Empowering Third-Year Medical Students to Detect Bias and Medical Misinformation Online via Experiential Learning of "Lateral Reading," A Fact-Checker’s Technique

<b><i>Problem</i></b>: Misleading health information is detrimental to public health. Even physicians can be misled by biased health information; however, medical students and physicians are not taught some of the most effective techniques for identifying bias and misinformation online. <b><i>Intervention</i></b>: Using the stages of Kolb's experiential learning cycle as a framework, we aimed to teach 117 third-year students at a United States medical school to apply a fact-checking technique for identifying bias and misinformation called "lateral reading" through a 50-minute learning cycle in a 90-minute class. Each student's <i>concrete experience</i> was to independently read a biased article and rate its credibility, demonstrating their baseline skills at identifying bias. Students were given structured opportunities for <i>reflective observation</i> through individual and large group discussion. Students were guided through <i>abstract conceptualization</i> to determine techniques and frameworks utilized by fact checkers, specifically "lateral reading"-utilizing the internet to research the background of the author, organization, and citations using independent sources before exploring the article itself in depth. Students' <i>active experimentation</i> included re-rating the credibility of the same article and discussing further implications with classmates and instructors. <b><i>Context</i></b>: In January 2020, sessions were offered to third-year medical students during their required, longitudinal transition-to-residency course. <b><i>Impact</i></b>: Compared to baseline, when using lateral reading, students deemed the article less credible. Students' active experimentation changed whether they identified the organization and sources behind the article as credible. Notably, 86% (53/62) of students who viewed the organization positively pre-intervention did not describe the organization positively post intervention. Similarly, 66% (36/55) of students who cited the sources as positive pre-exercise changed their assessment after the exercise. While three students mentioned the author negatively pre-intervention, none of the 21 students who described the author in a negative fashion post-intervention described the author negatively pre-intervention. Positively describing the organization, author, or sources pre-intervention correlated with differences in credibility rating after the intervention. These findings indicate that teaching students to read laterally may increase their ability to detect bias in online medical information. <b><i>Lessons Learned</i></b>: Further research is needed to determine whether students who learned lateral reading <i>via</i> experiential learning will apply this skill in their education and career. Additionally, research should assess whether this skill helps future physicians counter bias and misinformation in ways that improve health.