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Publications

Journal Article Ahead of print

PubMed: 42176999 DOI: 10.1016/j.jclinepi.2026.112340

What US Medical Students Need to Learn About Clinical Practice Guidelines: A Qualitative Study of US Students and a Global Subset of Guidelines Developers.

J Clin Epidemiol

Authors: Michael D Yi, Victoria Shi, Rachel E Christensen, Umer Nadir, Chloé Aymée de Mortier, Emma McFarlane, Yasser Sami Amer, Arnav Agarwal, Rebecca L Morgan, Rachel Archer, Brian A Cahn, A G Radhika, Maha Alqudah, Saphia Mokrane, Noor Anvery, John T Chang, Loma Dave, McKenzie A Dirr, Farhana Ikmal Hisham, Heba Hussein, Ahmad Ozair, Pooja Gandhi, Elda Righi, Sara Shaunfield, Mary Nix, Murad Alam

Affiliations

  • Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Guidelines Collaboration Working Group, Guidelines International Network (GIN), Scotland.
  • Department of Dermatology, Cornell-NYP, NYC, NY, USA; Guidelines Collaboration Working Group, Guidelines International Network (GIN), Scotland.
  • School of Health Professions Education (SHE), Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, Limburg, The Netherlands; Health Services Research (HSR), Faculty of Health, Medicine and Life Sciences (FHML), Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Limburg; Knowledge Institute of the Federation of Medical Specialists, Utrecht, The Netherlands.
  • Centre for Guidelines, National Institute for Health and Care Excellence, Manchester, UK; Guidelines Collaboration Working Group, Guidelines International Network (GIN), Scotland.
  • Guidelines Collaboration Working Group, Guidelines International Network (GIN), Scotland; Pediatrics Department and Corporate Quality Management Department, Clinical Practice Guidelines and Quality Research Unit, King Saud University Medical City, Riyadh, Saudi Arabia; Deanship of Scientific Research, Research Chair for Evidence-Based Health Care and Knowledge Translation, King Saud University, Riyadh, Saudi Arabia; Internal Medicine Department, Ribeirão Preto Medical School, University of São Paulo (FMRP-USP), Ribeirão Preto, São Paulo, Brazil.
  • Division of General Internal Medicine, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada; MAGIC Evidence Ecosystem Foundation, Oslo, Norway; Guidelines Collaboration Working Group, Guidelines International Network (GIN), Scotland.
  • Guidelines Collaboration Working Group, Guidelines International Network (GIN), Scotland; Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.
  • National Institute for Health and Care Excellence, UK.
  • Department of Dermatology, Columbia University, NYC, NY, USA.
  • Obstetrics and Gynecology, University College of Medical Sciences and GTB Hospital, Delhi, India; Guidelines Collaboration Working Group, Guidelines International Network (GIN), Scotland.
  • Healthcare Quality Department, Quality Improvement, Ministry of Public health, Doha, Qatar.
  • Department of Primary Care, Université Libre de Bruxelles, Brussels, Belgium; Guidelines Collaboration Working Group, Guidelines International Network (GIN), Scotland.
  • Department of Dermatology, SUNY Downstate Medical Center, Brooklyn, NY, USA.
  • Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA; Care Management Institute (CMI), Evidence Services, Kaiser Permanente, Oakland, CA, USA; Guidelines Collaboration Working Group, Guidelines International Network (GIN), Scotland.
  • Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
  • Department of Dermatology, Vanderbilt University Medical Center, Nashville, TN, USA.
  • Department of Oral Medicine and Periodontology, Faculty of Dentistry, Cairo University, Cairo, Egypt.
  • Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, MD, USA; Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada; Guidelines Collaboration Working Group, Guidelines International Network (GIN), Scotland.
  • Department of Communication Sciences and Disorders, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada; Swallowing Rehabilitation Research Laboratory, KITE Research Institute - Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.
  • Department of Infection, Guy's and St Thomas' NHS Foundation Trust, London, UK; Guidelines Collaboration Working Group, Guidelines International Network (GIN), Scotland.
  • Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
  • The Agency for Healthcare Research and Quality (Retired), Rockville, MD, USA; Guidelines Collaboration Working Group, Guidelines International Network (GIN), Scotland.
  • Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Department of Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Guidelines Collaboration Working Group, Guidelines International Network (GIN), Scotland.

Abstract

BACKGROUND

Undergraduate United States (US) medical education may not provide adequate education on clinical practice guidelines (CPGs).

OBJECTIVES

To identify types of information about CPG development and usage that US medical students and a global subset of CPG development experts considered important to teach students, to detect potential barriers that may limit the implementation of improved and comprehensive CPG education, and to understand the current education regarding CPGs.

STUDY DESIGN AND SETTING

Third- and fourth-year US medical students and CPG development experts participated in focus groups between September 2022 and August 2024. Verbal consent for audio recordings was obtained, with analysis via an inductive thematic approach.

RESULTS

Three focus groups of US medical students (n=20) and two focus groups of experts (n=28) were convened. Experts emphasized the need to teach students the purpose of CPGs through hands-on learning activities. Both students and experts agreed that educational materials on CPGs should include the purpose of CPGs, and how to evaluate the quality of CPGs and apply CPG recommendations to individual patient scenarios, and that time constraints for students within an already busy US medical school curriculum and resistance among lecturers and curriculum developers to altering traditional curricula may be barriers to implementing CPG education. Students and experts did not agree on when this education should be delivered in medical schools, with experts believing that education should be introduced during the students' pre-clinical years.

CONCLUSION

US medical students believe their CPG education needs to be bolstered. These findings support the development of new, structured and expanded educational modules on various crucial aspects of CPG development and application able to be integrated into existing US medical school curricula in both the pre-clinical and clinical years. Further work should examine the perspectives of non-US medical students and instructors to inform globally adaptable educational approaches.

MeSH

Epidemiology, Focus Groups, Curriculum, Schools, Schools, Medical, Education