the conclusion as satisfactory for 84 work files. In one-fifth of the work files, the students concluded that there was a need to change prevailing practice. INTERPRETATION At the end of their medical studies, the majority of the students are able to undertake appropriate literature searches and find answers to clinical questions in the best information resources available. A majority of the students require more training in critical appraisal of validity and interpretation of results.