Discussion
The research-based activity framed in a UR programme consisting of the implementation of a real RCT in which students were involved as participants and researchers, supervised by qualified lecturers, showed positive effects on the acquisition of theoretical content, the development of research competences, the level of self-efficacy in research skills and knowledge about RCT procedures. Furthermore, it provided a novel experience for students, making the learning process more meaningful.Strategies such as journal clubs or conducting a systematic review or meta-analysis are common in UR programs [In our study, most students reported that UR had a positive or very positive impact on critical thinking and assessment of methodological quality. Likewise, student showed that the RCT implementation improved the ability to understand and explain the placebo effect, the capacity to read and integrate the results of an RCT. This means that the students integrated better key knowledge of RCTs, such us how design features, risk of bias or placebo effect may distort results and lead to incorrect conclusions and substantially modulate clinical decision-making in physiotherapy [According to the EBP approach of the physiotherapy degree curriculum developed at the University of Deusto, the emerging framework enabled the early integration of UR and other innovative educational methods. Moreover, the inclusion of EBP education in early stages is an accreditation requirement for many health professional disciplines [The students evaluated very positively the adequacy of UR strategy, the active participation, and the involvement and structured organisation shown by the teaching staff. In this sense, the early and first-hand RCT experience within a subject related to research methodology, where students are actively involved in carrying out real research practical activities, fieldwork and/or act as participants is unique. This experience gave the students the opportunity to practise and become proficient at it, which has been described as an effective method to develop more sophisticated levels of intellectual development [The positive effect related to the integration of the placebo effect was most often mentioned by the students. To the best of our knowledge, this is the only UR strategy that has led to a real experience of the placebo effect among physiotherapy students. When the placebo group was revealed, the students could integrate how different design features of a trial, co-interventions, sample contamination, ambiguity of symptom detection, patient’s or researcher’s biases can have a substantial impact on estimates of treatment effects. Therewith, we consider the impact on the students’ critical appraisal skill was truly outstanding through unusual, exciting, and surprising pedagogical learning.The acquisition of research theoretical knowledge related to scientific articles, journals, systematic review and PICO did not improve as much as other items. We conclude that the design of the RCT encouraged students to focus on the theoretical content that engaged them most actively. Otherwise, the RCT itself is not very related to this type of theoretical content. If the design used was a systematic review instead of an RCT, the opposite would probably be the case with regard to the topics of theoretical content which scored lower.Finally, the role of lecturers seems to be very important as an active knowledge transfer agent and the person who motivates, supervises, promotes, executes, and develops research linking students as technicians or voluntary participants during research procedures [