Bazarian J J, Davis C O, Spillane L L, Blumstein H, Schneider S M
University of Rochester Medical Center, Rochester, NY, USA.
Ann Emerg Med. 1999 Aug;34(2):148-54. doi: 10.1016/s0196-0644(99)70222-2.
To compare the performance of an evidence-based medicine (EBM) approach and a traditional approach to teaching critical appraisal skills to emergency medicine residents.
This was a prospective, case-controlled trial of 32 emergency medicine residents (16 control and 16 intervention). Intervention residents were exposed to a monthly, 1-hour journal club using an EBM approach to critical appraisal over the course of 1 year. Control residents were exposed to a traditional, unstructured journal club, also monthly. Both groups were given a factitious article to evaluate in an essay format before and after the 12-month study period. The Wilcoxon rank sum test was used to compare mean improvement in test scores for each group.
The mean improvement in test scores was 1.80 for the control group and 1.53 for the intervention group; these values were not significantly different (P =.90). The difference in mean change in test score between the 2 groups was.27 points.
Compared with a traditional approach, an EBM approach to teaching critical appraisal did not appear to improve the critical appraisal skills of emergency medicine residents. However, because of the small number of subjects studied, small differences in critical appraisal skill improvement cannot be ruled out.
比较循证医学（EBM）教学方法与传统教学方法在向急诊医学住院医师传授批判性评估技能方面的效果。
这是一项针对32名急诊医学住院医师（16名对照组和16名干预组）的前瞻性病例对照试验。干预组住院医师在1年的时间里，每月参加一次为期1小时的期刊俱乐部，采用循证医学方法进行批判性评估。对照组住院医师同样每月参加一次传统的、无组织的期刊俱乐部。在为期12个月的研究期前后，两组均被给予一篇虚拟文章，要求以论文形式进行评估。采用Wilcoxon秩和检验比较两组测试成绩的平均提高情况。
对照组测试成绩的平均提高为1.80，干预组为1.53；这些值无显著差异（P = 0.90）。两组测试成绩平均变化的差异为0.27分。
与传统教学方法相比，循证医学教学方法在提高急诊医学住院医师批判性评估技能方面似乎并无效果。然而，由于研究对象数量较少，不能排除批判性评估技能提高存在微小差异的可能性。
