Experiences Using Media Health Claims to Teach Evidence-Based Practice to Healthcare Students: A Mixed Methods Study

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In this context, we advocate the strategic use of health claims in media to promote critical thinking and provide an accessible entry point to evidence-based practice for early-stage university healthcare students. Method We conducted a convergent mixed methods study, including a cross-sectional survey with structured and open-ended questions as well as focus group interviews, at the Faculty of Health Sciences, Oslo Metropolitan University, during the 2020-2021 academic year. Participants were bachelor’s students in bioengineering, physiotherapy, social education, and occupational therapy. We employed a blended learning approach, combining digital learning resources, teaching in critical assessment of health claims and evidence-based practice, and a concurrent group exam assignment centered around health news. The outcome measures included students’ experiences integrating health claims into evidence-based practice teaching and their experiences with teaching approaches, including the group exam. Results Out of 446 participants, 136 (30.5%) responded to the structured questions in the survey. In response to the open-ended questions within the survey, 109 (80.1%) of the respondents shared positive experiences about the course, while 98 (72%) suggested improvements. Additionally, 25 students participated in focus group interviews. Synthesizing the results, we found that students viewed the inclusion of health claim assessment as a useful entry point for learning evidence-based practice. In addition, both the blended learning design and the group exam were identified as contributors to a positive perception of learning outcomes from the course. Conclusions Integrating critical reflection on media health claims into evidence-based practice education, alongside a blended learning approach and a group exam, may be beneficial for educating bachelor’s healthcare students. However, further rigorous study designs are needed to assess the effect of the course on learning outcomes. Registration DOI 10.5281/zenodo.6985449 " } { "@context": "http://schema.org", "@type": "BreadcrumbList", "itemListElement": [ { "@type": "ListItem", "position": "1", "item": { "@id": "https://f1000research.com/", "name": "Home" } }, { "@type": "ListItem", "position": "2", "item": { "@id": "https://f1000research.com/browse/articles", "name": "Browse" } }, { "@type": "ListItem", "position": "3", "item": { "@id": "https://f1000research.com/articles/13-224/v3", "name": "Experiences Using Media Health Claims to Teach Evidence-Based Practice..." } } ] } Home Browse Experiences Using Media Health Claims to Teach Evidence-Based Practice... ALL Metrics - Views Downloads Get PDF Get XML Cite How to cite this article Elvsaas IKO, Myrhaug HT, Garnweidner-Holme L et al. Experiences Using Media Health Claims to Teach Evidence-Based Practice to Healthcare Students: A Mixed Methods Study [version 3; peer review: 3 approved, 1 approved with reservations] . F1000Research 2025, 13 :224 ( https://doi.org/10.12688/f1000research.146648.3 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. Close Copy Citation Details Export Export Citation Sciwheel EndNote Ref. Manager Bibtex ProCite Sente EXPORT Select a format first Track Share ▬ ✚ Research Article Revised Experiences Using Media Health Claims to Teach Evidence-Based Practice to Healthcare Students: A Mixed Methods Study [version 3; peer review: 3 approved, 1 approved with reservations] Previously titled: Using Health Claims to Teach Evidence-Based Practice to Healthcare Students: A Mixed Methods Study Ida-Kristin Orjasaeter Elvsaas https://orcid.org/0000-0001-5831-0915 1 , Hilde Tinderholt Myrhaug 1 , Lisa Garnweidner-Holme 1 , Jürgen Kasper 1 , Astrid Dahlgren 1 , Marianne Molin https://orcid.org/0000-0002-9425-2414 1,2 Ida-Kristin Orjasaeter Elvsaas https://orcid.org/0000-0001-5831-0915 1 , Hilde Tinderholt Myrhaug 1 , [...] Lisa Garnweidner-Holme 1 , Jürgen Kasper 1 , Astrid Dahlgren 1 , Marianne Molin https://orcid.org/0000-0002-9425-2414 1,2 PUBLISHED 28 Jan 2025 Author details Author details 1 Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Oslo, 0130, Norway 2 School of Health Sciences, Kristiania University College, Oslo, Oslo, 0107, Norway Ida-Kristin Orjasaeter Elvsaas Roles: Conceptualization, Data Curation, Formal Analysis, Methodology, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Hilde Tinderholt Myrhaug Roles: Conceptualization, Data Curation, Formal Analysis, Investigation, Methodology, Writing – Review & Editing Lisa Garnweidner-Holme Roles: Conceptualization, Methodology, Writing – Review & Editing Jürgen Kasper Roles: Conceptualization, Methodology, Writing – Review & Editing Astrid Dahlgren Roles: Conceptualization, Methodology, Writing – Review & Editing Marianne Molin Roles: Conceptualization, Data Curation, Formal Analysis, Investigation, Methodology, Project Administration, Writing – Review & Editing OPEN PEER REVIEW DETAILS REVIEWER STATUS Abstract Background A multifaceted and interactive teaching approach is recommended for achieving proficiency in evidence-based practice, with critical thinking considered vital for connecting theory and practice. In this context, we advocate the strategic use of health claims in media to promote critical thinking and provide an accessible entry point to evidence-based practice for early-stage university healthcare students. Method We conducted a convergent mixed methods study, including a cross-sectional survey with structured and open-ended questions as well as focus group interviews, at the Faculty of Health Sciences, Oslo Metropolitan University, during the 2020-2021 academic year. Participants were bachelor’s students in bioengineering, physiotherapy, social education, and occupational therapy. We employed a blended learning approach, combining digital learning resources, teaching in critical assessment of health claims and evidence-based practice, and a concurrent group exam assignment centered around health news. The outcome measures included students’ experiences integrating health claims into evidence-based practice teaching and their experiences with teaching approaches, including the group exam. Results Out of 446 participants, 136 (30.5%) responded to the structured questions in the survey. In response to the open-ended questions within the survey, 109 (80.1%) of the respondents shared positive experiences about the course, while 98 (72%) suggested improvements. Additionally, 25 students participated in focus group interviews. Synthesizing the results, we found that students viewed the inclusion of health claim assessment as a useful entry point for learning evidence-based practice. In addition, both the blended learning design and the group exam were identified as contributors to a positive perception of learning outcomes from the course. Conclusions Integrating critical reflection on media health claims into evidence-based practice education, alongside a blended learning approach and a group exam, may be beneficial for educating bachelor’s healthcare students. However, further rigorous study designs are needed to assess the effect of the course on learning outcomes. Registration DOI 10.5281/zenodo.6985449 READ ALL READ LESS Keywords Evidence-Based Practice, Evidence-Based Healthcare, Critical Thinking, Health Literacy, Health Education, Professional Education, Mixed Method Design Corresponding Author(s) Ida-Kristin Orjasaeter Elvsaas ( [email protected] ) Close Corresponding author: Ida-Kristin Orjasaeter Elvsaas Competing interests: No competing interests were disclosed. Grant information: This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. However, OsloMet funds a Ph.D. scholarship for the first author and paid for the gift cards used in the recruitment of participants for the study. Copyright: © 2025 Elvsaas IKO et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. How to cite: Elvsaas IKO, Myrhaug HT, Garnweidner-Holme L et al. Experiences Using Media Health Claims to Teach Evidence-Based Practice to Healthcare Students: A Mixed Methods Study [version 3; peer review: 3 approved, 1 approved with reservations] . F1000Research 2025, 13 :224 ( https://doi.org/10.12688/f1000research.146648.3 ) First published: 27 Mar 2024, 13 :224 ( https://doi.org/10.12688/f1000research.146648.1 ) Latest published: 28 Jan 2025, 13 :224 ( https://doi.org/10.12688/f1000research.146648.3 ) Revised Amendments from Version 2 Considering our peer reviewers' insightful comments, we have made some changes and clarifications to our article. The revisions include: - inclusion of objectives for both the quantitative and qualitative components, as well as a rationale for integrating the datasets, - specification of the focus group interview inclusion criteria, - conversion of the value of gift cards from Norwegian kroner (NOK) to the approximate US dollar equivalent, - definition of the response tool "Mentimeter," which allows teachers to interact with students in real-time, - specification of the types of research articles students needed to respond to in the exam task: a systematic review, a chapter in a clinical decision tool, or a guideline. Considering our peer reviewers' insightful comments, we have made some changes and clarifications to our article. The revisions include: - inclusion of objectives for both the quantitative and qualitative components, as well as a rationale for integrating the datasets, - specification of the focus group interview inclusion criteria, - conversion of the value of gift cards from Norwegian kroner (NOK) to the approximate US dollar equivalent, - definition of the response tool "Mentimeter," which allows teachers to interact with students in real-time, - specification of the types of research articles students needed to respond to in the exam task: a systematic review, a chapter in a clinical decision tool, or a guideline. See the authors' detailed response to the review by Wendy Romney See the authors' detailed response to the review by Sharon Tucker See the authors' detailed response to the review by Conor Gilligan See the authors' detailed response to the review by Anice George READ REVIEWER RESPONSES Background Evidence-based practice (EBP) is essential for enhancing healthcare quality and safety. 1 – 3 Educational programs in healthcare professions should incorporate EBP to ensure that graduates can deliver high-quality, evidence-based care. 4 , 5 In Norway, higher education institutions are legally obligated to equip health and welfare science students with EBP competencies. 6 While the core components of EBP are generally agreed upon, 3 , 4 , 7 successful teaching and learning in EBP require interactive and multifaceted approaches integrated with clinical practice. 5 These teaching strategies should incorporate various assessment methods to gauge students’ progress and comprehension. 5 In addition, cultivating critical thinking skills is considered essential for bridging the gap between theory and practice, allowing students to understand the relevance of evidence in their future professional roles. 8 To address this issue, we propose using health claims in the media to promote critical thinking and provide an entry point for EBP for university healthcare students 9 in the early stages of their education and lack of clinical practice experience. Health claims found in news articles, social media posts, and advertisements are easily identifiable and hold relevance to students’ daily lives, 9 as well as their future professional practice when faced with health claims from patients and caregivers. 10 , 11 Previous studies have shown this approach to be successful at teaching the public to think critically about health claims. 12 , 13 Consequently, there is potential for applying this strategy in professional education, fostering similar skills during training, and enhancing comprehension of the practical implementation of EBP. News stories in the media as a learning resource in EBP During the academic year 2020 to 2021, Oslo Metropolitan University (OsloMet) adopted a blended learning approach to deliver a newly developed three-week course on evidence-based practice in healthcare (hereafter called the EBHC course). The EBHC course was designed to align with the common learning outcomes for bachelor’s students in health and social services education, thereby becoming a mandatory course for first- or second-year students at the Faculty of Health Sciences. Despite the novelty of the EBHC course at our university, it was underpinned by the foundational elements of EBP instruction based on the Norwegian adaptation of the Critical Appraisal Skills Program (CASP) model. 14 In addition, the course incorporated a module with elements from a previous learning design called “Behind the Headlines”, 9 serving as a stepping-stone to EBP. The “Behind the Headlines” section builds on the Informed Health Choices (IHC) Key Concept Framework and focuses on assessing treatment claims. 15 In this context, treatment claims refer to actions or products used to maintain or improve health. Generic examples of such claims include statements as, “This product can help you lose weight,” “This exercise can reduce stress and anxiety” and “This treatment can help manage chronic pain.” The initial implementation of the EBHC course encompassed four study disciplines: bioengineering, physiotherapy, social education, and occupational therapy. Objective In this study, we aimed to explore healthcare students’ experiences during the first year of implementing our EBHC course. Our research questions were: 1. How do healthcare students rate their overall learning outcomes from our EBHC course and their learning outcomes from the educational resources provided? 2. How do students experience integrating health claim assessment into EBP teaching, and what are their experiences with a blended learning approach and a group exam assignment? 3. What new insights can be drawn from the combination of the results from questions 1 and 2? Methods We employed a convergent mixed methods research design, 16 which included a cross-sectional survey and focus group (FG) interviews. The convergent design is a single-phase approach that involves the collection of quantitative and qualitative data, followed by separate analyses, culminating in an integrated analysis. 16 , 17 Responses to Likert-scale questions were used to explore healthcare students’ perceived learning outcome from the EBHC course in its entirety, as well as the perceived learning outcomes from the provided learning resources. To elucidate the healthcare students’ experiences with the EBHC course, open-ended questionnaire items and data from focus group interviews were analyzed. The combination of structured and open-ended questions in the questionnaire, along with FG interviews, was used to comprehensively understand participants’ experiences. Our goal was to extract fresh insights that surpass the results obtained from separate analyses of the quantitative and qualitative data. 17 The reporting of the study was guided by the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement, 18 the Consolidated Criteria for Reporting Qualitative Research (COREQ), 19 and the Mixed Methods Appraisal Tool (MMAT), Version 2018. 20 Ethics This study evaluates healthcare education. Although OsloMet does not have an Ethics Review Board to approve projects, researchers are committed to adhering to ethical standards following applicable national regulations, institutional guidelines , and the principles of the Declaration of Helsinki (as revised in 2013). 21 The data in the study were collected anonymously, without personal or indirect personal information, or health and illness data. Therefore, according to the guidelines of the Norwegian Agency for Shared Services in Education and Research , no approval from them was necessary. Before participating in the study, all participants provided written informed consent for the collection and use of data for research purposes. Setting and participants We included healthcare students who participated in the EBHC course from 2020 to 2021. The eligible participants were 465 first- and second-year bachelor students enrolled in bioengineering, physiotherapy, social education, and occupational therapy programs at the Faculty of Health Sciences at OsloMet. Separate courses were conducted for each study program. To collect survey data, announcements were posted on “Canvas,” the learning management system utilized by OsloMet, toward the end of the courses. A reminder was posted 4 to 7 days later. Participation in the survey was voluntary and anonymous, although respondents who completed the survey had the opportunity to enter a lucky draw to win $50 USD gift cards. However, to participate in the draw, respondents needed to express their interest by emailing one of the lecturers. There was no connection between the submitted answers and participants’ email addresses to ensure anonymity. Toward the end of the EBHC courses, an invitation to participate in the FG interviews was issued through “Canvas,” with participants eligible if they had completed the EBHC course. Each participant in the FG interviews was offered a gift card worth $30 USD. The EBHC course The three-week EBHC course ( Figure 1 ) comprised digital learning materials, lectures, and student activities in “ Behind the Headlines ” and EBP, 4 with concurrent student collaboration on a group exam assignment. The course was structured for online teaching to accommodate the large student body. Health claims were consistently incorporated throughout its structure to achieve the learning outcomes. A blended learning strategy, which included elements from a flipped classroom approach, was implemented for teaching. A group exam centered around media health claims was used to assess the learning outcomes. In-class learning activities included eight half-day or full-day seminars (e.g., help desk, critical appraisal seminars, and seminars to present preliminary group exam work and peer feedback). Time was also allocated for individual study (in line with the flipped classroom approach). For the course generic timetable, see Extended data. 22 Figure 1. The components of the EBHC course. At the beginning of the course and before each new topic, students were encouraged to use digital learning materials covering the EBHC curriculum. These materials were accessed via the learning management system (“Canvas”) and consisted of textual content as well as links to videos and other multimedia resources. In the “Behind the Headlines” module, students were asked to critically reflect on the reliability of health claims made by the media regarding treatment effects. This was achieved through an assessment of the basis for these health claims using five key concepts ( Table 1 ) adopted from the Informed Health Choices (IHC) Key Concept Framework. 15 These five key concepts were previously chosen as essential elements of the “Behind the Headlines” learning design. This design, detailed in Oxman et al., 9 serves as the foundation for the EBHC module titled “Behind the Headlines.” Table 1. Overview of IHC Key Concepts introduced in the Behind the Headlines module. 1. Beliefs alone about how treatment work may not be relevant. 2. An outcome may be associated with a treatment but not caused by it. 3. The results of one study considered in isolation can be misleading. 4. Small studies may be misleading. 5. Fair comparisons of treatment in animals or highly selected groups of people may not be relevant. The students were taught EBP in six sequential steps ( Figure 1 ). This involved reflecting on information needs (Step 1) based on the evaluation of one or more health claims from the media, formulating questions using the PICO framework (Step 2), conducting literature searches (Step 3), critically appraising research studies (Step 4), gaining insight into implementing (Step 5), and evaluating (Step 6) EBP in clinical settings. Learning activity structure Our EBHC course aimed to provide a uniform learning experience for all healthcare students. Therefore, most seminars, including those in the “Behind the Headlines” module depicted in Figure 2 , followed a similar structure. They began with a plenary session lasting one to three sessions of 45 minutes each, featuring a presentation from the lecturer. During this plenary session, students were encouraged to clarify misunderstandings or highlight particularly challenging areas. Additionally, quizzes and a web-based interaction tool (Mentimeter), 23 which displays results in real-time, were used to assess students’ comprehension of the material. Subsequently, students worked in groups of approximately six to seven participants, with assignments provided in Canvas. These group sessions lasted about one to three hours, depending on the topic. During the group work, one or two lecturers would visit the groups in their breakout rooms for clarification and discussion. Each seminar culminated in a forty-five-minute plenary session, during which volunteer groups presented their findings. This session also provided an opportunity for these groups to engage in discussions about challenging aspects of the assignments with other groups in attendance at the seminar. Figure 2. The “Behind the Headlines” module in the EBHC course. To ensure a standardized learning experience for students, we adopted a consistent approach across different fields of study. This involved using the same learning materials provided in Canvas and employing teaching methods in EBP based on the Norwegian adaptation of the CASP model. 14 All lecturers were familiar with the teaching material, and there was a collective agreement on the content of the presentations. Furthermore, most of the teaching modules were delivered by the same lecturers across all courses. Exam assignment In the course’s first week, a group exam assignment was distributed, requiring students to critically assess the basis of one (out of several) provided health claims from the media using the five IHC Key Concepts ( Table 1 ). Real-world examples of media health claims utilized include: “Acupuncture is most effective for back pain,” “Creatine enhances performance and muscle volume,” “MMR vaccine potentially causes autism,” and “Laser treatment improves neck conditions.” This critical assessment process also prompted them to reflect and identify information needs, followed by formulating a research question using the PICO framework and conducting targeted literature searches. Additionally, they were required to provide a relevant checklist for appraising the methodological quality of the selected research article (a systematic review, a chapter in a clinical decision tool, or a clinical practice guideline). Finally, the students discussed whether the health claim made in the news article was supported by the selected research article and explored the potential relevance of these findings for patients or the Norwegian health service. Data collection and analysis Data was gathered individually for each discipline but analyzed collectively across these fields. This methodological approach was chosen to align with the study’s objective of exploring healthcare students’ experiences with the EBHC course. Evaluation survey The data were collected anonymously through a questionnaire created using nettskjema.no, a survey solution developed and hosted by the University of Oslo. The questionnaire 22 included several sections, starting with background information such as gender, age, and study program. Furthermore, there was a course evaluation section featuring Likert scale questions and open-ended questions. Two of the Likert scale questions in the questionnaire focused on course information (“ To what extent did the information provided by the course managers effectively serve its purpose in informing you about the course? ”) and overall learning outcomes (“ Please rate your learning outcomes in the course ”). The respondents were asked to rate these items from one (very good) to four (not good at all). The learning outcomes were further explored through other learning strategies used (detailed in Table 3 ), where students indicated their level of agreement on a scale from 1 (completely agree) to 6 (completely disagree), with an additional option for “do not know.” In addition, there was a section for participants to provide other comments. In the open-ended questions, students were allowed to provide feedback on the EBHC course by answering the following questions: “ Please share any positive aspects you found in the course, such as the content, teaching methods, organization, work style, assessment, etc. ” and “ Do you have any suggestions for improving the course, such as the content, teaching methods, organization, work style, assessment, etc.? ”. Statistical methods Descriptive statistics were used to analyze the respondents’ characteristics, and frequencies were employed to analyze the responses to each Likert scale evaluation question. In addition, the responses related to the detailed learning outcomes were collapsed and categorized into “agree” (ratings of 1, 2, and 3 on the 6-point scale), “disagree” (ratings of 4, 5, and 6 on the 6-point scale) and “do not know”. The data were analyzed using IBM SPSS Statistics version 27 software. 24 Qualitative analysis The answers to the open-ended questions were analyzed using the systematic text condensation strategy as follows: 1) obtaining an overall impression; 2) identifying and organizing meaningful units; 3) condensing the information; and 4) synthesizing the condensed material. 25 The analytical steps were carried out independently by two researchers. Subsequently, the researchers engaged in discussions to achieve a common understanding of the findings. Focus group interviews We utilized Rosenbaum’s honeycomb framework 26 as the basis for developing the FG interview guide. 22 This framework encompasses various problem aspects and differentiates between multiple facets of user experience. The FG interviews were conducted via Zoom following OsloMet’s privacy policy for Zoom interviews ( https://ansatt.oslomet.no/en/rutine-zoom-forskningsintervjuer ) and lasted for approximately one hour. The FG interviews were not audio recorded. One researcher was the moderator while two other researchers took notes during the interviews. All the participating researchers then cross-checked these notes. Any discrepancies or differences of opinion among the researchers were resolved through consensus. The student participants did not provide feedback on the notes. The notes obtained from the FG interviews were analyzed using the systematic text condensation strategy, 25 following the same analytical approach applied to the responses to the open-ended questions in the evaluation survey. Mixed methods approach To facilitate the synthesis of results from the structured and open-ended questions in the survey and focus group interviews, we initially analyzed similarities and differences in the datasets, considering their respective purposes and the responses they generated. Furthermore, to gain insights beyond what can be derived from the separate analysis of the quantitative and qualitative datasets, we synthesized and presented the findings in a joint display, 17 visually integrating the data. Reflexivity In qualitative research, which also encompasses a mixed-methods approach, researchers play an integral role in the research process, and our prior experiences, assumptions, and beliefs will therefore inevitably shape its trajectory and outcomes. 27 The authors of the study have diverse backgrounds, and experience in conducting systematic reviews, EBP teaching and research, and clinical and academic areas. The team collaborated to ensure investigator triangulation. Two of the co-authors (HTM and MM) actively participated in the development of the course and the teaching process and conducted the FG interviews. However, the remaining co-authors were not involved in either the teaching or the FG interviews. To address potential biases in the analysis of the qualitative data, two researchers (HTM and IKOE) independently conducted the data analysis before reaching a shared understanding. This methodological approach, together with the extensive use of quotations from open-ended questions and FG interviews, was used to strengthen the credibility of the study findings. 28 Results To ensure transparency, the underlying quantitative and qualitative data are made publicly available. 22 Quantitative results from the evaluation survey Our survey included 136 out of 465 eligible participants, representing a response rate of 29.2% ( Table 2 ). There were no missing values. 22 Most of the study participants were women, accounting for 79.4% of the sample, and a substantial proportion were younger than the age of 26 (78.0%). All the various fields of study were represented, with the highest representation from physiotherapy (32.4%) and the lowest from occupational therapy (19.1%). Table 2. Study participants in the evaluation survey. Evaluation survey (n = 136) Female, n (%) 108 (79.4) Age (year), n (%) ≤ 20 62 (45.6) 21-25 44 (32.4) 26-30 14 (10.3) 31-35 2 (1.5) ≥36 14 (10.3) Study program, n (%) Bioengineering 34 (25.0) Physiotherapy 44 (32.4) Social Education 32 (23.5) Occupational therapy 26 (19.1) A total of 75.7% of the students rated the course information as either “good” or “very good,” while 90.5% reported a positive perception of their overall learning outcome, indicating that it was either “good” or “very good”. The overall learning outcome was further investigated through eight questions related to different educational methods implemented in the EBHC course. When analyzing these subcategories, students exhibited the highest satisfaction within the collaborative exam group, with 50.4% completely agreeing with the statement “ I have experienced positive learning outcomes from working in the exam group. ” The subcategories related to experienced learning outcomes for other resources or teaching methods displayed variability. However, upon categorizing the results of the subcategories of learning outcomes as “agree,” “disagree,” and “do not know,” it became evident that these learning outcome measures leaned toward agreement, as indicated in Table 3 . Table 3. The proportion of responses to the learning outcome subcategories. I have experienced positive learning outcomes from: Agree, % Disagree, % Do not know, % Digital learning resources in general 70.6 28.6 0.8 Digital learning resources related to “Behind the Headlines” 70.9 26.2 2.9 Digital learning resource from the Western Norway University of Applied Sciences 68.0 27.6 4.4 Lectures 74.3 25.7 0 Problem-solving seminars with teachers 73.5 22.7 3.8 Working in the exam group 78.0 20.3 1.7 Reading syllabus on their own 66.5 29.1 4.4 Combination of campus and digital teaching 48.7 20.0 31.3 Results from the open-ended questions in the evaluation survey In total, 80.1% (109/136) of the students answered what they regarded as positive about the course and 72.1% (98/136) suggested improvements. See Extended data 22 for the distribution of responses to the open-ended questions in the evaluation survey. Positive feedback about the course Analysis of the positive feedback about the course was divided into topics about (1) digital learning resources, (2) student learning activities, (3) group exam collaboration, and (4) the usefulness of the course. Additional quotes supporting the topics can be found in Extended data. 22 The availability of comprehensive digital learning resources both before and after the lessons was appreciated by many. For instance, as one student wrote, “ The organization of self-learning through Canvas etc … was fantastic and easy to follow along. ” The students held a positive perception of the student learning activities, expressing the lecturers’ proficiency in facilitating diverse learning activities such as quizzes, group discussions, seminar presentations, and peer reviews. A student commented, “ Exciting content, committed lecturers, fun with collaborative tasks/discussion in plenary. ” The incorporation of the group exam early in the course and thus ample time for reflection received positive feedback. A student noted, “ You got so much more out of the course when you worked in groups. Then you could discuss with each other and generally hear what others think. You could be good together. ” Additionally, the students expressed appreciation for the acquisition of critical assessment skills regarding health claims in the media, familiarity with the evidence pyramid, and the ability to critically appraise scientific research papers, considering these components relevant to their future professional endeavors. A student wrote, “ I think being able to be critical of health claims on the internet was incredibly good. ” Furthermore, another student wrote, “ Everything about this course has been educational and useful. It is very relevant for future assignments and bachelor’s thesis. ” Suggestions for improvement The analysis of the open questions about suggestions for improvements was distributed among the topics of (1) digital learning resources, (2) education, and (3) the group exam. Additional quotes supporting the topics can be found in Extended data . 22 Some students expressed concerns about the organization of the learning management system (“Canvas”) and the presence of two similar platforms from different universities, one affiliated with OsloMet in English and the other with the Western Norway University of Applied Sciences in Norwegian. A student who articulated this concern serves as an example, writing “Difficult to find the right information, as there were several Canvas rooms and a bit “messy” with information in both English and Norwegian.” As a suggestion for improvement, a student wrote, “ As for the organization inside Canvas, I think this was very good when I first understood it, but there should perhaps have been a little clearer information about how to find and use Canvas, this learning platform is new and unfamiliar to many so early in the studies.” Concerns were raised about the efficacy of breakout rooms, as many students either did not actively participate or were unprepared, resulting in a lack of meaningful discussion. For instance, a student wrote, “Many digital lectures had almost only breakout rooms, with very little academic content. I felt there was no point in discussing something I didn’t know with someone who also didn’t know [the academic content].” This perspective was echoed by others, for example, a student who wrote, “There were a lot of breakout rooms/seminars which were a bit of a waste. That there was unnecessary time spent in breakout rooms.” Although the group exam was generally successful, some concerns arose regarding the possibility of free riders and the appropriate approach to managing such situations. A student commented, “The group project method – having to do the exam in a group – will always be challenging when some contribute a lot and are very engaged and interested, while others are checked out and unmotivated.” A possible solution to the free rider problem was expressed by a student, writing “In the case of further online group work, I think [there should be] a requirement to log attendance so that everyone contributes and that it is not difficult for the students to report if someone wandered off.” Results from the Focus Group interviews Out of 29 interested students, 25 from the various programs participated in the FG interviews. The first FG interview included five bioengineering students, the second involved eight physiotherapy students, the third comprised five social education students, and the fourth consisted of seven occupational therapy students. Details regarding participation and drop-outs are provided in Extended data, 22 although no reasons were given for the dropouts. The analysis of the FG interviews covered the following topics: (1) digital learning resources, (2) course comprehension, (3) the relevance of health claims, (4) group collaboration, and (5) the course’s usefulness. Several pertinent quotations corroborating the topics are available in Extended data. 22 The students acknowledged the presence of diverse information within the learning management system ("Canvas"), as exemplified by one comment from a student, "[…] good [learning] resources in Canvas. " However, some initially perceived its layout to be disorganized. As they became more familiar with the system, they found navigation to be effortless. One student expressed that “ [It was] easy to find [the information] once you became familiar [with Canvas].” At the outset of the course, most students showed limited familiarity with the concept of evidence-based practice and the course content. However, they appreciated the course’s well-structured progression and the clarity of the learning materials, making the content easily understandable, aided by the logical steps in EBP teaching. One student expressed, “ Well structured, easy to follow. Everything was clear. ” Health claims, introduced through the “Behind the Headlines” module, were acknowledged as a useful entry point for EBP, as expressed by one student, “ Behind the headlines and EBP are connected. EBP is sort of next step … ”. This could be attributed to their direct relevance to everyday experiences. One student expressed “ I think it would have been much duller if you had removed [the health claims]. That’s how [the course] becomes relevant for us. ” Another student further emphasized the significance of health claims for their future profession, stating, “ You can get patients who base their knowledge on [health claims]. [We] must be able to refute them sensitively. ” Several students emphasized the importance of group collaboration as a catalyst for fostering critical reflection. A student expressed, “ It is important to have a group when we are going to be critical, several points of view emerge. ” Another student echoed a similar sentiment, expressing an appreciation for the collaborative learning approach, “ I liked that it was group work. It makes it easier to learn when you are in a team. Easier to discuss. ” The students perceived the course as highly beneficial, serving multiple purposes. These included enhancing their ability to write their bachelor’s thesis, critically assessing health claims encountered in their everyday lives, and preparing themselves for their forthcoming roles as updated healthcare practitioners, informed by best practices. One student expressed, “ I have already started searching the Health Library (“Helsebiblioteket”) to prepare for practice, [I have] never done [that] before. ” All the students articulated that the course provided them with the necessary skills to critically assess media claims. One student expressed that “ Being critical of sources is useful. [Behind the Headlines] was like an ABC. ” Moreover, the students reported the acquisition of skills in locating trustworthy research and the ability to autonomously appraise its validity. One student highlighted that “ [I have] learned to be critical of research - learned good ways to be critical - a proper recipe. ” Furthermore, the students acknowledged the universal significance of this knowledge, emphasizing its potential benefits for a broader audience. Results from the mixed methods synthesis Our datasets served distinct purposes and provided diverse insights. The structured questions in the survey primarily evaluated learning outcomes, lacking inquiries about, for example, the usefulness of “Behind the Headlines” for understanding the concept of EBP. Students provided open-ended responses in the survey concerning content, teaching methods, organization, work style, and the exam. The primary concerns centered around how teaching methods, organization, and work style prepared them for the exam, with some offering feedback on the practical applicability of course content. The FG interviews provided an in-depth understanding of students’ experiences with the EBHC course, including the integration of health claims as a fundamental aspect of the educational process. We identified three main outcomes addressing our study objective through the synthesis of results obtained from our datasets, as presented in Table 4 . First, we found that critical reflection on health claims introduced through the “Behind the Headlines” module was a useful entry point for EBP. Second, the blended learning design had a positive influence on the students’ perceived learning outcomes. Finally, the collaborative exam assignment promoted both critical reflection and positively impacted perceived learning outcomes. Table 4. Joint display of the quantitative and qualitative data synthesis * . Main findings Quantitative survey Open-ended questions FG interviews Critical reflection on health claims as an introduction to EBP N/A Positive feedback “ Behind the Headlines and EBP are connected. EBP is sort of next step … ” “ I think being able to be critical of health claims on the internet was incredibly good. ” Suggestions for improvement “ I think it would have been much duller if you had removed [the health claims]. That’s how [the course] becomes relevant for us. ” N/A “ You can get patients who base their knowledge on [health claims]. [We] must be able to refute them sensitively. ” “Health claims are most (compared to scientific literature) recognizable in everyday life. It is important to learn how to deal with this” (From Suppl. 8) Blended learning design on perceived learning outcomes Most students reported positive learning outcomes from the digital learning materials: (1) in general, 70.6%, (2) to “Behind the Headlines,” 70.9%, (3) from the Western Norway University of Applied Sciences, 68.0% Positive feedback "[ … ] good [learning] resources in Canvas. " “ The organization of self-learning through Canvas etc … was fantastic and easy to follow along. ” “ Exciting content, committed lecturers, fun with collaborative tasks/discussion in plenary. ” “ [It was] easy to find [the information] once you became familiar [with Canvas].” “ The structure of the teaching, where you first prepare, then lecture and then work with assignments [was positive].” (From Suppl. 5) “ Well structured, easy to follow. Everything was clear. ” Most students (74.3%) reported positive learning outcomes from lectures “ Nice assignments and exciting with active lectures. It forced me to pay more attention and I learned more. ” (From Suppl. 5) Most students (73.5%) reported positive learning outcomes from problem-solving seminars with teachers Suggestions for improvement “ As for the organization inside Canvas, I think this was very good when I first understood it, […].” “Many digital lectures had almost only breakout rooms, with very little academic content. […].” Most students (66.5%) reported positive learning outcomes from reading the syllabus on their own “There were a lot of breakout rooms/seminars which were a bit of a waste. That there was unnecessary time spent in breakout rooms.” The collaborative exam for critical reflection and perceived learning outcomes Most students (78.0%) reported positive learning outcomes from working in the exam group Positive feedback “It is important to have a group when we are going to be critical, several points of view emerge. " “ You got so much more out of the course when you worked in groups. Then you could discuss with each other and generally hear what others think. You could be good together. ” ” [Positive to] way of working, working in groups and getting different opinions on issues is always educational and fun ” (From Suppl. 5) " I liked that it was group work. It makes it easier to learn when you are in a team. Easier to discuss. " “ I got the most out of the exam assignment. Nice to present the task to other groups. This led to greater insight into the entire assignment and constructive feedback from other students. ” (From Suppl. 5) “Nice to work in groups. [Awarding!]” (From Suppl. 8) Suggestions for improvement “The group project method – having to do the exam in a group – will always be challenging when some contribute a lot and are very engaged and interested, while others are checked out and unmotivated.” “In the case of further online group work, I think [there should be] a requirement to log attendance so that everyone contributes and that it is not difficult for the students to report if someone wandered off.” * Most of the quotes are directly translated from Norwegian to English using Google Translate. Therefore, the wording and sentence structure may be somewhat unfamiliar to an English-speaking audience. N/A=not assessed. Discussion We designed an EBHC course that integrated the assessment of media health claims, along with the use of a blended learning approach and a group exam. Our study aimed to explore healthcare students’ experiences with this course by analyzing quantitative and qualitative data separately and in a combined integrated analysis. To our knowledge, this is the first study to examine the experiences of bachelor healthcare students where the use of health claims for critical thinking is applied. Health claims from the media served as an entry point to EBP and were consistently incorporated into EBP teaching and the exam assignment. Main findings We found that engaging in critical reflection on the reliability of health claims presented in the “Behind the Headlines” module helped introduce healthcare students to the concept of EBP. The implementation of blended learning, which combined online and in-person components, proved beneficial for students’ perceived learning outcomes. In addition, the collaborative exam assignment centered around health claims succeeded not only in promoting critical reflection but also in enhancing students’ perceived learning outcomes. However, the findings are derived from students’ subjective experiences and, therefore, do not allow for causal inferences. The following sections provide a detailed elaboration of our findings. Health claims as an entry point for EBP Our study revealed that health claims, introduced through the “Behind the Headlines” module, served as a helpful entry point for EBP. Five IHC Key Concepts, 15 most of which align with the “0.2 Recognize the rationale for EBP” section of Albarqouni et al.’s EBP framework, 4 were introduced via this module to foster an understanding of the role of reliable research in informing practical application. Students’ perception of the interrelationship between the “Behind the Headlines” module and EBP was likely influenced by the use of health claims in the initial module, acting as a bridge to the broader context of the EBP course. 29 Our results further indicate that students found health claims advantageous for multiple purposes. Rather than starting directly with scientific articles, they found this approach useful for facilitating critical evaluation of health claims in everyday life and preparing for their future roles as healthcare professionals. The ability to critically assess health claims, an aspect of critical health literacy, 29 , 30 plays a role in protecting individuals against misleading treatment claims and enabling them to make informed decisions regarding their health. 15 With the growing prevalence of health claims in various media channels 31 and an emphasis on shared decision-making, 32 , 33 future healthcare professionals are likely to encounter health claims from patients sourced from the media. 11 However, the ability to assess health claims remains limited among various individuals, including healthcare professionals. 34 , 35 Thus, interventions aimed at promoting critical thinking in this domain hold value. Several initiatives, including the strategy described in our current study, as well as other relevant approaches, 12 , 13 , 36 , 37 have the potential to facilitate this process. We believe that the integration of health claims into EBP teaching will empower future healthcare professionals to skillfully navigate the vast media landscape. This empowerment may enable healthcare professionals to assist patients in making informed decisions about their health through shared decision-making. Consequently, this approach can result in improved health outcomes, enhanced quality of life, and better access to suitable and cost-effective treatments, 38 making it a valuable contribution to evidence-based healthcare. The blended learning design for perceived learning outcomes Our EBHC course employed a blended learning strategy 39 with elements from a flipped classroom approach. 40 This approach involved utilizing digital learning resources for pre-class preparation and in-class sessions, which included lectures and collaborative problem-solving activities. We found that students appreciated the extensive digital learning resources available both before and after the lectures. Furthermore, the students expressed their appreciation for the wide range of learning activities incorporated during the lectures, such as quizzes, seminars, and peer assessments. For instance, 73.5% of the students agreed that they had experienced positive learning outcomes from problem-solving seminars with teachers. This finding is consistent with the findings of Bala et al.’s systematic review, which emphasized the importance of interactive and multifaceted approaches in EBP education. 5 However, students’ experience with breakout rooms revealed that many students were unprepared, leading to frustration during lecture sessions that involved multiple breakout room activities. This finding aligns with findings in a review that identified the drawbacks of a flipped classroom approach, which highlighted the frequent occurrence of insufficient student preparation before in-class sessions. 41 Ødegaard et al. 42 found, in their systematic review, that various digital learning designs, including blended learning and flipped classrooms, in physiotherapy education demonstrated comparable or superior effects to traditional classroom teaching in terms of knowledge and practical skills acquisition. In addition, Akçayır and Akçayır 41 reported that the most common benefit associated with a flipped classroom approach was the enhancement of student learning performance. These findings align with the results of Naing et al., 43 who also concluded that the implementation of flipped classrooms has the potential to improve academic achievement and enhance student satisfaction across various health professional programs. Although our study did not specifically assess students’ learning performance in terms of EBP knowledge, skills, and attitudes, most participants (90.5%) reported a positive perception of the overall learning outcome on the Likert scale in the evaluation survey. Our findings indicate that implementing the active engagement approach through a blended learning design in the EBHC course contributed to a positive perception of the students’ learning achievements. In previous studies, active engagement has consistently demonstrated positive associations with learning outcomes. 5 , 44 The alignment of our findings with existing research underscores the potential effect of the active engagement approach, as found in blended learning, in promoting favorable learning outcomes for students. Group collaboration for critical reflection A core element of our EBHC course was the collaborative exam assignment, which was designed to promote critical reflection and student engagement, enhance learning outcomes, and assess students’ grasp of EBP principles. The students recognized group collaboration as vital for promoting critical thinking 45 and experienced the benefits of collaborative efforts in critically assessing a health claim and discussing the research evidence. Engaging with peers in the group setting probably encouraged them to challenge assumptions, consider alternative viewpoints, and arrive at well-informed conclusions. 46 A substantial 78% of participants acknowledged that engaging in exam groups contributed to increased learning outcomes. The FG interviews additionally underscored the students’ recognition of the benefits of group work in enhancing learning outcomes, emphasizing that discussing and learning in a collaborative group setting was beneficial. The interactive exam group discussions and seminars facilitated a collaborative learning environment, encouraging active participation and the exchange of ideas. 47 In the open-ended feedback, emphasis was placed on the advantages of working in groups during the course. This was attributed to the ability to engage in discussions and gain exposure to diverse viewpoints, fostering a deeper understanding of the assignment. Furthermore, feedback from peers was noted to contribute to enhanced insights. This highlights how collaboration among students likely fostered an environment conducive to questioning, seeking clarity, giving constructive feedback, and cultivating a sense of responsibility for meaningful contributions to their group’s advancement. However, the issue of potential free riders emerged as a concern. This aligns with the findings of Donelan and Kear’s systematic review of challenges in online group projects in higher education, which highlighted key issues, including low and uneven student participation. 48 Improving the collaborative learning experience can likely be achieved by implementing strategies to solve the free rider problem, such as logging participation in group work, as suggested in the open-ended response. Other strategies for addressing online group project challenges include clear student guidance and preparation, and ongoing practical and emotional support to boost confidence and engagement. 48 The incorporation of group collaboration in the course aligns with educational theories that emphasize the value of social interaction in learning. 49 Collaborative learning models have been shown to promote critical thinking, problem-solving skills, and communication abilities, 47 , 50 all of which are integral to EBP. 5 The positive outcomes from the collaborative learning experience within the group exam task in our study confirm its relevance and applicability as a strategic component of EBP education and as a useful method for assessing students’ understanding of EBP principles. Limitations Our study has several limitations. Surveys are susceptible to limitations in representing the sample population, such as potential non-response issues. 51 In our study, the response rate was relatively low, as we were able to recruit approximately 29% of the students who were enrolled in the EBHC course. This low response rate introduces the possibility of sampling bias, as the characteristics of the respondents may differ systematically from those of the non-responders. 52 Consequently, there is an increased risk that the obtained results may not accurately represent the entire study population. 53 However, our sample mirrors the general gender distribution of students enrolled in the course, with women making up approximately 78% of the student body compared to approximately 79% in the sample. Moreover, our aim was not specifically focused on attaining statistical generalizability. Instead, we sought to delve into students’ experiences with the EBHC course, using the convergent mixed methods design to enhance our understanding. Adding to this context, 80.1% (109/136) of respondents provided positive feedback about the course, and 72.0% (98/136) provided constructive suggestions for improvement. These response rates demonstrate a high level of engagement and participation from the individuals surveyed. Participants from the various courses were included in the FG interviews, ensuring representation across the board. Nevertheless, the presence of lecturers as both moderators and note-takers during the interviews may have introduced social desirability bias, 54 leading participants to provide responses that align with researchers’ expectations. It is noteworthy, however, that the findings derived from the FG interviews were consistent with the anonymous responses obtained through open-ended questions in the evaluation survey. This alignment of results suggested that the responses were not susceptible to the influence of social desirability bias. The primary objective of this study was to assess the experiences of healthcare students in the EBHC course, with a specific emphasis on the integration of health claims, student-active learning activities and a group exam assignment. However, this study is part of a broader feasibility project. 55 Therefore, some findings that are not included in this paper will contribute to the refinement of the course structure, ultimately facilitating a comprehensive evaluation of students’ learning outcomes using objective measurements. Conclusion Incorporating critical reflection on media health claims into EBP education, along with a blended learning approach and a group exam, showed promise as a useful approach for educating bachelor healthcare students in this study. However, the only basis for our evaluation was the subjective experiences of the students. Therefore, further research employing more robust study designs will be necessary to objectively assess the effect of our pedagogical design on learning outcomes. Data availability Underlying data Zenodo: Supplements and underlying data for the study: Using Health Claims to Teach Evidence-Based Practice to Healthcare Students: A Mixed Methods Study, https://doi.org/10.5281/zenodo.10532808 . 22 This project contains the following underlying data: • Quantitative data. 2_All quantitative data_English translation.xlsx • Qualitative data (open-ended questions). 3_All open questions_English translation.docx • Qualitative data (FG interviews). 4_All FG interviews_English translation.docx Extended data Zenodo: Supplements and underlying data for the study: Using Health Claims to Teach Evidence-Based Practice to Healthcare Students: A Mixed Methods Study, https://doi.org/10.5281/zenodo.10532808 . 22 This project contains the following extended data: • 1_Supplements_.docx • STROBE_checklist_BHinEBP.docx • Consolidated criteria for reporting qualitative studies.docx • Mixed Methods Approach checklist.docx Data are available under the terms of the Creative Commons Attribution 4.0 International license (CC-BY 4.0). Acknowledgments The authors thank all the students who participated in the study. The authors also thank Matt Oxman and Gro Røkholt for their assistance in conducting the FG interviews. Matt Oxman is a Ph.D. candidate at OsloMet and Gro Røkholt is an associate professor at OsloMet. References 1. Lehane E, et al. : Evidence-based practice education for healthcare professions: an expert view. BMJ Evid. Based Med. 2019; 24 (3): 103–108. PubMed Abstract | Publisher Full Text | Free Full Text 2. Sackett DL, et al. : Evidence based medicine: what it is and what it isn’t. BMJ. 1996; 312 (7023): 71–72. PubMed Abstract | Publisher Full Text | Free Full Text 3. Dawes M, et al. : Sicily statement on evidence-based practice. BMC Med. Educ. 2005; 5 (1): 1. PubMed Abstract | Publisher Full Text | Free Full Text 4. Albarqouni L, et al. : Core Competencies in Evidence-Based Practice for Health Professionals: Consensus Statement Based on a Systematic Review and Delphi Survey. JAMA Netw. 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Comments on this article Comments (0) Version 3 VERSION 3 PUBLISHED 27 Mar 2024 ADD YOUR COMMENT Comment Author details Author details 1 Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Oslo, 0130, Norway 2 School of Health Sciences, Kristiania University College, Oslo, Oslo, 0107, Norway Ida-Kristin Orjasaeter Elvsaas Roles: Conceptualization, Data Curation, Formal Analysis, Methodology, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Hilde Tinderholt Myrhaug Roles: Conceptualization, Data Curation, Formal Analysis, Investigation, Methodology, Writing – Review & Editing Lisa Garnweidner-Holme Roles: Conceptualization, Methodology, Writing – Review & Editing Jürgen Kasper Roles: Conceptualization, Methodology, Writing – Review & Editing Astrid Dahlgren Roles: Conceptualization, Methodology, Writing – Review & Editing Marianne Molin Roles: Conceptualization, Data Curation, Formal Analysis, Investigation, Methodology, Project Administration, Writing – Review & Editing Competing interests No competing interests were disclosed. Grant information This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. However, OsloMet funds a Ph.D. scholarship for the first author and paid for the gift cards used in the recruitment of participants for the study. Article Versions (3) version 3 Revised Published: 28 Jan 2025, 13:224 https://doi.org/10.12688/f1000research.146648.3 version 2 Revised Published: 17 Sep 2024, 13:224 https://doi.org/10.12688/f1000research.146648.2 version 1 Published: 27 Mar 2024, 13:224 https://doi.org/10.12688/f1000research.146648.1 Copyright © 2025 Elvsaas IKO et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Download Export To Sciwheel Bibtex EndNote ProCite Ref. Manager (RIS) Sente metrics Views Downloads F1000Research - - PubMed Central info_outline Data from PMC are received and updated monthly. - - Citations open_in_new 0 open_in_new 0 open_in_new SEE MORE DETAILS CITE how to cite this article Elvsaas IKO, Myrhaug HT, Garnweidner-Holme L et al. Experiences Using Media Health Claims to Teach Evidence-Based Practice to Healthcare Students: A Mixed Methods Study [version 3; peer review: 3 approved, 1 approved with reservations] . F1000Research 2025, 13 :224 ( https://doi.org/10.12688/f1000research.146648.3 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS track receive updates on this article Track an article to receive email alerts on any updates to this article. TRACK THIS ARTICLE Share Open Peer Review Current Reviewer Status: ? Key to Reviewer Statuses VIEW HIDE Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Version 3 VERSION 3 PUBLISHED 28 Jan 2025 Revised Views 0 Cite How to cite this report: Romney W. Reviewer Report For: Experiences Using Media Health Claims to Teach Evidence-Based Practice to Healthcare Students: A Mixed Methods Study [version 3; peer review: 3 approved, 1 approved with reservations] . F1000Research 2025, 13 :224 ( https://doi.org/10.5256/f1000research.177294.r363094 ) The direct URL for this report is: https://f1000research.com/articles/13-224/v3#referee-response-363094 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 06 Feb 2025 Wendy Romney , Department of Physical Therapy and Human Movement Science, Sacred Heart University, Fairfield, Connecticut, USA Approved VIEWS 0 https://doi.org/10.5256/f1000research.177294.r363094 Thank you for your thorough ... Continue reading READ ALL Thank you for your thorough revisions. I approve this submission. Competing Interests: No competing interests were disclosed. Reviewer Expertise: physical therapy, evidence based practice, mixed methods I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Romney W. Reviewer Report For: Experiences Using Media Health Claims to Teach Evidence-Based Practice to Healthcare Students: A Mixed Methods Study [version 3; peer review: 3 approved, 1 approved with reservations] . F1000Research 2025, 13 :224 ( https://doi.org/10.5256/f1000research.177294.r363094 ) The direct URL for this report is: https://f1000research.com/articles/13-224/v3#referee-response-363094 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Version 2 VERSION 2 PUBLISHED 17 Sep 2024 Revised Views 0 Cite How to cite this report: Tucker S. Reviewer Report For: Experiences Using Media Health Claims to Teach Evidence-Based Practice to Healthcare Students: A Mixed Methods Study [version 3; peer review: 3 approved, 1 approved with reservations] . F1000Research 2025, 13 :224 ( https://doi.org/10.5256/f1000research.171631.r337010 ) The direct URL for this report is: https://f1000research.com/articles/13-224/v2#referee-response-337010 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 28 Nov 2024 Sharon Tucker , University of Central Florida (Ringgold ID: 6243), Orlando, Florida, USA; The Ohio State University, The Ohio State University, Columbus, Ohio, USA Approved VIEWS 0 https://doi.org/10.5256/f1000research.171631.r337010 This revised manuscript addresses the previous reviewers' concerns. I do not find the findings (all subjective) overly robust, however, the unique approach of using media health claims to stimulate the EBP thinking process for health professions' students is innovative and ... Continue reading READ ALL This revised manuscript addresses the previous reviewers' concerns. I do not find the findings (all subjective) overly robust, however, the unique approach of using media health claims to stimulate the EBP thinking process for health professions' students is innovative and meaningful. I have only a few comments for this revision. 1. Low response rate and likely biased, however this is addressed in the limitations. 2. Not sure what NOK means. 3. What is mentimeter in Figure 2? 4. I would be clear about formulating an EBP question not research in the methods. 5. I also think important to be clear (under exam assignment) that the findings should be more than one research article. This is all; overall revisions well done. Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? Yes Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Yes Competing Interests: No competing interests were disclosed. Reviewer Expertise: EBP, implementation science, ,intervention research I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Tucker S. Reviewer Report For: Experiences Using Media Health Claims to Teach Evidence-Based Practice to Healthcare Students: A Mixed Methods Study [version 3; peer review: 3 approved, 1 approved with reservations] . F1000Research 2025, 13 :224 ( https://doi.org/10.5256/f1000research.171631.r337010 ) The direct URL for this report is: https://f1000research.com/articles/13-224/v2#referee-response-337010 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Author Response 22 Jan 2025 Ida-Kristin Orjasaeter Elvsaas , Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, 0130, Norway 22 Jan 2025 Author Response We appreciate Dr. Sharon Tucker’s thoughtful comments on our article about students' experiences with our EBHC course. Your feedback has been carefully considered, and the following responses address your comments. ... Continue reading We appreciate Dr. Sharon Tucker’s thoughtful comments on our article about students' experiences with our EBHC course. Your feedback has been carefully considered, and the following responses address your comments. We hope that the revisions and clarifications will meet your expectations. 1. Low response rate and likely biased, however this is addressed in the limitations. Response from the authors: We appreciate Dr. Sharon Tucker's observation that we addressed the likelihood of a biased sample in the first revision of the article. 2. Not sure what NOK means. Response from the authors: NOK means Norwegian kroner. However, for ease of understanding, we have converted the value to the approximate US dollar equivalent in the revised article. 3. What is mentimeter in Figure 2? Response from the authors: Mentimeter ( https://www.mentimeter.com/ ) is a response tool that allows teachers to interact with students in real-time. We have defined Mentimeter and provided the reference in the revised article. 4. I would be clear about formulating an EBP question not research in the methods. Response from the authors: Based on this input, as well as Dr. Anice George's comment regarding the necessity of having clear objectives for each strand of the research design, we have included the research questions in the objectives section and a description of the methods used to answer these research questions in the methods section of the revised article. 5. I also think important to be clear (under exam assignment) that the findings should be more than one research article. Response from the authors: We fully agree that using results from individual studies is inconsistent with the fundamental principles of EBP. Students are trained throughout the EBHC course to use findings from systematic reviews in their decision-making, both for their own practice and in interactions with patients. In the exam task, students had to answer their PICO using a systematic review, a chapter in a clinical decision tool, or a guideline. This has been clarified in the updated article. We appreciate Dr. Sharon Tucker’s thoughtful comments on our article about students' experiences with our EBHC course. Your feedback has been carefully considered, and the following responses address your comments. We hope that the revisions and clarifications will meet your expectations. 1. Low response rate and likely biased, however this is addressed in the limitations. Response from the authors: We appreciate Dr. Sharon Tucker's observation that we addressed the likelihood of a biased sample in the first revision of the article. 2. Not sure what NOK means. Response from the authors: NOK means Norwegian kroner. However, for ease of understanding, we have converted the value to the approximate US dollar equivalent in the revised article. 3. What is mentimeter in Figure 2? Response from the authors: Mentimeter ( https://www.mentimeter.com/ ) is a response tool that allows teachers to interact with students in real-time. We have defined Mentimeter and provided the reference in the revised article. 4. I would be clear about formulating an EBP question not research in the methods. Response from the authors: Based on this input, as well as Dr. Anice George's comment regarding the necessity of having clear objectives for each strand of the research design, we have included the research questions in the objectives section and a description of the methods used to answer these research questions in the methods section of the revised article. 5. I also think important to be clear (under exam assignment) that the findings should be more than one research article. Response from the authors: We fully agree that using results from individual studies is inconsistent with the fundamental principles of EBP. Students are trained throughout the EBHC course to use findings from systematic reviews in their decision-making, both for their own practice and in interactions with patients. In the exam task, students had to answer their PICO using a systematic review, a chapter in a clinical decision tool, or a guideline. This has been clarified in the updated article. Competing Interests: No competing interests were disclosed. Close Report a concern Respond or Comment COMMENTS ON THIS REPORT Author Response 22 Jan 2025 Ida-Kristin Orjasaeter Elvsaas , Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, 0130, Norway 22 Jan 2025 Author Response We appreciate Dr. Sharon Tucker’s thoughtful comments on our article about students' experiences with our EBHC course. Your feedback has been carefully considered, and the following responses address your comments. ... Continue reading We appreciate Dr. Sharon Tucker’s thoughtful comments on our article about students' experiences with our EBHC course. Your feedback has been carefully considered, and the following responses address your comments. We hope that the revisions and clarifications will meet your expectations. 1. Low response rate and likely biased, however this is addressed in the limitations. Response from the authors: We appreciate Dr. Sharon Tucker's observation that we addressed the likelihood of a biased sample in the first revision of the article. 2. Not sure what NOK means. Response from the authors: NOK means Norwegian kroner. However, for ease of understanding, we have converted the value to the approximate US dollar equivalent in the revised article. 3. What is mentimeter in Figure 2? Response from the authors: Mentimeter ( https://www.mentimeter.com/ ) is a response tool that allows teachers to interact with students in real-time. We have defined Mentimeter and provided the reference in the revised article. 4. I would be clear about formulating an EBP question not research in the methods. Response from the authors: Based on this input, as well as Dr. Anice George's comment regarding the necessity of having clear objectives for each strand of the research design, we have included the research questions in the objectives section and a description of the methods used to answer these research questions in the methods section of the revised article. 5. I also think important to be clear (under exam assignment) that the findings should be more than one research article. Response from the authors: We fully agree that using results from individual studies is inconsistent with the fundamental principles of EBP. Students are trained throughout the EBHC course to use findings from systematic reviews in their decision-making, both for their own practice and in interactions with patients. In the exam task, students had to answer their PICO using a systematic review, a chapter in a clinical decision tool, or a guideline. This has been clarified in the updated article. We appreciate Dr. Sharon Tucker’s thoughtful comments on our article about students' experiences with our EBHC course. Your feedback has been carefully considered, and the following responses address your comments. We hope that the revisions and clarifications will meet your expectations. 1. Low response rate and likely biased, however this is addressed in the limitations. Response from the authors: We appreciate Dr. Sharon Tucker's observation that we addressed the likelihood of a biased sample in the first revision of the article. 2. Not sure what NOK means. Response from the authors: NOK means Norwegian kroner. However, for ease of understanding, we have converted the value to the approximate US dollar equivalent in the revised article. 3. What is mentimeter in Figure 2? Response from the authors: Mentimeter ( https://www.mentimeter.com/ ) is a response tool that allows teachers to interact with students in real-time. We have defined Mentimeter and provided the reference in the revised article. 4. I would be clear about formulating an EBP question not research in the methods. Response from the authors: Based on this input, as well as Dr. Anice George's comment regarding the necessity of having clear objectives for each strand of the research design, we have included the research questions in the objectives section and a description of the methods used to answer these research questions in the methods section of the revised article. 5. I also think important to be clear (under exam assignment) that the findings should be more than one research article. Response from the authors: We fully agree that using results from individual studies is inconsistent with the fundamental principles of EBP. Students are trained throughout the EBHC course to use findings from systematic reviews in their decision-making, both for their own practice and in interactions with patients. In the exam task, students had to answer their PICO using a systematic review, a chapter in a clinical decision tool, or a guideline. This has been clarified in the updated article. Competing Interests: No competing interests were disclosed. Close Report a concern COMMENT ON THIS REPORT Views 0 Cite How to cite this report: George A. Reviewer Report For: Experiences Using Media Health Claims to Teach Evidence-Based Practice to Healthcare Students: A Mixed Methods Study [version 3; peer review: 3 approved, 1 approved with reservations] . F1000Research 2025, 13 :224 ( https://doi.org/10.5256/f1000research.171631.r337008 ) The direct URL for this report is: https://f1000research.com/articles/13-224/v2#referee-response-337008 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 27 Nov 2024 Anice George , Manipal Academy of Higher Education, Manipal, India Approved with Reservations VIEWS 0 https://doi.org/10.5256/f1000research.171631.r337008 This article is written with clarity and explains the experiences of Health Care students, both quantitatively and qualitatively about media health claims to learn evidence-based practice. The teaching used is a blended approach incorporating interactive teaching and critical thinking process. ... Continue reading READ ALL This article is written with clarity and explains the experiences of Health Care students, both quantitatively and qualitatively about media health claims to learn evidence-based practice. The teaching used is a blended approach incorporating interactive teaching and critical thinking process. This research is very relevant in inculcating the concept of EBP in carrying out the care responsibilities by the health care students to provide safe and quality care. The article has given explanation about the Evidence Based Practice in Health Care (EBHC) which was a three weeks course. The study participants were from Bio Engineering, Physiotherapy, Social Education and Occupational therapy. The study design was convergent mixed research design. The ethical considerations and process of data collection are explained by the authors. The EBP teaching steps included, Reflect, Ask, Acquire, Appraise, Apply and Evaluate. Also, participants were asked to critically reflect on the health claims made by media. Critical thinking is an essential ability required for health care professionals. Collected data were analyzed collectively across all the four disciplines. Quantitative data were collected through a questionnaire and qualitative data were collected through FGDs. The researchers collected positive feedback about the course from the participants. The major outcomes were that critical reflection on health claims was a useful entry point for EBP the blended learning design had a positive influence on the students’ perceived learning outcomes and that the collaborative group exam assignment promoted both critical reflection and positively impacted perceived learning outcomes. Strengths of the study The EBHC course and its implementation along with blended learning, critical thinking is very good. The Collaborative group exam is a new method included in the study. The data collection process is explained well. Weakness The research approach is mentioned as convergent mixed methods. Since there is a quantitative and qualitative strand for the design, it requires clear objective for each of the strands separately and then for the mixed integrative aspect also. On page 13, under the title of ‘Results from the mixed methods synthesis’, the researchers have clearly given each of the strands evaluated what, as well as the main outcomes. Hence it is expected to give the clear objectives which will give more clarity for the mixed methods research approach utilized by the researchers. (Major) The participants for the qualitative phase are taken by convenience, instead some criteria-based selection would have been better. The FG group discussion audio recording would have been much better to validate the data. Suggestions Apart from the above comments the following also may be noted and rectified: Under the heading ‘Objective” the sentence starts like ‘The study aimed to explore” it may be given as an objective statement. The first two sentences under “The EBHC Course” (Page 5) are repetitions. This may be taken care of. Relevance This study is quite relevant for the health care profession, as EBP is essential to ensure high quality safe health care services. The critical thinking and blended learning approach is very good in teaching EBP. Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? Yes Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Yes Competing Interests: No competing interests were disclosed. Reviewer Expertise: Adolescent Health, Migraine, Hypertension, Child safety and IPE I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT George A. Reviewer Report For: Experiences Using Media Health Claims to Teach Evidence-Based Practice to Healthcare Students: A Mixed Methods Study [version 3; peer review: 3 approved, 1 approved with reservations] . F1000Research 2025, 13 :224 ( https://doi.org/10.5256/f1000research.171631.r337008 ) The direct URL for this report is: https://f1000research.com/articles/13-224/v2#referee-response-337008 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Author Response 28 Jan 2025 Ida-Kristin Orjasaeter Elvsaas , Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, 0130, Norway 28 Jan 2025 Author Response We greatly appreciate Dr. Anice George’s insightful feedback on our article regarding students' experiences with our EBHC course. Your feedback has been carefully considered, and the following responses address your ... Continue reading We greatly appreciate Dr. Anice George’s insightful feedback on our article regarding students' experiences with our EBHC course. Your feedback has been carefully considered, and the following responses address your comments. We hope that the revisions and clarifications will meet your expectations. The research approach is mentioned as convergent mixed methods. Since there is a quantitative and qualitative strand for the design, it requires clear objective for each of the strands separately and then for the mixed integrative aspect also. On page 13, under the title of ‘Results from the mixed methods synthesis’, the researchers have clearly given each of the strands evaluated what, as well as the main outcomes. Hence it is expected to give the clear objectives which will give more clarity for the mixed methods research approach utilized by the researchers. (Major) Response from the authors: We recognize that the research design requires objectives for both the quantitative and qualitative components, as well as a rationale for integrating the datasets. We have revised the article accordingly. The participants for the qualitative phase are taken by convenience, instead some criteria-based selection would have been better. Response from the authors: The eligibility criteria for participation in the focus group interviews was that students had to have completed the EBHC course. In the revised article, we have rephrased the relevant sentence to include this. The FG group discussion audio recording would have been much better to validate the data. Response from the authors: We fully agree that the best course of action would have been to audio-record the focus group interviews. However, this was not feasible in our study. Instead, two note-takers took individual notes from the discussions. To ensure equal understanding of the discussions, the notes were compared and discussed by both the note-takers and the moderator immediately after the focus group interviews. Any discrepancies were resolved by consensus. Given the circumstances, this was the only way we could ensure the validity of the notes in this study. Suggestions Apart from the above comments the following also may be noted and rectified: Under the heading ‘Objective” the sentence starts like ‘The study aimed to explore” it may be given as an objective statement. Response from the authors: In response to the suggestion, we have rephrased this sentence in the revised article. The first two sentences under “The EBHC Course” (Page 5) are repetitions. This may be taken care of. Response from the authors: We appreciate the observation, and the repeated sentence has been removed from the revised article. We greatly appreciate Dr. Anice George’s insightful feedback on our article regarding students' experiences with our EBHC course. Your feedback has been carefully considered, and the following responses address your comments. We hope that the revisions and clarifications will meet your expectations. The research approach is mentioned as convergent mixed methods. Since there is a quantitative and qualitative strand for the design, it requires clear objective for each of the strands separately and then for the mixed integrative aspect also. On page 13, under the title of ‘Results from the mixed methods synthesis’, the researchers have clearly given each of the strands evaluated what, as well as the main outcomes. Hence it is expected to give the clear objectives which will give more clarity for the mixed methods research approach utilized by the researchers. (Major) Response from the authors: We recognize that the research design requires objectives for both the quantitative and qualitative components, as well as a rationale for integrating the datasets. We have revised the article accordingly. The participants for the qualitative phase are taken by convenience, instead some criteria-based selection would have been better. Response from the authors: The eligibility criteria for participation in the focus group interviews was that students had to have completed the EBHC course. In the revised article, we have rephrased the relevant sentence to include this. The FG group discussion audio recording would have been much better to validate the data. Response from the authors: We fully agree that the best course of action would have been to audio-record the focus group interviews. However, this was not feasible in our study. Instead, two note-takers took individual notes from the discussions. To ensure equal understanding of the discussions, the notes were compared and discussed by both the note-takers and the moderator immediately after the focus group interviews. Any discrepancies were resolved by consensus. Given the circumstances, this was the only way we could ensure the validity of the notes in this study. Suggestions Apart from the above comments the following also may be noted and rectified: Under the heading ‘Objective” the sentence starts like ‘The study aimed to explore” it may be given as an objective statement. Response from the authors: In response to the suggestion, we have rephrased this sentence in the revised article. The first two sentences under “The EBHC Course” (Page 5) are repetitions. This may be taken care of. Response from the authors: We appreciate the observation, and the repeated sentence has been removed from the revised article. Competing Interests: No competing interests. Close Report a concern Respond or Comment COMMENTS ON THIS REPORT Author Response 28 Jan 2025 Ida-Kristin Orjasaeter Elvsaas , Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, 0130, Norway 28 Jan 2025 Author Response We greatly appreciate Dr. Anice George’s insightful feedback on our article regarding students' experiences with our EBHC course. Your feedback has been carefully considered, and the following responses address your ... Continue reading We greatly appreciate Dr. Anice George’s insightful feedback on our article regarding students' experiences with our EBHC course. Your feedback has been carefully considered, and the following responses address your comments. We hope that the revisions and clarifications will meet your expectations. The research approach is mentioned as convergent mixed methods. Since there is a quantitative and qualitative strand for the design, it requires clear objective for each of the strands separately and then for the mixed integrative aspect also. On page 13, under the title of ‘Results from the mixed methods synthesis’, the researchers have clearly given each of the strands evaluated what, as well as the main outcomes. Hence it is expected to give the clear objectives which will give more clarity for the mixed methods research approach utilized by the researchers. (Major) Response from the authors: We recognize that the research design requires objectives for both the quantitative and qualitative components, as well as a rationale for integrating the datasets. We have revised the article accordingly. The participants for the qualitative phase are taken by convenience, instead some criteria-based selection would have been better. Response from the authors: The eligibility criteria for participation in the focus group interviews was that students had to have completed the EBHC course. In the revised article, we have rephrased the relevant sentence to include this. The FG group discussion audio recording would have been much better to validate the data. Response from the authors: We fully agree that the best course of action would have been to audio-record the focus group interviews. However, this was not feasible in our study. Instead, two note-takers took individual notes from the discussions. To ensure equal understanding of the discussions, the notes were compared and discussed by both the note-takers and the moderator immediately after the focus group interviews. Any discrepancies were resolved by consensus. Given the circumstances, this was the only way we could ensure the validity of the notes in this study. Suggestions Apart from the above comments the following also may be noted and rectified: Under the heading ‘Objective” the sentence starts like ‘The study aimed to explore” it may be given as an objective statement. Response from the authors: In response to the suggestion, we have rephrased this sentence in the revised article. The first two sentences under “The EBHC Course” (Page 5) are repetitions. This may be taken care of. Response from the authors: We appreciate the observation, and the repeated sentence has been removed from the revised article. We greatly appreciate Dr. Anice George’s insightful feedback on our article regarding students' experiences with our EBHC course. Your feedback has been carefully considered, and the following responses address your comments. We hope that the revisions and clarifications will meet your expectations. The research approach is mentioned as convergent mixed methods. Since there is a quantitative and qualitative strand for the design, it requires clear objective for each of the strands separately and then for the mixed integrative aspect also. On page 13, under the title of ‘Results from the mixed methods synthesis’, the researchers have clearly given each of the strands evaluated what, as well as the main outcomes. Hence it is expected to give the clear objectives which will give more clarity for the mixed methods research approach utilized by the researchers. (Major) Response from the authors: We recognize that the research design requires objectives for both the quantitative and qualitative components, as well as a rationale for integrating the datasets. We have revised the article accordingly. The participants for the qualitative phase are taken by convenience, instead some criteria-based selection would have been better. Response from the authors: The eligibility criteria for participation in the focus group interviews was that students had to have completed the EBHC course. In the revised article, we have rephrased the relevant sentence to include this. The FG group discussion audio recording would have been much better to validate the data. Response from the authors: We fully agree that the best course of action would have been to audio-record the focus group interviews. However, this was not feasible in our study. Instead, two note-takers took individual notes from the discussions. To ensure equal understanding of the discussions, the notes were compared and discussed by both the note-takers and the moderator immediately after the focus group interviews. Any discrepancies were resolved by consensus. Given the circumstances, this was the only way we could ensure the validity of the notes in this study. Suggestions Apart from the above comments the following also may be noted and rectified: Under the heading ‘Objective” the sentence starts like ‘The study aimed to explore” it may be given as an objective statement. Response from the authors: In response to the suggestion, we have rephrased this sentence in the revised article. The first two sentences under “The EBHC Course” (Page 5) are repetitions. This may be taken care of. Response from the authors: We appreciate the observation, and the repeated sentence has been removed from the revised article. Competing Interests: No competing interests. Close Report a concern COMMENT ON THIS REPORT Views 0 Cite How to cite this report: Gilligan C. Reviewer Report For: Experiences Using Media Health Claims to Teach Evidence-Based Practice to Healthcare Students: A Mixed Methods Study [version 3; peer review: 3 approved, 1 approved with reservations] . F1000Research 2025, 13 :224 ( https://doi.org/10.5256/f1000research.171631.r324328 ) The direct URL for this report is: https://f1000research.com/articles/13-224/v2#referee-response-324328 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 07 Oct 2024 Conor Gilligan , Bond University, Robina, Queensland, Australia Approved VIEWS 0 https://doi.org/10.5256/f1000research.171631.r324328 I am happy to accept the responses made by ... Continue reading READ ALL I am happy to accept the responses made by the authors and appreciate their comprehensive consideration of each point. Competing Interests: No competing interests were disclosed. Reviewer Expertise: Medical Education, Public Health, Social Sciences, Healthcare Communication I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Gilligan C. Reviewer Report For: Experiences Using Media Health Claims to Teach Evidence-Based Practice to Healthcare Students: A Mixed Methods Study [version 3; peer review: 3 approved, 1 approved with reservations] . F1000Research 2025, 13 :224 ( https://doi.org/10.5256/f1000research.171631.r324328 ) The direct URL for this report is: https://f1000research.com/articles/13-224/v2#referee-response-324328 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Version 1 VERSION 1 PUBLISHED 27 Mar 2024 Views 0 Cite How to cite this report: Gilligan C. Reviewer Report For: Experiences Using Media Health Claims to Teach Evidence-Based Practice to Healthcare Students: A Mixed Methods Study [version 3; peer review: 3 approved, 1 approved with reservations] . F1000Research 2025, 13 :224 ( https://doi.org/10.5256/f1000research.160754.r285772 ) The direct URL for this report is: https://f1000research.com/articles/13-224/v1#referee-response-285772 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 04 Jul 2024 Conor Gilligan , Bond University, Robina, Queensland, Australia Approved with Reservations VIEWS 0 https://doi.org/10.5256/f1000research.160754.r285772 The paper is well written and clear. The limitation of the evaluation to very low-level outcomes (student perceptions) needs to be acknowledged. The paper is set up (though title and abstract) as focussing on the health claims ... Continue reading READ ALL The paper is well written and clear. The limitation of the evaluation to very low-level outcomes (student perceptions) needs to be acknowledged. The paper is set up (though title and abstract) as focussing on the health claims aspect but in fact the evaluation and results focus more on the course as a whole including the groupwork approaches and learning management system. The authors could focus the presented results and discussion more on the health claims aspect to make the paper more concise and aligned with their research question. Please also consider: The demographics of participants is provided but to what extent are participants representative of those enrolled in the course? Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Partly If applicable, is the statistical analysis and its interpretation appropriate? Partly Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Yes Competing Interests: No competing interests were disclosed. Reviewer Expertise: Medical Education, Public Health, Social Sciences, Healthcare Communication I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Gilligan C. Reviewer Report For: Experiences Using Media Health Claims to Teach Evidence-Based Practice to Healthcare Students: A Mixed Methods Study [version 3; peer review: 3 approved, 1 approved with reservations] . F1000Research 2025, 13 :224 ( https://doi.org/10.5256/f1000research.160754.r285772 ) The direct URL for this report is: https://f1000research.com/articles/13-224/v1#referee-response-285772 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Author Response 17 Sep 2024 Ida-Kristin Orjasaeter Elvsaas , Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, 0130, Norway 17 Sep 2024 Author Response Dear Dr. Gilligan, We appreciate the insightful feedback on our article about students' experiences with our EBHC course. We have carefully considered your feedback and addressed your comments in ... Continue reading Dear Dr. Gilligan, We appreciate the insightful feedback on our article about students' experiences with our EBHC course. We have carefully considered your feedback and addressed your comments in the responses that follow. We hope that the revisions and clarifications will meet your expectations. Reviewers feedback : The limitation of the evaluation to very low-level outcomes (student perceptions) needs to be acknowledged. Response : We have revised the title, abstract, and main body of the article to reflect that this study reports student experiences with our course and that no causal inference can be drawn based on our findings. Reviewers feedback : The paper is set up (though title and abstract) as focussing on the health claims aspect but in fact the evaluation and results focus more on the course as a whole including the groupwork approaches and learning management system. The authors could focus the presented results and discussion more on the health claims aspect to make the paper more concise and aligned with their research question. Response : We recognize that our article is comprehensive and could have potentially been condensed. However, media health claims are intricately incorporated throughout the course. We regret our inability to explicitly state that health claims formed a crucial part of our learning design. The article has been revised to indicate that this study evaluated the full EBHC course, wherein health claims were consistently used to achieve learning outcomes through both the learning activities and the group exam assignment. Reviewers feedback: Please also consider: The demographics of participants is provided but to what extent are participants representative of those enrolled in the course? Response : Most of the study participants were women, constituting 79.4% of the sample. The included sample broadly mirrors the overall gender distribution of students enrolled in the EBHC course, with women constituting about 78% of the enrolled student body. The Limitations section of the article has been updated with this information. Once again, we would like to express our gratitude for your constructive feedback and valuable suggestions, which have helped to improve the quality of our article. Dear Dr. Gilligan, We appreciate the insightful feedback on our article about students' experiences with our EBHC course. We have carefully considered your feedback and addressed your comments in the responses that follow. We hope that the revisions and clarifications will meet your expectations. Reviewers feedback : The limitation of the evaluation to very low-level outcomes (student perceptions) needs to be acknowledged. Response : We have revised the title, abstract, and main body of the article to reflect that this study reports student experiences with our course and that no causal inference can be drawn based on our findings. Reviewers feedback : The paper is set up (though title and abstract) as focussing on the health claims aspect but in fact the evaluation and results focus more on the course as a whole including the groupwork approaches and learning management system. The authors could focus the presented results and discussion more on the health claims aspect to make the paper more concise and aligned with their research question. Response : We recognize that our article is comprehensive and could have potentially been condensed. However, media health claims are intricately incorporated throughout the course. We regret our inability to explicitly state that health claims formed a crucial part of our learning design. The article has been revised to indicate that this study evaluated the full EBHC course, wherein health claims were consistently used to achieve learning outcomes through both the learning activities and the group exam assignment. Reviewers feedback: Please also consider: The demographics of participants is provided but to what extent are participants representative of those enrolled in the course? Response : Most of the study participants were women, constituting 79.4% of the sample. The included sample broadly mirrors the overall gender distribution of students enrolled in the EBHC course, with women constituting about 78% of the enrolled student body. The Limitations section of the article has been updated with this information. Once again, we would like to express our gratitude for your constructive feedback and valuable suggestions, which have helped to improve the quality of our article. Competing Interests: No competing interests. Close Report a concern Respond or Comment COMMENTS ON THIS REPORT Author Response 17 Sep 2024 Ida-Kristin Orjasaeter Elvsaas , Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, 0130, Norway 17 Sep 2024 Author Response Dear Dr. Gilligan, We appreciate the insightful feedback on our article about students' experiences with our EBHC course. We have carefully considered your feedback and addressed your comments in ... Continue reading Dear Dr. Gilligan, We appreciate the insightful feedback on our article about students' experiences with our EBHC course. We have carefully considered your feedback and addressed your comments in the responses that follow. We hope that the revisions and clarifications will meet your expectations. Reviewers feedback : The limitation of the evaluation to very low-level outcomes (student perceptions) needs to be acknowledged. Response : We have revised the title, abstract, and main body of the article to reflect that this study reports student experiences with our course and that no causal inference can be drawn based on our findings. Reviewers feedback : The paper is set up (though title and abstract) as focussing on the health claims aspect but in fact the evaluation and results focus more on the course as a whole including the groupwork approaches and learning management system. The authors could focus the presented results and discussion more on the health claims aspect to make the paper more concise and aligned with their research question. Response : We recognize that our article is comprehensive and could have potentially been condensed. However, media health claims are intricately incorporated throughout the course. We regret our inability to explicitly state that health claims formed a crucial part of our learning design. The article has been revised to indicate that this study evaluated the full EBHC course, wherein health claims were consistently used to achieve learning outcomes through both the learning activities and the group exam assignment. Reviewers feedback: Please also consider: The demographics of participants is provided but to what extent are participants representative of those enrolled in the course? Response : Most of the study participants were women, constituting 79.4% of the sample. The included sample broadly mirrors the overall gender distribution of students enrolled in the EBHC course, with women constituting about 78% of the enrolled student body. The Limitations section of the article has been updated with this information. Once again, we would like to express our gratitude for your constructive feedback and valuable suggestions, which have helped to improve the quality of our article. Dear Dr. Gilligan, We appreciate the insightful feedback on our article about students' experiences with our EBHC course. We have carefully considered your feedback and addressed your comments in the responses that follow. We hope that the revisions and clarifications will meet your expectations. Reviewers feedback : The limitation of the evaluation to very low-level outcomes (student perceptions) needs to be acknowledged. Response : We have revised the title, abstract, and main body of the article to reflect that this study reports student experiences with our course and that no causal inference can be drawn based on our findings. Reviewers feedback : The paper is set up (though title and abstract) as focussing on the health claims aspect but in fact the evaluation and results focus more on the course as a whole including the groupwork approaches and learning management system. The authors could focus the presented results and discussion more on the health claims aspect to make the paper more concise and aligned with their research question. Response : We recognize that our article is comprehensive and could have potentially been condensed. However, media health claims are intricately incorporated throughout the course. We regret our inability to explicitly state that health claims formed a crucial part of our learning design. The article has been revised to indicate that this study evaluated the full EBHC course, wherein health claims were consistently used to achieve learning outcomes through both the learning activities and the group exam assignment. Reviewers feedback: Please also consider: The demographics of participants is provided but to what extent are participants representative of those enrolled in the course? Response : Most of the study participants were women, constituting 79.4% of the sample. The included sample broadly mirrors the overall gender distribution of students enrolled in the EBHC course, with women constituting about 78% of the enrolled student body. The Limitations section of the article has been updated with this information. Once again, we would like to express our gratitude for your constructive feedback and valuable suggestions, which have helped to improve the quality of our article. Competing Interests: No competing interests. Close Report a concern COMMENT ON THIS REPORT Views 0 Cite How to cite this report: Romney W. Reviewer Report For: Experiences Using Media Health Claims to Teach Evidence-Based Practice to Healthcare Students: A Mixed Methods Study [version 3; peer review: 3 approved, 1 approved with reservations] . F1000Research 2025, 13 :224 ( https://doi.org/10.5256/f1000research.160754.r260812 ) The direct URL for this report is: https://f1000research.com/articles/13-224/v1#referee-response-260812 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 26 Apr 2024 Wendy Romney , Department of Physical Therapy and Human Movement Science, Sacred Heart University, Fairfield, Connecticut, USA Approved with Reservations VIEWS 0 https://doi.org/10.5256/f1000research.160754.r260812 This article highlights a novel teaching approach to evidence based practice using media health claims. It uses mixed methods to evaluate the teaching approach from a variety of students who completed the course. It is well written and clear. ... Continue reading READ ALL This article highlights a novel teaching approach to evidence based practice using media health claims. It uses mixed methods to evaluate the teaching approach from a variety of students who completed the course. It is well written and clear. In terms of citations: consider other EBP research in physiotherapy: 1. Kaplan S et al, 2016 [Ref 1] 2.Chen Y et al, 2023 [Ref 2] Minor recommendations: Consider naming, add “media” health claims in the title and define it by providing an example right away. Provide a “behind the headlines” example so it is clear what health claims means. The reader is left to guess what this could mean until they click on a link. I thought about insurance claims. A worked example would also provide the reader with the ability to reproduce the course. Please also describe the course. 3 weeks, how many hours? Was the course split between blending learning and flipped classroom? A general outline would be helpful. Is it possible to compare the sample that consented to the sex of students in each of the classes? Also compare the sizes of the program in general to the response rate? For example, of the 446 eligible, what % were from each program? Was the response rate comparable across program types? Table 1. Please provide all 5 of the IHC Key Concepts that were used versus just 3. The reader is left to click on the link to find the 49 key concept. Under data collection: please describe 'the learning outcomes were further explored through eight questions'- what are these eight questions? Suggestion summarizing eight questions as ‘other learning strategies used’ or refer to table 3. Methods: Is it possible to see if there were any differences in quantitative data between program type? Separate courses were conducted for each program and focus groups were conducted by program type, yet the quantitative analysis isn’t separated. Even though the shell was the same, some course instructors may have been different in delivery and could explain some of the findings. Or not, but then the discussion could include information on that as support for the flipped classroom style. Please write out IHC the first time and describe the IHC key concept framework for those who are not familiar with it. It appears to just be published. How were 5 key concepts were selected from the 49? Are the 5 key concepts the lower rows on table 1? Details of this are needed. Please update citation on the IHC key concepts: https://f1000research.com/articles/11-890 Is the work clearly and accurately presented and does it cite the current literature? Partly Is the study design appropriate and is the work technically sound? Partly Are sufficient details of methods and analysis provided to allow replication by others? Partly If applicable, is the statistical analysis and its interpretation appropriate? Partly Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Yes References 1. Kaplan S, Tilson J, Levine D, George S, et al.: Strategies for Using the APTA Section on Research Evidence-Based Practice Curriculum Guidelines. Journal of Physical Therapy Education . 2016; 30 (2): 23-31 Publisher Full Text 2. Chen Y, Selby-Silverstein L, Greenberger HB, Gobert D, et al.: Evidence-Based Practice Doctor of Physical Therapy Curricular Guideline Utilization: A Convergent Parallel Mixed Methods Study. J Phys Ther Educ . 2023; 37 (1): 9-16 PubMed Abstract | Publisher Full Text Competing Interests: No competing interests were disclosed. Reviewer Expertise: Physical Therapy, Evidence Based Practice, Education I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Romney W. Reviewer Report For: Experiences Using Media Health Claims to Teach Evidence-Based Practice to Healthcare Students: A Mixed Methods Study [version 3; peer review: 3 approved, 1 approved with reservations] . F1000Research 2025, 13 :224 ( https://doi.org/10.5256/f1000research.160754.r260812 ) The direct URL for this report is: https://f1000research.com/articles/13-224/v1#referee-response-260812 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Author Response 17 Sep 2024 Ida-Kristin Orjasaeter Elvsaas , Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, 0130, Norway 17 Sep 2024 Author Response Dear Dr. Romney, We are grateful for your insightful feedback on our article regarding students' experiences with our EBHC course. We have thoroughly considered your suggestions and addressed your comments ... Continue reading Dear Dr. Romney, We are grateful for your insightful feedback on our article regarding students' experiences with our EBHC course. We have thoroughly considered your suggestions and addressed your comments in the subsequent responses. We sincerely apologize for the delay in our response and greatly appreciate your patience. We hope that you will find the modifications we have made to the article and the explanations provided below satisfactory. Reviewers comment : In terms of citations: consider other EBP research in physiotherapy: 1. Kaplan S et al, 2016 [Ref 1] 2.Chen Y et al, 2023 [Ref 2] Response : We appreciate your input on the literature. However, we find that these references may not be entirely relevant to our study, which encompasses healthcare students more broadly. In the revised version, we have introduced multiple clarifications about our learning design, hoping to shed more light on the structure of our EBHC course. Elaboration : In our enthusiasm to disseminate the students' experiences with our course, we may have inadvertently overlooked the inclusion of sufficient detail about the specific Norwegian context within which EBP is taught. In Norway, we have spent considerable time developing an approach to EBP education based on the Norwegian adaption of the CASP model (detailed (in Norwegian) in: Tuntland H, Nordheim L. Teaching and learning in evidence-based practice. Presentation of the CASP-model, Ergoterapauten. 2009;9), which has been adopted by most Norwegian institutions teaching EBP. Our unique contribution to this learning design involves the consistent integration of health claims, the encouragement of active student learning through a blended learning approach, and the application of a group exam to assess the course's learning outcomes. Our main objective was to explore students' experiences with these added components. We hope that our revisions provide a more detailed understanding of our study. Despite being set in a Norwegian context, we believe this study may capture the interest of those looking to integrate similar elements into their own EBP context. Reviewers comment : Consider naming, add “media” health claims in the title and define it by providing an example right away. Provide a “behind the headlines” example so it is clear what health claims means. The reader is left to guess what this could mean until they click on a link. I thought about insurance claims. A worked example would also provide the reader with the ability to reproduce the course. Please also describe the course. 3 weeks, how many hours? Was the course split between blending learning and flipped classroom? A general outline would be helpful. Response : We have updated the title to include the term "media health claims" and have emphasized that this study focuses on students' experiences with our course. We have also added generic examples of health claims in the Background section and real examples from exam assignments in the section about the exam paper. Our initial plan was to employ a flipped classroom approach. However, the course implementation leaned towards a broader blended learning approach, which included elements from the flipped classroom approach. We have added a general course description to the article, while details (the course's general timetable) can be found in the extended data file. Reviewers comment : Is it possible to compare the sample that consented to the sex of students in each of the classes? Also compare the sizes of the program in general to the response rate? For example, of the 446 eligible, what % were from each program? Was the response rate comparable across program types? Response : During the revision process, an error was identified in the count of eligible participants for the EBHC course. The corrected total of participants is 465, including 70 eligible bioengineering students, 159 eligible physiotherapy students, 161 eligible social education students, and 75 eligible occupational therapy students. Consequently, the overall response rate, following the correction of the total number of eligible students, is 29.2%. The response rate, relative to the number of students in each study program, was as follows: bioengineering (48.6%), physiotherapy (27.7%), social education (19.9%), and occupational therapy (34.7%). There could be several factors influencing a student's decision to respond to our voluntary evaluation questions. Still, the differences in response rates between the study programs are not deemed relevant to our overall aim with the study. The quantitative portion serves as one of three sources for gaining insights about the general experiences of healthcare students with our course. This point has been emphasized by extending the Limitations section of the article. Reviewers comment : Table 1. Please provide all 5 of the IHC Key Concepts that were used versus just 3. The reader is left to click on the link to find the 49 key concept. Response : A new table that better captures the five key concepts taught in "Behind the Headlines" is included in the revised article. Reviewers comment : Under data collection: please describe 'the learning outcomes were further explored through eight questions'- what are these eight questions? Suggestion summarizing eight questions as ‘other learning strategies used’ or refer to table 3. Response : We have restructured this sentence to enhance its readability and comprehension. Reviewers comment : Methods: Is it possible to see if there were any differences in quantitative data between program type? Separate courses were conducted for each program and focus groups were conducted by program type, yet the quantitative analysis isn’t separated. Even though the shell was the same, some course instructors may have been different in delivery and could explain some of the findings. Or not, but then the discussion could include information on that as support for the flipped classroom style. Response : The quantitative and qualitative data were independently collected for each study program. However, all datasets were collectively analyzed across disciplines during the analysis phase, separate and in a joint display. Our approach was informed by our primary objective of gathering experiences from students across various healthcare disciplines, rather than investigating the differences between these fields. While the quotations drawn from the qualitative datasets are presented with their associated study specializations, this method was implemented primarily due to its customary application in qualitative research. We endeavored to select quotes from diverse fields of study, underscoring the universality of these perceptions across all disciplines. However, to prevent an emphasis on study specializations, we have now omitted the students' study affiliation associated with their quotes in the revised article. Furthermore, the article has been updated with a new section to describe the learning activity structure, which was comparable across disciplines. Reviewers comment : Please write out IHC the first time and describe the IHC key concept framework for those who are not familiar with it. It appears to just be published. How were 5 key concepts were selected from the 49? Are the 5 key concepts the lower rows on table 1? Details of this are needed. Please update citation on the IHC key concepts: https://f1000research.com/articles/11-890 Response : The present study is partly part of a broader "Behind the Headlines" project at OsloMet, which commenced in 2018. During the initial stages of this project, lectures at OsloMet, external researchers, and students collaborated to identify IHC Key Concepts deemed essential for assessing health claims, resulting in the inclusion of five concepts. This initial phase of the project is detailed in Oxman M, Habib L, Jamtvedt G, Kalsnes B, Molin M. Using claims in the media to teach essential concepts for evidence-based healthcare. BMJ Evidence-Based Medicine. 2021;26(5):234-6. We have updated our article with a brief description of the original “Behind the Headlines” learning design, which was implemented in a condensed form in our EBHC course. Additionally, the five key concepts included in the EBHC course are those presented in the lower rows of Table 1. However, in the revised version of the article, we have provided an alternative overview of the key concepts used. The citation is also updated. Once again, we would like to express our gratitude for your insightful comments and valuable suggestions, which have greatly contributed to enhancing the quality of our article. Dear Dr. Romney, We are grateful for your insightful feedback on our article regarding students' experiences with our EBHC course. We have thoroughly considered your suggestions and addressed your comments in the subsequent responses. We sincerely apologize for the delay in our response and greatly appreciate your patience. We hope that you will find the modifications we have made to the article and the explanations provided below satisfactory. Reviewers comment : In terms of citations: consider other EBP research in physiotherapy: 1. Kaplan S et al, 2016 [Ref 1] 2.Chen Y et al, 2023 [Ref 2] Response : We appreciate your input on the literature. However, we find that these references may not be entirely relevant to our study, which encompasses healthcare students more broadly. In the revised version, we have introduced multiple clarifications about our learning design, hoping to shed more light on the structure of our EBHC course. Elaboration : In our enthusiasm to disseminate the students' experiences with our course, we may have inadvertently overlooked the inclusion of sufficient detail about the specific Norwegian context within which EBP is taught. In Norway, we have spent considerable time developing an approach to EBP education based on the Norwegian adaption of the CASP model (detailed (in Norwegian) in: Tuntland H, Nordheim L. Teaching and learning in evidence-based practice. Presentation of the CASP-model, Ergoterapauten. 2009;9), which has been adopted by most Norwegian institutions teaching EBP. Our unique contribution to this learning design involves the consistent integration of health claims, the encouragement of active student learning through a blended learning approach, and the application of a group exam to assess the course's learning outcomes. Our main objective was to explore students' experiences with these added components. We hope that our revisions provide a more detailed understanding of our study. Despite being set in a Norwegian context, we believe this study may capture the interest of those looking to integrate similar elements into their own EBP context. Reviewers comment : Consider naming, add “media” health claims in the title and define it by providing an example right away. Provide a “behind the headlines” example so it is clear what health claims means. The reader is left to guess what this could mean until they click on a link. I thought about insurance claims. A worked example would also provide the reader with the ability to reproduce the course. Please also describe the course. 3 weeks, how many hours? Was the course split between blending learning and flipped classroom? A general outline would be helpful. Response : We have updated the title to include the term "media health claims" and have emphasized that this study focuses on students' experiences with our course. We have also added generic examples of health claims in the Background section and real examples from exam assignments in the section about the exam paper. Our initial plan was to employ a flipped classroom approach. However, the course implementation leaned towards a broader blended learning approach, which included elements from the flipped classroom approach. We have added a general course description to the article, while details (the course's general timetable) can be found in the extended data file. Reviewers comment : Is it possible to compare the sample that consented to the sex of students in each of the classes? Also compare the sizes of the program in general to the response rate? For example, of the 446 eligible, what % were from each program? Was the response rate comparable across program types? Response : During the revision process, an error was identified in the count of eligible participants for the EBHC course. The corrected total of participants is 465, including 70 eligible bioengineering students, 159 eligible physiotherapy students, 161 eligible social education students, and 75 eligible occupational therapy students. Consequently, the overall response rate, following the correction of the total number of eligible students, is 29.2%. The response rate, relative to the number of students in each study program, was as follows: bioengineering (48.6%), physiotherapy (27.7%), social education (19.9%), and occupational therapy (34.7%). There could be several factors influencing a student's decision to respond to our voluntary evaluation questions. Still, the differences in response rates between the study programs are not deemed relevant to our overall aim with the study. The quantitative portion serves as one of three sources for gaining insights about the general experiences of healthcare students with our course. This point has been emphasized by extending the Limitations section of the article. Reviewers comment : Table 1. Please provide all 5 of the IHC Key Concepts that were used versus just 3. The reader is left to click on the link to find the 49 key concept. Response : A new table that better captures the five key concepts taught in "Behind the Headlines" is included in the revised article. Reviewers comment : Under data collection: please describe 'the learning outcomes were further explored through eight questions'- what are these eight questions? Suggestion summarizing eight questions as ‘other learning strategies used’ or refer to table 3. Response : We have restructured this sentence to enhance its readability and comprehension. Reviewers comment : Methods: Is it possible to see if there were any differences in quantitative data between program type? Separate courses were conducted for each program and focus groups were conducted by program type, yet the quantitative analysis isn’t separated. Even though the shell was the same, some course instructors may have been different in delivery and could explain some of the findings. Or not, but then the discussion could include information on that as support for the flipped classroom style. Response : The quantitative and qualitative data were independently collected for each study program. However, all datasets were collectively analyzed across disciplines during the analysis phase, separate and in a joint display. Our approach was informed by our primary objective of gathering experiences from students across various healthcare disciplines, rather than investigating the differences between these fields. While the quotations drawn from the qualitative datasets are presented with their associated study specializations, this method was implemented primarily due to its customary application in qualitative research. We endeavored to select quotes from diverse fields of study, underscoring the universality of these perceptions across all disciplines. However, to prevent an emphasis on study specializations, we have now omitted the students' study affiliation associated with their quotes in the revised article. Furthermore, the article has been updated with a new section to describe the learning activity structure, which was comparable across disciplines. Reviewers comment : Please write out IHC the first time and describe the IHC key concept framework for those who are not familiar with it. It appears to just be published. How were 5 key concepts were selected from the 49? Are the 5 key concepts the lower rows on table 1? Details of this are needed. Please update citation on the IHC key concepts: https://f1000research.com/articles/11-890 Response : The present study is partly part of a broader "Behind the Headlines" project at OsloMet, which commenced in 2018. During the initial stages of this project, lectures at OsloMet, external researchers, and students collaborated to identify IHC Key Concepts deemed essential for assessing health claims, resulting in the inclusion of five concepts. This initial phase of the project is detailed in Oxman M, Habib L, Jamtvedt G, Kalsnes B, Molin M. Using claims in the media to teach essential concepts for evidence-based healthcare. BMJ Evidence-Based Medicine. 2021;26(5):234-6. We have updated our article with a brief description of the original “Behind the Headlines” learning design, which was implemented in a condensed form in our EBHC course. Additionally, the five key concepts included in the EBHC course are those presented in the lower rows of Table 1. However, in the revised version of the article, we have provided an alternative overview of the key concepts used. The citation is also updated. Once again, we would like to express our gratitude for your insightful comments and valuable suggestions, which have greatly contributed to enhancing the quality of our article. Competing Interests: No competing interests Close Report a concern Respond or Comment COMMENTS ON THIS REPORT Author Response 17 Sep 2024 Ida-Kristin Orjasaeter Elvsaas , Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, 0130, Norway 17 Sep 2024 Author Response Dear Dr. Romney, We are grateful for your insightful feedback on our article regarding students' experiences with our EBHC course. We have thoroughly considered your suggestions and addressed your comments ... Continue reading Dear Dr. Romney, We are grateful for your insightful feedback on our article regarding students' experiences with our EBHC course. We have thoroughly considered your suggestions and addressed your comments in the subsequent responses. We sincerely apologize for the delay in our response and greatly appreciate your patience. We hope that you will find the modifications we have made to the article and the explanations provided below satisfactory. Reviewers comment : In terms of citations: consider other EBP research in physiotherapy: 1. Kaplan S et al, 2016 [Ref 1] 2.Chen Y et al, 2023 [Ref 2] Response : We appreciate your input on the literature. However, we find that these references may not be entirely relevant to our study, which encompasses healthcare students more broadly. In the revised version, we have introduced multiple clarifications about our learning design, hoping to shed more light on the structure of our EBHC course. Elaboration : In our enthusiasm to disseminate the students' experiences with our course, we may have inadvertently overlooked the inclusion of sufficient detail about the specific Norwegian context within which EBP is taught. In Norway, we have spent considerable time developing an approach to EBP education based on the Norwegian adaption of the CASP model (detailed (in Norwegian) in: Tuntland H, Nordheim L. Teaching and learning in evidence-based practice. Presentation of the CASP-model, Ergoterapauten. 2009;9), which has been adopted by most Norwegian institutions teaching EBP. Our unique contribution to this learning design involves the consistent integration of health claims, the encouragement of active student learning through a blended learning approach, and the application of a group exam to assess the course's learning outcomes. Our main objective was to explore students' experiences with these added components. We hope that our revisions provide a more detailed understanding of our study. Despite being set in a Norwegian context, we believe this study may capture the interest of those looking to integrate similar elements into their own EBP context. Reviewers comment : Consider naming, add “media” health claims in the title and define it by providing an example right away. Provide a “behind the headlines” example so it is clear what health claims means. The reader is left to guess what this could mean until they click on a link. I thought about insurance claims. A worked example would also provide the reader with the ability to reproduce the course. Please also describe the course. 3 weeks, how many hours? Was the course split between blending learning and flipped classroom? A general outline would be helpful. Response : We have updated the title to include the term "media health claims" and have emphasized that this study focuses on students' experiences with our course. We have also added generic examples of health claims in the Background section and real examples from exam assignments in the section about the exam paper. Our initial plan was to employ a flipped classroom approach. However, the course implementation leaned towards a broader blended learning approach, which included elements from the flipped classroom approach. We have added a general course description to the article, while details (the course's general timetable) can be found in the extended data file. Reviewers comment : Is it possible to compare the sample that consented to the sex of students in each of the classes? Also compare the sizes of the program in general to the response rate? For example, of the 446 eligible, what % were from each program? Was the response rate comparable across program types? Response : During the revision process, an error was identified in the count of eligible participants for the EBHC course. The corrected total of participants is 465, including 70 eligible bioengineering students, 159 eligible physiotherapy students, 161 eligible social education students, and 75 eligible occupational therapy students. Consequently, the overall response rate, following the correction of the total number of eligible students, is 29.2%. The response rate, relative to the number of students in each study program, was as follows: bioengineering (48.6%), physiotherapy (27.7%), social education (19.9%), and occupational therapy (34.7%). There could be several factors influencing a student's decision to respond to our voluntary evaluation questions. Still, the differences in response rates between the study programs are not deemed relevant to our overall aim with the study. The quantitative portion serves as one of three sources for gaining insights about the general experiences of healthcare students with our course. This point has been emphasized by extending the Limitations section of the article. Reviewers comment : Table 1. Please provide all 5 of the IHC Key Concepts that were used versus just 3. The reader is left to click on the link to find the 49 key concept. Response : A new table that better captures the five key concepts taught in "Behind the Headlines" is included in the revised article. Reviewers comment : Under data collection: please describe 'the learning outcomes were further explored through eight questions'- what are these eight questions? Suggestion summarizing eight questions as ‘other learning strategies used’ or refer to table 3. Response : We have restructured this sentence to enhance its readability and comprehension. Reviewers comment : Methods: Is it possible to see if there were any differences in quantitative data between program type? Separate courses were conducted for each program and focus groups were conducted by program type, yet the quantitative analysis isn’t separated. Even though the shell was the same, some course instructors may have been different in delivery and could explain some of the findings. Or not, but then the discussion could include information on that as support for the flipped classroom style. Response : The quantitative and qualitative data were independently collected for each study program. However, all datasets were collectively analyzed across disciplines during the analysis phase, separate and in a joint display. Our approach was informed by our primary objective of gathering experiences from students across various healthcare disciplines, rather than investigating the differences between these fields. While the quotations drawn from the qualitative datasets are presented with their associated study specializations, this method was implemented primarily due to its customary application in qualitative research. We endeavored to select quotes from diverse fields of study, underscoring the universality of these perceptions across all disciplines. However, to prevent an emphasis on study specializations, we have now omitted the students' study affiliation associated with their quotes in the revised article. Furthermore, the article has been updated with a new section to describe the learning activity structure, which was comparable across disciplines. Reviewers comment : Please write out IHC the first time and describe the IHC key concept framework for those who are not familiar with it. It appears to just be published. How were 5 key concepts were selected from the 49? Are the 5 key concepts the lower rows on table 1? Details of this are needed. Please update citation on the IHC key concepts: https://f1000research.com/articles/11-890 Response : The present study is partly part of a broader "Behind the Headlines" project at OsloMet, which commenced in 2018. During the initial stages of this project, lectures at OsloMet, external researchers, and students collaborated to identify IHC Key Concepts deemed essential for assessing health claims, resulting in the inclusion of five concepts. This initial phase of the project is detailed in Oxman M, Habib L, Jamtvedt G, Kalsnes B, Molin M. Using claims in the media to teach essential concepts for evidence-based healthcare. BMJ Evidence-Based Medicine. 2021;26(5):234-6. We have updated our article with a brief description of the original “Behind the Headlines” learning design, which was implemented in a condensed form in our EBHC course. Additionally, the five key concepts included in the EBHC course are those presented in the lower rows of Table 1. However, in the revised version of the article, we have provided an alternative overview of the key concepts used. The citation is also updated. Once again, we would like to express our gratitude for your insightful comments and valuable suggestions, which have greatly contributed to enhancing the quality of our article. Dear Dr. Romney, We are grateful for your insightful feedback on our article regarding students' experiences with our EBHC course. We have thoroughly considered your suggestions and addressed your comments in the subsequent responses. We sincerely apologize for the delay in our response and greatly appreciate your patience. We hope that you will find the modifications we have made to the article and the explanations provided below satisfactory. Reviewers comment : In terms of citations: consider other EBP research in physiotherapy: 1. Kaplan S et al, 2016 [Ref 1] 2.Chen Y et al, 2023 [Ref 2] Response : We appreciate your input on the literature. However, we find that these references may not be entirely relevant to our study, which encompasses healthcare students more broadly. In the revised version, we have introduced multiple clarifications about our learning design, hoping to shed more light on the structure of our EBHC course. Elaboration : In our enthusiasm to disseminate the students' experiences with our course, we may have inadvertently overlooked the inclusion of sufficient detail about the specific Norwegian context within which EBP is taught. In Norway, we have spent considerable time developing an approach to EBP education based on the Norwegian adaption of the CASP model (detailed (in Norwegian) in: Tuntland H, Nordheim L. Teaching and learning in evidence-based practice. Presentation of the CASP-model, Ergoterapauten. 2009;9), which has been adopted by most Norwegian institutions teaching EBP. Our unique contribution to this learning design involves the consistent integration of health claims, the encouragement of active student learning through a blended learning approach, and the application of a group exam to assess the course's learning outcomes. Our main objective was to explore students' experiences with these added components. We hope that our revisions provide a more detailed understanding of our study. Despite being set in a Norwegian context, we believe this study may capture the interest of those looking to integrate similar elements into their own EBP context. Reviewers comment : Consider naming, add “media” health claims in the title and define it by providing an example right away. Provide a “behind the headlines” example so it is clear what health claims means. The reader is left to guess what this could mean until they click on a link. I thought about insurance claims. A worked example would also provide the reader with the ability to reproduce the course. Please also describe the course. 3 weeks, how many hours? Was the course split between blending learning and flipped classroom? A general outline would be helpful. Response : We have updated the title to include the term "media health claims" and have emphasized that this study focuses on students' experiences with our course. We have also added generic examples of health claims in the Background section and real examples from exam assignments in the section about the exam paper. Our initial plan was to employ a flipped classroom approach. However, the course implementation leaned towards a broader blended learning approach, which included elements from the flipped classroom approach. We have added a general course description to the article, while details (the course's general timetable) can be found in the extended data file. Reviewers comment : Is it possible to compare the sample that consented to the sex of students in each of the classes? Also compare the sizes of the program in general to the response rate? For example, of the 446 eligible, what % were from each program? Was the response rate comparable across program types? Response : During the revision process, an error was identified in the count of eligible participants for the EBHC course. The corrected total of participants is 465, including 70 eligible bioengineering students, 159 eligible physiotherapy students, 161 eligible social education students, and 75 eligible occupational therapy students. Consequently, the overall response rate, following the correction of the total number of eligible students, is 29.2%. The response rate, relative to the number of students in each study program, was as follows: bioengineering (48.6%), physiotherapy (27.7%), social education (19.9%), and occupational therapy (34.7%). There could be several factors influencing a student's decision to respond to our voluntary evaluation questions. Still, the differences in response rates between the study programs are not deemed relevant to our overall aim with the study. The quantitative portion serves as one of three sources for gaining insights about the general experiences of healthcare students with our course. This point has been emphasized by extending the Limitations section of the article. Reviewers comment : Table 1. Please provide all 5 of the IHC Key Concepts that were used versus just 3. The reader is left to click on the link to find the 49 key concept. Response : A new table that better captures the five key concepts taught in "Behind the Headlines" is included in the revised article. Reviewers comment : Under data collection: please describe 'the learning outcomes were further explored through eight questions'- what are these eight questions? Suggestion summarizing eight questions as ‘other learning strategies used’ or refer to table 3. Response : We have restructured this sentence to enhance its readability and comprehension. Reviewers comment : Methods: Is it possible to see if there were any differences in quantitative data between program type? Separate courses were conducted for each program and focus groups were conducted by program type, yet the quantitative analysis isn’t separated. Even though the shell was the same, some course instructors may have been different in delivery and could explain some of the findings. Or not, but then the discussion could include information on that as support for the flipped classroom style. Response : The quantitative and qualitative data were independently collected for each study program. However, all datasets were collectively analyzed across disciplines during the analysis phase, separate and in a joint display. Our approach was informed by our primary objective of gathering experiences from students across various healthcare disciplines, rather than investigating the differences between these fields. While the quotations drawn from the qualitative datasets are presented with their associated study specializations, this method was implemented primarily due to its customary application in qualitative research. We endeavored to select quotes from diverse fields of study, underscoring the universality of these perceptions across all disciplines. However, to prevent an emphasis on study specializations, we have now omitted the students' study affiliation associated with their quotes in the revised article. Furthermore, the article has been updated with a new section to describe the learning activity structure, which was comparable across disciplines. Reviewers comment : Please write out IHC the first time and describe the IHC key concept framework for those who are not familiar with it. It appears to just be published. How were 5 key concepts were selected from the 49? Are the 5 key concepts the lower rows on table 1? Details of this are needed. Please update citation on the IHC key concepts: https://f1000research.com/articles/11-890 Response : The present study is partly part of a broader "Behind the Headlines" project at OsloMet, which commenced in 2018. During the initial stages of this project, lectures at OsloMet, external researchers, and students collaborated to identify IHC Key Concepts deemed essential for assessing health claims, resulting in the inclusion of five concepts. This initial phase of the project is detailed in Oxman M, Habib L, Jamtvedt G, Kalsnes B, Molin M. Using claims in the media to teach essential concepts for evidence-based healthcare. BMJ Evidence-Based Medicine. 2021;26(5):234-6. We have updated our article with a brief description of the original “Behind the Headlines” learning design, which was implemented in a condensed form in our EBHC course. Additionally, the five key concepts included in the EBHC course are those presented in the lower rows of Table 1. However, in the revised version of the article, we have provided an alternative overview of the key concepts used. The citation is also updated. Once again, we would like to express our gratitude for your insightful comments and valuable suggestions, which have greatly contributed to enhancing the quality of our article. Competing Interests: No competing interests Close Report a concern COMMENT ON THIS REPORT Comments on this article Comments (0) Version 3 VERSION 3 PUBLISHED 27 Mar 2024 ADD YOUR COMMENT Comment keyboard_arrow_left keyboard_arrow_right Open Peer Review Reviewer Status info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Reviewer Reports Invited Reviewers 1 2 3 4 Version 3 (revision) 28 Jan 25 read Version 2 (revision) 17 Sep 24 read read read Version 1 27 Mar 24 read read Wendy Romney , Sacred Heart University, Fairfield, USA Conor Gilligan , Bond University, Robina, Australia Anice George , Manipal Academy of Higher Education, Manipal, India Sharon Tucker , University of Central Florida (Ringgold ID: 6243), Orlando, USA; The Ohio State University, Columbus, USA Comments on this article All Comments (0) Add a comment Sign up for content alerts Sign Up You are now signed up to receive this alert Browse by related subjects keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Romney W. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 06 Feb 2025 | for Version 3 Wendy Romney , Department of Physical Therapy and Human Movement Science, Sacred Heart University, Fairfield, Connecticut, USA 0 Views copyright © 2025 Romney W. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Thank you for your thorough revisions. I approve this submission. Competing Interests No competing interests were disclosed. Reviewer Expertise physical therapy, evidence based practice, mixed methods I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. reply Respond to this report Responses (0) Romney W. Peer Review Report For: Experiences Using Media Health Claims to Teach Evidence-Based Practice to Healthcare Students: A Mixed Methods Study [version 3; peer review: 3 approved, 1 approved with reservations] . F1000Research 2025, 13 :224 ( https://doi.org/10.5256/f1000research.177294.r363094) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/13-224/v3#referee-response-363094 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2024 Tucker S. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 28 Nov 2024 | for Version 2 Sharon Tucker , University of Central Florida (Ringgold ID: 6243), Orlando, Florida, USA; The Ohio State University, The Ohio State University, Columbus, Ohio, USA 0 Views copyright © 2024 Tucker S. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (1) Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions This revised manuscript addresses the previous reviewers' concerns. I do not find the findings (all subjective) overly robust, however, the unique approach of using media health claims to stimulate the EBP thinking process for health professions' students is innovative and meaningful. I have only a few comments for this revision. 1. Low response rate and likely biased, however this is addressed in the limitations. 2. Not sure what NOK means. 3. What is mentimeter in Figure 2? 4. I would be clear about formulating an EBP question not research in the methods. 5. I also think important to be clear (under exam assignment) that the findings should be more than one research article. This is all; overall revisions well done. Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? Yes Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Yes Competing Interests No competing interests were disclosed. Reviewer Expertise EBP, implementation science, ,intervention research I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. reply Respond to this report Responses (1) Author Response 22 Jan 2025 Ida-Kristin Orjasaeter Elvsaas, Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, 0130, Norway We appreciate Dr. Sharon Tucker’s thoughtful comments on our article about students' experiences with our EBHC course. Your feedback has been carefully considered, and the following responses address your comments. We hope that the revisions and clarifications will meet your expectations. 1. Low response rate and likely biased, however this is addressed in the limitations. Response from the authors: We appreciate Dr. Sharon Tucker's observation that we addressed the likelihood of a biased sample in the first revision of the article. 2. Not sure what NOK means. Response from the authors: NOK means Norwegian kroner. However, for ease of understanding, we have converted the value to the approximate US dollar equivalent in the revised article. 3. What is mentimeter in Figure 2? Response from the authors: Mentimeter ( https://www.mentimeter.com/ ) is a response tool that allows teachers to interact with students in real-time. We have defined Mentimeter and provided the reference in the revised article. 4. I would be clear about formulating an EBP question not research in the methods. Response from the authors: Based on this input, as well as Dr. Anice George's comment regarding the necessity of having clear objectives for each strand of the research design, we have included the research questions in the objectives section and a description of the methods used to answer these research questions in the methods section of the revised article. 5. I also think important to be clear (under exam assignment) that the findings should be more than one research article. Response from the authors: We fully agree that using results from individual studies is inconsistent with the fundamental principles of EBP. Students are trained throughout the EBHC course to use findings from systematic reviews in their decision-making, both for their own practice and in interactions with patients. In the exam task, students had to answer their PICO using a systematic review, a chapter in a clinical decision tool, or a guideline. This has been clarified in the updated article. View more View less Competing Interests No competing interests were disclosed. reply Respond Report a concern Tucker S. Peer Review Report For: Experiences Using Media Health Claims to Teach Evidence-Based Practice to Healthcare Students: A Mixed Methods Study [version 3; peer review: 3 approved, 1 approved with reservations] . F1000Research 2025, 13 :224 ( https://doi.org/10.5256/f1000research.171631.r337010) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/13-224/v2#referee-response-337010 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2024 George A. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 27 Nov 2024 | for Version 2 Anice George , Manipal Academy of Higher Education, Manipal, India 0 Views copyright © 2024 George A. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (1) Approved With Reservations info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions This article is written with clarity and explains the experiences of Health Care students, both quantitatively and qualitatively about media health claims to learn evidence-based practice. The teaching used is a blended approach incorporating interactive teaching and critical thinking process. This research is very relevant in inculcating the concept of EBP in carrying out the care responsibilities by the health care students to provide safe and quality care. The article has given explanation about the Evidence Based Practice in Health Care (EBHC) which was a three weeks course. The study participants were from Bio Engineering, Physiotherapy, Social Education and Occupational therapy. The study design was convergent mixed research design. The ethical considerations and process of data collection are explained by the authors. The EBP teaching steps included, Reflect, Ask, Acquire, Appraise, Apply and Evaluate. Also, participants were asked to critically reflect on the health claims made by media. Critical thinking is an essential ability required for health care professionals. Collected data were analyzed collectively across all the four disciplines. Quantitative data were collected through a questionnaire and qualitative data were collected through FGDs. The researchers collected positive feedback about the course from the participants. The major outcomes were that critical reflection on health claims was a useful entry point for EBP the blended learning design had a positive influence on the students’ perceived learning outcomes and that the collaborative group exam assignment promoted both critical reflection and positively impacted perceived learning outcomes. Strengths of the study The EBHC course and its implementation along with blended learning, critical thinking is very good. The Collaborative group exam is a new method included in the study. The data collection process is explained well. Weakness The research approach is mentioned as convergent mixed methods. Since there is a quantitative and qualitative strand for the design, it requires clear objective for each of the strands separately and then for the mixed integrative aspect also. On page 13, under the title of ‘Results from the mixed methods synthesis’, the researchers have clearly given each of the strands evaluated what, as well as the main outcomes. Hence it is expected to give the clear objectives which will give more clarity for the mixed methods research approach utilized by the researchers. (Major) The participants for the qualitative phase are taken by convenience, instead some criteria-based selection would have been better. The FG group discussion audio recording would have been much better to validate the data. Suggestions Apart from the above comments the following also may be noted and rectified: Under the heading ‘Objective” the sentence starts like ‘The study aimed to explore” it may be given as an objective statement. The first two sentences under “The EBHC Course” (Page 5) are repetitions. This may be taken care of. Relevance This study is quite relevant for the health care profession, as EBP is essential to ensure high quality safe health care services. The critical thinking and blended learning approach is very good in teaching EBP. Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? Yes Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Yes Competing Interests No competing interests were disclosed. Reviewer Expertise Adolescent Health, Migraine, Hypertension, Child safety and IPE I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. reply Respond to this report Responses (1) Author Response 28 Jan 2025 Ida-Kristin Orjasaeter Elvsaas, Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, 0130, Norway We greatly appreciate Dr. Anice George’s insightful feedback on our article regarding students' experiences with our EBHC course. Your feedback has been carefully considered, and the following responses address your comments. We hope that the revisions and clarifications will meet your expectations. The research approach is mentioned as convergent mixed methods. Since there is a quantitative and qualitative strand for the design, it requires clear objective for each of the strands separately and then for the mixed integrative aspect also. On page 13, under the title of ‘Results from the mixed methods synthesis’, the researchers have clearly given each of the strands evaluated what, as well as the main outcomes. Hence it is expected to give the clear objectives which will give more clarity for the mixed methods research approach utilized by the researchers. (Major) Response from the authors: We recognize that the research design requires objectives for both the quantitative and qualitative components, as well as a rationale for integrating the datasets. We have revised the article accordingly. The participants for the qualitative phase are taken by convenience, instead some criteria-based selection would have been better. Response from the authors: The eligibility criteria for participation in the focus group interviews was that students had to have completed the EBHC course. In the revised article, we have rephrased the relevant sentence to include this. The FG group discussion audio recording would have been much better to validate the data. Response from the authors: We fully agree that the best course of action would have been to audio-record the focus group interviews. However, this was not feasible in our study. Instead, two note-takers took individual notes from the discussions. To ensure equal understanding of the discussions, the notes were compared and discussed by both the note-takers and the moderator immediately after the focus group interviews. Any discrepancies were resolved by consensus. Given the circumstances, this was the only way we could ensure the validity of the notes in this study. Suggestions Apart from the above comments the following also may be noted and rectified: Under the heading ‘Objective” the sentence starts like ‘The study aimed to explore” it may be given as an objective statement. Response from the authors: In response to the suggestion, we have rephrased this sentence in the revised article. The first two sentences under “The EBHC Course” (Page 5) are repetitions. This may be taken care of. Response from the authors: We appreciate the observation, and the repeated sentence has been removed from the revised article. View more View less Competing Interests No competing interests. reply Respond Report a concern George A. Peer Review Report For: Experiences Using Media Health Claims to Teach Evidence-Based Practice to Healthcare Students: A Mixed Methods Study [version 3; peer review: 3 approved, 1 approved with reservations] . F1000Research 2025, 13 :224 ( https://doi.org/10.5256/f1000research.171631.r337008) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/13-224/v2#referee-response-337008 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2024 Gilligan C. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 07 Oct 2024 | for Version 2 Conor Gilligan , Bond University, Robina, Queensland, Australia 0 Views copyright © 2024 Gilligan C. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions I am happy to accept the responses made by the authors and appreciate their comprehensive consideration of each point. Competing Interests No competing interests were disclosed. Reviewer Expertise Medical Education, Public Health, Social Sciences, Healthcare Communication I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. reply Respond to this report Responses (0) Gilligan C. Peer Review Report For: Experiences Using Media Health Claims to Teach Evidence-Based Practice to Healthcare Students: A Mixed Methods Study [version 3; peer review: 3 approved, 1 approved with reservations] . F1000Research 2025, 13 :224 ( https://doi.org/10.5256/f1000research.171631.r324328) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/13-224/v2#referee-response-324328 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2024 Gilligan C. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 04 Jul 2024 | for Version 1 Conor Gilligan , Bond University, Robina, Queensland, Australia 0 Views copyright © 2024 Gilligan C. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (1) Approved With Reservations info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions The paper is well written and clear. The limitation of the evaluation to very low-level outcomes (student perceptions) needs to be acknowledged. The paper is set up (though title and abstract) as focussing on the health claims aspect but in fact the evaluation and results focus more on the course as a whole including the groupwork approaches and learning management system. The authors could focus the presented results and discussion more on the health claims aspect to make the paper more concise and aligned with their research question. Please also consider: The demographics of participants is provided but to what extent are participants representative of those enrolled in the course? Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Partly If applicable, is the statistical analysis and its interpretation appropriate? Partly Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Yes Competing Interests No competing interests were disclosed. Reviewer Expertise Medical Education, Public Health, Social Sciences, Healthcare Communication I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. reply Respond to this report Responses (1) Author Response 17 Sep 2024 Ida-Kristin Orjasaeter Elvsaas, Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, 0130, Norway Dear Dr. Gilligan, We appreciate the insightful feedback on our article about students' experiences with our EBHC course. We have carefully considered your feedback and addressed your comments in the responses that follow. We hope that the revisions and clarifications will meet your expectations. Reviewers feedback : The limitation of the evaluation to very low-level outcomes (student perceptions) needs to be acknowledged. Response : We have revised the title, abstract, and main body of the article to reflect that this study reports student experiences with our course and that no causal inference can be drawn based on our findings. Reviewers feedback : The paper is set up (though title and abstract) as focussing on the health claims aspect but in fact the evaluation and results focus more on the course as a whole including the groupwork approaches and learning management system. The authors could focus the presented results and discussion more on the health claims aspect to make the paper more concise and aligned with their research question. Response : We recognize that our article is comprehensive and could have potentially been condensed. However, media health claims are intricately incorporated throughout the course. We regret our inability to explicitly state that health claims formed a crucial part of our learning design. The article has been revised to indicate that this study evaluated the full EBHC course, wherein health claims were consistently used to achieve learning outcomes through both the learning activities and the group exam assignment. Reviewers feedback: Please also consider: The demographics of participants is provided but to what extent are participants representative of those enrolled in the course? Response : Most of the study participants were women, constituting 79.4% of the sample. The included sample broadly mirrors the overall gender distribution of students enrolled in the EBHC course, with women constituting about 78% of the enrolled student body. The Limitations section of the article has been updated with this information. Once again, we would like to express our gratitude for your constructive feedback and valuable suggestions, which have helped to improve the quality of our article. View more View less Competing Interests No competing interests. reply Respond Report a concern Gilligan C. Peer Review Report For: Experiences Using Media Health Claims to Teach Evidence-Based Practice to Healthcare Students: A Mixed Methods Study [version 3; peer review: 3 approved, 1 approved with reservations] . F1000Research 2025, 13 :224 ( https://doi.org/10.5256/f1000research.160754.r285772) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/13-224/v1#referee-response-285772 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2024 Romney W. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 26 Apr 2024 | for Version 1 Wendy Romney , Department of Physical Therapy and Human Movement Science, Sacred Heart University, Fairfield, Connecticut, USA 0 Views copyright © 2024 Romney W. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (1) Approved With Reservations info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions This article highlights a novel teaching approach to evidence based practice using media health claims. It uses mixed methods to evaluate the teaching approach from a variety of students who completed the course. It is well written and clear. In terms of citations: consider other EBP research in physiotherapy: 1. Kaplan S et al, 2016 [Ref 1] 2.Chen Y et al, 2023 [Ref 2] Minor recommendations: Consider naming, add “media” health claims in the title and define it by providing an example right away. Provide a “behind the headlines” example so it is clear what health claims means. The reader is left to guess what this could mean until they click on a link. I thought about insurance claims. A worked example would also provide the reader with the ability to reproduce the course. Please also describe the course. 3 weeks, how many hours? Was the course split between blending learning and flipped classroom? A general outline would be helpful. Is it possible to compare the sample that consented to the sex of students in each of the classes? Also compare the sizes of the program in general to the response rate? For example, of the 446 eligible, what % were from each program? Was the response rate comparable across program types? Table 1. Please provide all 5 of the IHC Key Concepts that were used versus just 3. The reader is left to click on the link to find the 49 key concept. Under data collection: please describe 'the learning outcomes were further explored through eight questions'- what are these eight questions? Suggestion summarizing eight questions as ‘other learning strategies used’ or refer to table 3. Methods: Is it possible to see if there were any differences in quantitative data between program type? Separate courses were conducted for each program and focus groups were conducted by program type, yet the quantitative analysis isn’t separated. Even though the shell was the same, some course instructors may have been different in delivery and could explain some of the findings. Or not, but then the discussion could include information on that as support for the flipped classroom style. Please write out IHC the first time and describe the IHC key concept framework for those who are not familiar with it. It appears to just be published. How were 5 key concepts were selected from the 49? Are the 5 key concepts the lower rows on table 1? Details of this are needed. Please update citation on the IHC key concepts: https://f1000research.com/articles/11-890 Is the work clearly and accurately presented and does it cite the current literature? Partly Is the study design appropriate and is the work technically sound? Partly Are sufficient details of methods and analysis provided to allow replication by others? Partly If applicable, is the statistical analysis and its interpretation appropriate? Partly Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Yes References 1. Kaplan S, Tilson J, Levine D, George S, et al.: Strategies for Using the APTA Section on Research Evidence-Based Practice Curriculum Guidelines. Journal of Physical Therapy Education . 2016; 30 (2): 23-31 Publisher Full Text 2. Chen Y, Selby-Silverstein L, Greenberger HB, Gobert D, et al.: Evidence-Based Practice Doctor of Physical Therapy Curricular Guideline Utilization: A Convergent Parallel Mixed Methods Study. J Phys Ther Educ . 2023; 37 (1): 9-16 PubMed Abstract | Publisher Full Text Competing Interests No competing interests were disclosed. Reviewer Expertise Physical Therapy, Evidence Based Practice, Education I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. reply Respond to this report Responses (1) Author Response 17 Sep 2024 Ida-Kristin Orjasaeter Elvsaas, Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, 0130, Norway Dear Dr. Romney, We are grateful for your insightful feedback on our article regarding students' experiences with our EBHC course. We have thoroughly considered your suggestions and addressed your comments in the subsequent responses. We sincerely apologize for the delay in our response and greatly appreciate your patience. We hope that you will find the modifications we have made to the article and the explanations provided below satisfactory. Reviewers comment : In terms of citations: consider other EBP research in physiotherapy: 1. Kaplan S et al, 2016 [Ref 1] 2.Chen Y et al, 2023 [Ref 2] Response : We appreciate your input on the literature. However, we find that these references may not be entirely relevant to our study, which encompasses healthcare students more broadly. In the revised version, we have introduced multiple clarifications about our learning design, hoping to shed more light on the structure of our EBHC course. Elaboration : In our enthusiasm to disseminate the students' experiences with our course, we may have inadvertently overlooked the inclusion of sufficient detail about the specific Norwegian context within which EBP is taught. In Norway, we have spent considerable time developing an approach to EBP education based on the Norwegian adaption of the CASP model (detailed (in Norwegian) in: Tuntland H, Nordheim L. Teaching and learning in evidence-based practice. Presentation of the CASP-model, Ergoterapauten. 2009;9), which has been adopted by most Norwegian institutions teaching EBP. Our unique contribution to this learning design involves the consistent integration of health claims, the encouragement of active student learning through a blended learning approach, and the application of a group exam to assess the course's learning outcomes. Our main objective was to explore students' experiences with these added components. We hope that our revisions provide a more detailed understanding of our study. Despite being set in a Norwegian context, we believe this study may capture the interest of those looking to integrate similar elements into their own EBP context. Reviewers comment : Consider naming, add “media” health claims in the title and define it by providing an example right away. Provide a “behind the headlines” example so it is clear what health claims means. The reader is left to guess what this could mean until they click on a link. I thought about insurance claims. A worked example would also provide the reader with the ability to reproduce the course. Please also describe the course. 3 weeks, how many hours? Was the course split between blending learning and flipped classroom? A general outline would be helpful. Response : We have updated the title to include the term "media health claims" and have emphasized that this study focuses on students' experiences with our course. We have also added generic examples of health claims in the Background section and real examples from exam assignments in the section about the exam paper. Our initial plan was to employ a flipped classroom approach. However, the course implementation leaned towards a broader blended learning approach, which included elements from the flipped classroom approach. We have added a general course description to the article, while details (the course's general timetable) can be found in the extended data file. Reviewers comment : Is it possible to compare the sample that consented to the sex of students in each of the classes? Also compare the sizes of the program in general to the response rate? For example, of the 446 eligible, what % were from each program? Was the response rate comparable across program types? Response : During the revision process, an error was identified in the count of eligible participants for the EBHC course. The corrected total of participants is 465, including 70 eligible bioengineering students, 159 eligible physiotherapy students, 161 eligible social education students, and 75 eligible occupational therapy students. Consequently, the overall response rate, following the correction of the total number of eligible students, is 29.2%. The response rate, relative to the number of students in each study program, was as follows: bioengineering (48.6%), physiotherapy (27.7%), social education (19.9%), and occupational therapy (34.7%). There could be several factors influencing a student's decision to respond to our voluntary evaluation questions. Still, the differences in response rates between the study programs are not deemed relevant to our overall aim with the study. The quantitative portion serves as one of three sources for gaining insights about the general experiences of healthcare students with our course. This point has been emphasized by extending the Limitations section of the article. Reviewers comment : Table 1. Please provide all 5 of the IHC Key Concepts that were used versus just 3. The reader is left to click on the link to find the 49 key concept. Response : A new table that better captures the five key concepts taught in "Behind the Headlines" is included in the revised article. Reviewers comment : Under data collection: please describe 'the learning outcomes were further explored through eight questions'- what are these eight questions? Suggestion summarizing eight questions as ‘other learning strategies used’ or refer to table 3. Response : We have restructured this sentence to enhance its readability and comprehension. Reviewers comment : Methods: Is it possible to see if there were any differences in quantitative data between program type? Separate courses were conducted for each program and focus groups were conducted by program type, yet the quantitative analysis isn’t separated. Even though the shell was the same, some course instructors may have been different in delivery and could explain some of the findings. Or not, but then the discussion could include information on that as support for the flipped classroom style. Response : The quantitative and qualitative data were independently collected for each study program. However, all datasets were collectively analyzed across disciplines during the analysis phase, separate and in a joint display. Our approach was informed by our primary objective of gathering experiences from students across various healthcare disciplines, rather than investigating the differences between these fields. While the quotations drawn from the qualitative datasets are presented with their associated study specializations, this method was implemented primarily due to its customary application in qualitative research. We endeavored to select quotes from diverse fields of study, underscoring the universality of these perceptions across all disciplines. However, to prevent an emphasis on study specializations, we have now omitted the students' study affiliation associated with their quotes in the revised article. Furthermore, the article has been updated with a new section to describe the learning activity structure, which was comparable across disciplines. Reviewers comment : Please write out IHC the first time and describe the IHC key concept framework for those who are not familiar with it. It appears to just be published. How were 5 key concepts were selected from the 49? Are the 5 key concepts the lower rows on table 1? Details of this are needed. Please update citation on the IHC key concepts: https://f1000research.com/articles/11-890 Response : The present study is partly part of a broader "Behind the Headlines" project at OsloMet, which commenced in 2018. During the initial stages of this project, lectures at OsloMet, external researchers, and students collaborated to identify IHC Key Concepts deemed essential for assessing health claims, resulting in the inclusion of five concepts. This initial phase of the project is detailed in Oxman M, Habib L, Jamtvedt G, Kalsnes B, Molin M. Using claims in the media to teach essential concepts for evidence-based healthcare. BMJ Evidence-Based Medicine. 2021;26(5):234-6. We have updated our article with a brief description of the original “Behind the Headlines” learning design, which was implemented in a condensed form in our EBHC course. Additionally, the five key concepts included in the EBHC course are those presented in the lower rows of Table 1. However, in the revised version of the article, we have provided an alternative overview of the key concepts used. The citation is also updated. Once again, we would like to express our gratitude for your insightful comments and valuable suggestions, which have greatly contributed to enhancing the quality of our article. View more View less Competing Interests No competing interests reply Respond Report a concern Romney W. Peer Review Report For: Experiences Using Media Health Claims to Teach Evidence-Based Practice to Healthcare Students: A Mixed Methods Study [version 3; peer review: 3 approved, 1 approved with reservations] . F1000Research 2025, 13 :224 ( https://doi.org/10.5256/f1000research.160754.r260812) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/13-224/v1#referee-response-260812 Alongside their report, reviewers assign a status to the article: Approved - the paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations - A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. 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