Taylor R, Reeves B, Ewings P, Binns S, Keast J, Mears R
HSRU, Department of Public Health & Policy, London School of Hygiene & Tropical Medicine, UK.
Med Educ. 2000 Feb;34(2):120-5. doi: 10.1046/j.1365-2923.2000.00574.x.
The aim of this paper is to undertake a descriptive systematic review of the effectiveness of critical appraisal skills training for clinicians. Of the 10 controlled studies which examined this issue and were found to meet the eligibility criteria of this review, all used a study population of either medical students or doctors in training. The studies used a variety of different intervention 'dosages' and reported a range of outcomes. These included participants' knowledge of epidemiology/biostatistics, their attitudes towards medical literature, their ability to appraise medical literature, and medical literature reading behaviour. An overall improvement in assessed outcomes of 68% was reported after critical appraisal skills training, particularly in knowledge relating to epidemiology and biostatistics. This review appears to provide some evidence of the benefit of teaching critical appraisal skills to clinicians, in terms of both knowledge of methodological/statistical issues in clinical research and attitudes to medical literature. However, these findings should be considered with caution as the methodological quality of studies was generally poor, with only one study employing a randomized controlled design. There is a need for educators within the field of evidence-based health to consider the implications of this review.
本文旨在对临床医生批判性评价技能培训的有效性进行描述性系统综述。在审查的10项对照研究中,这些研究均涉及该问题且符合本综述的纳入标准,所有研究的研究对象均为医学生或实习医生。这些研究采用了各种不同的干预“剂量”,并报告了一系列结果。这些结果包括参与者对流行病学/生物统计学的知识、他们对医学文献的态度、他们评价医学文献的能力以及医学文献阅读行为。批判性评价技能培训后,评估结果总体提高了68%,尤其是在与流行病学和生物统计学相关的知识方面。就临床研究中的方法学/统计学问题知识以及对医学文献的态度而言,本综述似乎提供了一些证据,证明向临床医生传授批判性评价技能是有益的。然而,由于研究的方法学质量普遍较差,仅有一项研究采用了随机对照设计,因此应谨慎看待这些发现。循证健康领域的教育工作者有必要考虑本综述的影响。