OBJECTIVE: To determine if evidence-based medicine (EBM) can be successfully taught to undergraduate students using topics of women's health and reproduction. METHODS: The effects of EBM training were studied in an undergraduate course “Understanding the Evidence: Provocative Topics of Women's Health and Reproduction.” The class comprised weekly didactic lectures and discussions with elective clinical shadowing. Specifically, the effects of knowledge acquisition, critical thinking, and shifts in attitudes on health-related topics were assessed by an 11-item questionnaire that students completed at the semester's beginning and end. Responses of 74 students from three semesters were evaluated. The nonparametric Wilcoxon Signed Rank test was used to compare presurvey and postsurvey responses using the Likert Scale (1=strongly disagree, 2=disagree, 3=no opinion, 4=agree, 5=strongly agree) at a P<.05 level of significance. RESULTS: Five questions showed significant positive shifts on the postsurvey and two questions showed significant negative shifts. Examples of significant positive shifts of proportions agreeing or strongly agreeing were familiarity with evidence-based medicine (58.1–98.7%, P<.001), confidence in finding information about a new medication (36.5–67.6%, P<.001) and legalization of sex workers (33.3–75.6%, P<.001). Examples of significant negative shifts included not trusting medical information from the news (67.5–90.5%, P<.001) and experiencing fear upon learning of a triplet pregnancy (53.4–82.4%, P<.001). Questions having sizable percentages of students without opinions on the presurvey (20–25%) had virtually all students forming opinions by postsurvey (P<.01). DISCUSSION: An EBM curriculum can teach undergraduates to think critically and make informed decisions.

Objective. The objective of our study was to determine the accuracy of gynecology residents' colposcopic impressions.Methods. A retrospective review of colposcopic examinations was performed. Colposcopic impressions were compared to cervical biopsy and the results stratified by level of residency training. kappa Statistics were calculated to determine the strength of correlation between impression and biopsy results.Results. Agreement within one-step between cervical histology and the colposcopic impression was found in 351 (77%) of the subjects. Histology impression agreement occurred in 92% of the nurse practitioner procedures, 77% of the second year resident (R2) cases, 75% of R3 colposcopies and 73% of the R4 procedures. The association between cervical biopsy and impression was highly significant (P < 0.0001). However, the strength of the correlation was only slight (kappa=0.197). The kappa value was highest for the nurse practitioners (0.376, fair correlation) and lowest for the R3 residents (0.110, slight correlation). The positive predictive value for the association of any colposcopically detected abnormality with any histologic abnormality was 64.1%. The overall PPV was highest for the nurse practitioners (79.3%) and lowest for the R2 residents (58.7%).Conclusions. While the colposcopic impressions of gynecology residents were accurate, there was little difference in the accuracy of colposcopic assessment based upon the level of resident training. (c) 2006 Elsevier Inc. All rights reserved.