Meyer Thorsten, Ströbel Angelika, Raspe Heiner
Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Institut für Sozialmedizin.
Z Arztl Fortbild Qualitatssich. 2004 Jun;98(4):293-300.
In 2002 a curriculum on evidence-based medicine (EbM) has been developed and published in Germany on behalf of the national statutory health care administrations. Planning and guiding medical education in EbM requires an empirically-based knowledge of the level of awareness and acceptance of EbM as well as specific educational needs and organisational preferences. In Germany, there is no such systematic knowledge, particularly in regard to general practitioners. A random sample of 900 office-based physicians in the German state of Schleswig-Holstein, stratified by medical specialties, was surveyed by means of a postal questionnaire. After two reminders the response rate was 65.6%. Respondents mainly welcomed EbM, in terms of their own daily work, for the benefit of the patient and the healthcare system as a whole. Integrating EbM into their daily practice and possible restrictions to therapeutic freedom were considered the most serious problems of EbM. 46.8% of the respondents were interested in EbM training. They preferred a rather low-cost 2-day weekend seminar. Office-based physicians were found to be sufficiently motivated to participate in EbM courses, which is in marked contrast to the actual participation rate being rather low in Schleswig-Holstein. The training should primarily focus on integrating EbM into daily routines. In public presentations efforts should be directed towards promoting the way in which EbM enhances professional autonomy and therapeutic freedom.
2002年,受国家法定医疗保健管理部门委托,德国制定并发布了循证医学(EbM)课程。规划和指导循证医学的医学教育需要基于实证了解循证医学的认知水平和接受程度,以及特定的教育需求和组织偏好。在德国,缺乏这样的系统知识,尤其是关于全科医生的知识。通过邮政问卷对德国石勒苏益格-荷尔斯泰因州900名基层医生进行随机抽样调查,抽样按医学专业分层。经过两次催复后,回复率为65.6%。受访者总体上欢迎循证医学,认为其对自身日常工作、患者以及整个医疗保健系统都有益处。将循证医学融入日常实践以及对治疗自由可能产生的限制被认为是循证医学最严重的问题。46.8%的受访者对循证医学培训感兴趣。他们更喜欢成本较低的为期两天的周末研讨会。结果发现基层医生有足够的积极性参加循证医学课程,这与石勒苏益格-荷尔斯泰因州实际参与率较低形成鲜明对比。培训应主要侧重于将循证医学融入日常工作。在公开宣传中,应致力于推广循证医学增强专业自主性和治疗自由的方式。