Clinically integrated or problem-based style of training has been shown to improve skills and knowledge in randomised controlled trials (http://www.ncbi.nlm.nih.gov/pubmed/23212499) 

An example will be to use evidence-based Journal Clubs with practical and relevant scenario led by a, for example, clinical example broken down into structured questions (e.g. using the PICOD model). If used with a combination of well-established "checklists" for appraisal (CEBM or CASP-UK, http://bit.ly/1UcIZvR), students and trainees could learn to appraise the work objectively. 

I work with BJOG to run an evidence-based journal club, the Blue Journal Club (#BlueJC). This is an example of our discussion guide which you may find useful: http://bit.ly/1NAOwxe

I agree with Elaine. You should also use CONSORT statement check-list and their manuals in case of randomized trials. It is nowadays probably necessary to follow their instructions on how to resport such studies, why it will become clear for your students if a study is not reported in that manner.

http://www.consort-statement.org/

Agree with above.  However for your students with a more pragmatic / action-oriented learning style it can also be helpful to frame a paper within the context of a recent patient (especially if it's a typical "atypical" patient, ie one with multi-morbidity, polypharmacy etc) as it helps to demonstrate the number of grounds on which they would have been excluded from the trial in question.

Better still (for experienced students) - pick a medical education paper to appraise, albeit this needs careful planning since such studies are often quite different to traditional positivist clinical research.  In my experience students are more likely to challenge the findings of a medical education study (presumably as they identify so well with the study population) and this can in turn lead to their questioning clinical studies.

(Edited to add:  A great book is "How to Read A Paper" by Trisha Greenhalgh, BMJ Books - I found this very useful when I was a student, and I now recommend it to my own students)

I understand that students at this undergraduate level are not in a position of research appraisal. If I were you, I would then teach them how to read research articles focusing on the reported findings and compare them against current practices. Students can then make deductions about theory practice gap, importance of these findings and how they can improve practice. Not sure t this stage student can understand he methods; even researchers make mistakes here.

have you tried journal clubs that could help as well. but first you may need to give a few lectures on evidence based education, reviewing and appraising scientific etc

As in our institution, during undergraduate training for medical students in the Department of Community Medicine, a project is given to the students as a learning exercise. Department assigns a project to a the group of students (5-6 ), they prepare the questionnaire themselves with the help of the residents in the department, then they go to the field practice area for collection of data and writing of the project is done according the research design with following sub topics as Introduction,Review of Literature, Aims & objectives, Methodology , observations and discussion along with different graphs & diagrams and conclusion of the study. Resident play important role to assist the students  to prepare their projects then each group presents this project to the faculty staff, no doubt the students find a little bit difficult while writing project, but helps them to know the basics of the research methodology.

Over the last 35 years, physicians were not able to critically evaluate their own literature.  The fault lies with the Med Schools who very rarely emphasize critical thinking over memorization. If Med students perhaps spend an extra year studying Epidemiology and biostatistics this would go a long way.   If not this situation will continue

Just my 2 cents.

Hi ! Patricia,

Training the mind to critically evaluate should be done and difficult to do. A research project should train them for to do lit review and writing etc. And during this they should be trained to critically evaluate all the papers they include in their review, not just report what has been done in the area of research and in the discussion they can think how results from other studies differed from their own and why.

Before getting them involved in a project what we used to do was have journal clubs and also group work for them to read papers. 

It would always help, to ask the students to pick one unclear area from each of those assigned papers and bring it up during discussion. This will lead to a healthy discussion and get the minds ticking. 

hope this would help

In my teaching of research methods and statistics over the years I have placed emphasis on the "threats to inference" approach to evaluating research designs and implementation procedures. See: Experimental and Quasi-Experimental Designs for Research, Jul 13, 1963 by Donald T. Campbell and Julian Stanley.

Also important to teach is content about the peer review process, its effectiveness, and limitations. See: John H Noble Jr. Peer review: quality control of applied social research, Science, vol. 185 (13 Sept 1974): 916-921. 

Finally, I have encouraged students to examine their own biases and those of authors, peer reviewers, and journal editors when evaluating published research. See the recent important contribution by Chauvin A, Ravaud P, Baron G, Barnes C, Boutron I. The most important tasks for peer reviewers evaluating a randomized control trial are not congruent with the tasks most often requested by journal editors. BMC Medicine. DOI 10.1186/s12916-015-0395-3.

Hopefully, students come to realize the value of healthy skepticism when appraising medical research studies. It is sobering to learn that as much as 85 percent of reported research may represent avoidable waste! See: Chalmers I, Glasziou P. Avoidable waste in the production and reporting of research evidence. Lancet, vol 373, no. 9683 (4 July 2009): 86-89. http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736%2809%2960329-9.pdf

Expanding on my previous answer which emphasizes teaching students to employ the "threats inference approach" to critiquing published medical research with healthy skepticism, I have published a couple of papers that address the detection of bias, its motivational sources, and the techniques that researchers employ to produce it. There is a critical difference between unknowing and "premeditated bias." Students need to know the difference between them and to be alert to the possibilities in every report that they read. Students should read letters to the editor of medical journals that relate to published reports for the airing of alternative views as well as clues for delving deeper. My publications in this regard are archived in ResearchGate.

Article Detecting bias in biomedical research: looking at study desi...

Article Meta-analysis: Methods, strengths, weaknesses, and political uses

Statistics and epidemiology training enables students and trainees to critique and understand research studies. However, even without this training, students and trainees can examine data representativeness, size, source, and analyses as outlined in the following brief, readable summary: 

·      West, Joe, Timothy R. Card, and Kate M. Fleming. "How to critically read the GI epidemiology literature." Gastroenterology 145.3 (2013): 496-499.

·      pdf at: http://www.nghd.pt/nghd/images/epidemiological_GI_literature.pdf

There is module that french medical students study  and they get evaluated later by giving them articles to critic ,this module is called "critic reading of an article" , (in french its name is  "lecture critique d'un article"ECN ) i think you may find it interesting . In my opinion, creating groups for those who are interested and discuss with them good and bad articles after teaching them the necessarly basics  may help them develop their reading skills.

Hi, I also think that you must improve the statistic knowledge and implement critical lecture workshops. We use to have discussions with a epidemiology Master and discuss meta-analysis and all kind of papers.

Regards 

Hi, this is one of the best questions I have seen posted here so fare. Let me sleep it over, and I will try to help answering it.

Dear Patricia Mcgettigan, realising your 'ranking' could scare me to silence. How to advice such rénomée? Yet, I still am stunned that you share your thoughts, and SUCH thoughts. Thank you. BMS

I agree with the suggestions regarding regular journal club meetings. These have to be handled differently between undergraduate and postgraduate levels. At undergraduate level the emphasis should be more on the "anatomy" of a paper. Examples need not be current, but should be chosen to exemplify different types of study, their advantages and disadvantages, and should include sources of error and cases of scientific fraud.

At postgraduate level, the trainees tend to be less tolerant of a historical approach and are more interested in developing knowledge currency with the literature. Nevertheless they still need to be exposed to different types of study. And yes, an evidence based approach is valuable to their practice but they also need to know the limitations of a reductive approach and be aware of the mythical nature of pure objectivity.  A useful exercise for discussion in a general session is to get the trainees to "create" (they've been exposed to it so much it tends to be regurgitated) the pyramid of "evidence value" and then get them to create a pyramid of "research value" in terms of creation of new knowledge, and discuss why the two are different.

At both levels there needs to be exposure to qualitative designs. 

I would strongly suggest:  Greenhalgh, T. (2014). How to Read a Paper. NY: Wiley. It is now in its 5th edition. Dr. Greenhalgh, a physician, discusses not only how to read and appraise papers, but why. Each chapter is a different study design. Many libraries have this book electronically.

Lots of good suggestions in training folk in appraisal. After they have some basics though, it is a good idea to get them to apply this to real clinical questions. Students get very interested once they see how finding and appraising research can help. One method is to ask them to present a "critically appraised topic in small groups (7 minutes to present; 3 for questions by the group) on either a patient they have seen or their own/family question. The format is in the 5 Questions below (but you can give a ppt template for this): 

1.      Give a description of the clinical situation and the clinical question you need to answer.  Question (PICO):

 2.      Give your search strategy including: (a) database used, (b) search terms used, and (c) number of papers identified, and (d) why did you choose the particular article? 

3.      What was the question of the study.  Appraise the validity of the study 

4. What were the results of the study?

5. State how the study applies to the patient you identified.

Once they have done this, following with journal club sessions is easier.

The National Clinical Guideline Centre (funded by NICE and affiliated to the Royal College of Physicians) runs an excellent one day course on critical appraisal. http://www.ncgc.ac.uk/training-courses

Also, get them to read 'Bad Science' by Ben Goldacre.

Interduce them to equator

http://www.equator-network.org

Thank you for all the great suggestions, and the links to good websites, and for sharing experiences of what you have found to work - I have learned so much - and I'm putting them into practice - thank you