Narrative review of research competence curricula in undergraduate medical education

Research competence, or the abilities to be effective consumers of and contributors to medical research is a core competence of medical doctors. The past decades have witnessed increasing research competence requirements in evidence-based medicine for accreditation, licensing and certification purposes. However, their integration into medical education has been at most heterogenous, with wide differences in terms of content and instructional strategies and in terms of duration and integration within the core program. While longitudinal and integrated instruction bears the highest potential for competence development in medical education, it remains unclear how to apply those principles to instructional design in research competence. Currently, there is no clear guideline for educators on how to integrate research competence longitudinally into undergraduate medical education programs. The present narrative review aims at providing a better understanding of how medical students are currently trained in research competence through longitudinal curricula integrated within undergraduate medical education programs. Nine published studies and four local curriculum descriptions conformed to the inclusion criteria and were analyzed. All curricula covered at least half of the undergraduate medical education years with the majority extending through all or all but one year. The curricula were implemented to comply with local legislative and competency frameworks, and to conform to accreditation requirements, underlining the importance of these developments. The overarching program objectives of the reviewed curricula were two: training in the scientific facet of medical practice, which amounts to the knowledge, skills and attitudes related to evidence-based medicine, and training in the practice of research relevant to medicine. While the former was shared by all included curricula, there were four curricula that did not mention program objectives related to the latter. Translation of program objectives into instruction was heterogeneous and partly incomplete. A single curriculum addressed the entire evidence-based medicine process while the majority focused only on the steps of searching for and appraising evidence. Likewise, all but one curriculum addressing research competence through research experience focused on the principles and methods of research from natural sciences and did not include those of social sciences and the humanities relevant to medicine. Finally, the database search only found very few studies describing and evaluating longitudinal research competence curricula, while institutional website searches for research competence curricula descriptions found several high-quality programs. Scholarly work in the field is critically needed to develop a shared understanding of what research competence entails, to value excellent existing programs and to inform curriculum design in this field.