Guiding undergraduate medical students to use literature appropriately


  • Gina Joubert,

  • Hannes Steinberg,

  • Adri Beylefeld

Gina Joubert, Department of Biostatistics, University of the Free State, PO Box 339 (G31), Bloemfontein 9300, South Africa. Tel: 00 27 51 401 3117; Fax: 00 27 51 401 3641; E-mail:

Context and setting Students on our 5-year medical programme receive instruction on finding, summarising and referencing literature sources in the General Skills module during the first week of their training. During their second semester, the importance of these skills is highlighted in the research module. Students are expected to use these skills in writing their protocols and research reports in years 2 and 3, respectively.

Why the idea was necessary When their protocols and reports were marked, it became clear that students often used inappropriate sources. Cases of inadvertent plagiarism or misrepresentation of findings were also discovered. In cases where reports were submitted as articles to journals, referees commented on the use of inappropriate sources and occasionally highlighted issues regarding plagiarism.

What was done When students were already in the process of writing their protocols, they were given a task of focusing mainly on their use of the literature. They were requested to:

  • • state the aim of the study planned in the protocol;
  • • provide a summary of a useful finding related to this aim, obtained from an appropriate journal article;
  • • provide the full reference of the article, and
  • • attach the relevant pages(s) of the article.

Written individual feedback was given to students within a week. Students were requested to attach their marked task to the protocol when they handed it in and to add a paragraph reflecting on the value of the task in writing the protocol. They were assured that these paragraphs would be read only after the protocol had been marked, and were given 5 out of 5 marks if they attached the paragraph (irrespective of its content).

Evaluation of results and impact The average class mark for the task was 65%. A third of the 126 students used an inappropriate reference that was not a scientific journal article, an old reference or a reference not related to the aim of the project. Half the students (54%) summarised their sources incorrectly, either by directly copying the words of the source or by failing to communicate what the source had reported in the summary; 13% of the students did not provide reference details for the source and 32% gave incomplete details.

A total of 78% of the students attached the reflection paragraph as requested. Only three students were negative, but they seemed to have learned something from the task; one wrote: ‘The task was done fast and in a hurry… If I had spent more time on the task it could really have been valuable.’

Students who were positive mainly stated that the task had forced them to work on their protocol, made it clear what was expected, and identified errors. For example, one student wrote: ‘The comments clearly indicated to me that there were still problems regarding terminology, deductions which were made incorrectly, instructions which were followed incorrectly, incompleteness. These problems were addressed and helped me to compile a better protocol.’

Despite the increased prominence of general skills in undergraduate medical education, examples of the assessment thereof are rare. The outcome of this referencing task challenges long-standing assumptions about medical students’ attitudes towards general skills and these skills’ insusceptibility to measurement.