Elnicki D M, Halperin A K, Shockcor W T, Aronoff S C
Department of Medicine, West Virginia University, Morgantown 26506, USA.
Am J Med Sci. 1999 Apr;317(4):243-6. doi: 10.1097/00000441-199904000-00006.
Evidence-based medicine (EBM) is becoming an accepted educational paradigm in medical education at a variety of levels. It focuses on identifying the best evidence for medical decision making and applying that evidence to patient care.
Three EBM journal clubs were developed at the West Virginia University School of Medicine. One was for senior medical students, another for residents, and the third for primary care faculty members. In each, the sessions stressed answering clinical questions arising from actual patient-care issues. The curricular structure and development of the journal clubs are described. Participants anonymously evaluated aspects of the journal clubs regarding their educational value with Likert scale questions.
Faculty members and residents generally gave high evaluations to all aspects of the EBM journal clubs. Student evaluations were more mixed. For each of the evaluation questions, the student means were lower than those of faculty and residents. However the differences reached statistical significance only in the responses to the usefulness of the sessions in understanding the medical literature (P < 0.01). Residents and faculty rated the EBM sessions more favorably than grand rounds or the resident lecture series.
The establishment of evidence-based medicine journal clubs is feasible, and learners seem to value the sessions. More developed learners may gain more from the experience than those earlier in their medical education.
循证医学(EBM)正在成为各级医学教育中被广泛接受的教育范式。它专注于为医学决策确定最佳证据,并将该证据应用于患者护理。
西弗吉尼亚大学医学院设立了三个循证医学期刊俱乐部。一个面向高年级医学生,另一个面向住院医师,第三个面向初级保健教员。在每个俱乐部中,会议都强调回答实际患者护理问题中产生的临床问题。本文描述了期刊俱乐部的课程结构和发展情况。参与者通过李克特量表问题对期刊俱乐部在教育价值方面的各个方面进行匿名评估。
教员和住院医师对循证医学期刊俱乐部的各个方面普遍给予高度评价。学生的评价则较为参差不齐。对于每个评估问题,学生的平均分低于教员和住院医师。然而,差异仅在对会议在理解医学文献方面的有用性的回答中具有统计学意义(P < 0.01)。住院医师和教员对循证医学会议的评价比对临床大查房或住院医师讲座系列的评价更高。
循证医学期刊俱乐部的设立是可行的,学习者似乎重视这些会议。与医学教育早期的学习者相比,发展更为成熟的学习者可能从该经历中收获更多。