Effect of the EBM-Integrated BOPPPS Model on Clinical Competence and EBM Confidence in Neurology Clerkships for three-year Junior College medical clerks

Yaxi Chen¹Zhanqin Xiao²Xiang Gu²Qi Lang²Chanxi Chen²Junhuai Zhang^2*

• ¹Chongqing Medical and Pharmaceutical College, Chongqing, China
• ²The People’s Hospital of Chongqing Yubei District, Chongqing, China

Background: Neurology clerkships are critical for clerks' transition from student to assistant physician, but complex neurological content and traditional lecture-based teaching often reduce learning enthusiasm and skill mastery. Objectives: This study aimed to evaluate whether integrating Evidence Based Medicine into the BOPPPS teaching model (EBM-BOPPPS) can enhance the clinical competence and EBM confidence of three-year junior college medical clerks during neurology clerkships, in comparison to the standalone BOPPPS model. Methods: A mixed-method research approach was adopted, with its core quantitative component being a stratified randomized controlled trial with quasi-experimental design. A total of 97 three-year junior college medical clerks were recruited and randomly assigned to the EBM-BOPPPS group (n=47) or standalone BOPPPS group (n=50). Outcomes were measured via a modified OSCE (4 stations, ICC=0.87), a 22-item EBM confidence survey tailored for junior college clerks (3-point scale, Cronbach's α=0.76), and MCQs for foundational neurological knowledge. Statistical analyses included independent samples t-test, Mann-Whitney U test, and Bonferroni correction (corrected α=0.003). Results: At baseline, the two groups showed no significant differences in gender, age, epidemiology scores, core medical course averages or pre-rotation MCQs scores. Post intervention, MCQs scores remained comparable between groups. However, the EBM-BOPPPS group achieved significantly higher total OSCE scores (91.65±2.54 vs. 88.86±4.19, P<0.001) and Physical Interview station scores (20.82±1.56 vs. 19.64±1.78, P=0.001), with both results retaining significance after Bonferroni correction. For EBM confidence, the EBM-BOPPPS group showed a significant pre-post increase in total scores (baseline: 20.1±2.8 vs. post: 30.2±3.3, P<0.001), particularly in understanding EBM concepts. In satisfaction surveys, the EBM-BOPPPS group showed significantly better outcomes in "develop problem-solving skills" (P=0.003), "formulating clinical questions(P=0.001), "critically appraising journal articles" (P=0.003), and "recognizing EBM's future career importance" (P=0.001). Conclusion: The EBM-integrated BOPPPS model effectively enhances the clinical competence and EBM confidence of three-year junior college medical clerks, better aligning with the training needs of grassroots primary care compared to the standalone BOPPPS model. Future studies should focus on long-term skill retention and optimizing the model to reduce perceived learning burden.