Purpose
Lifelong learning is essential in medicine to ensure the best care for patients. A gap was identified in teaching evidence-based medicine (EBM) and self-directed learning (SDL) within the curriculum. While content was being delivered, opportunities for regular integration were missed. Additionally, clerkship students were unaware of their routine SDL practice. To address this, a longitudinal approach was developed to enhance students’ understanding of EBM and SDL, starting in the first semester of year one and progressively building these skills over the first two years.

Methods
The curriculum integrates new SDL-focused activities within the existing Clinical Skills Integration course. In the first semester of year one, students participate in a didactic session on literature analysis and clinical question formulation. During clinical preceptorships, students independently formulate clinical questions, conduct literature searches, and present findings in a small group setting, receiving formative peer and faculty feedback. In the second semester, existing sessions on study types and sources are expanded upon in a course on Population Medicine. In year two, students revisit the clinical question exercise during required hospital visits, demonstrating advanced literature search skills and critical appraisal of information credibility. These findings are presented to clinical mentors, who provide feedback on both clinical reasoning and literature evaluation.

Results
The effectiveness of the introductory session will be measured by the ability of year 1 students to formulate questions and critically search the literature. In year two, the EBM and SDL performances will be evaluated for measurable skill development. Initial feedback from students and faculty highlights the addition of the clinical question during hospital visits as instrumental in preparing for third-year learning.

Conclusions
Early and deliberate, longitudinal practice of SDL fosters improved EBM skills and lifelong learning habits. Teaching clinical question formulation to first-year students, even with limited medical knowledge, is both feasible and beneficial.