DISCUSSION
congestion
CONGESTION
Both the intervention and control groups improved on their post-tests compared to their pre-test scores. At the same time, neither group significantly performed better statistically than the other as measured by post-test scores. Specifically, the intervention group's added 25-minute training did not lead to statistically better post-test scores compared to the control group. Medical educators often note that “Assessment drives the curriculum” and this adage might offer a partial explanation for these results that rejected the hypothesis. Our medical students are expected to take considerable responsibility for their own learning. From the block orientation onward, the students also knew that their EBP question formulation skills would constitute 5% of the final block grade on an assessment 12 days later in the block. One might infer that the students were motivated by this looming graded assignment. As for the lack of differences between the 25-minute intervention group and the solely 5-minute control groups experiences, the specific intervention training itself possibly was insufficient to improve students' skills more than the 5-minute alone explanation of the rubric. Although the three instructors have received multiple teaching awards for this Block, and their students have performed well on the Block topics on their national U.S. Medical Licensure Exam (USMLE) Step One, the extra 25-minute instruction segment still might have not been as effective as their instruction elsewhere in the Block so this factor must be considered among other potential limitations.The present study confirmed that brief instruction and student use of a rubric led to significant improvement in post-test scores. Three previous randomized controlled trials involving health sciences students documented a similar overall improvement effect. A general pattern might be emerging from the evidence that library or informatics training leads to improvement. Yet, similarly, these These students operated in a solely online learning environment during the Covid-19 pandemic. Perhaps an online factor such as the instructors' inability to monitor their peer learning online in all breakout rooms meant that the intervention Group students did not really perform the requested skills applications. If not, then the students would have interrupted Kolb's theoretical Experiential Learning Cycle by omitting their own Active Experimentation and the Concrete Experience phases [Medical educators regularly struggle with deciding which knowledge content and skills to include in the crowded curriculum of undergraduate medical education. This study suggests that medical students, apparently motivated by knowing that their acquiring these skills might influence their block grade, will perform well using the rubric for their EBP question formulation. Using the rubric with a brief instructional session will potentially reduce the cognitive load during classroom time for students and contribute to reducing overall congestion in the crowded curriculum. Time saved in teaching question formulation skills potentially can be reallocated to other EBP training such as searching skills.The authors hypothesized that a 25-minute training session would result in a statistically-significant increase in scores compared to a control group receiving a 5-minute explanation of a rubric only. These results suggest that a 5-minute explanation of the rubric alone might be sufficient guidance for students motivated by an impending graded-event in using the FAC rubric to improve their scores when learning their EBP question formulation skills. Introducing students to the rubric definitely boosted all student scores. Further replication of this study at multiple sites, particularly in an in-person environment will be essential.