循证医学的研究生教学能改变什么？一项系统评价。
What is the evidence that postgraduate teaching in evidence based medicine changes anything? A systematic review.
作者信息
Coomarasamy Arri, Khan Khalid S
机构信息
Education Resource Centre, Birmingham Women's Hospital, Birmingham, B15 2TG.
出版信息
BMJ. 2004 Oct 30;329(7473):1017. doi: 10.1136/bmj.329.7473.1017.
Abstract
OBJECTIVE
To evaluate the effects of standalone versus clinically integrated teaching in evidence based medicine on various outcomes in postgraduates.
DESIGN
Systematic review of randomised and non-randomised controlled trials and before and after comparison studies.
DATA SOURCES
Medline, Embase, ERIC, Cochrane Library, DARE, HTA database, Best Evidence, BEME, and SCI.
STUDY SELECTION
23 studies: four randomised trials, seven non-randomised controlled studies, and 12 before and after comparison studies. 18 studies (including two randomised trials) evaluated a standalone teaching method, and five studies (including two randomised trials) evaluated a clinically integrated teaching method.
MAIN OUTCOME MEASURES
Knowledge, critical appraisal skills, attitudes, and behaviour.
RESULTS
Standalone teaching improved knowledge but not skills, attitudes, or behaviour. Clinically integrated teaching improved knowledge, skills, attitudes, and behaviour.
CONCLUSION
Teaching of evidence based medicine should be moved from classrooms to clinical practice to achieve improvements in substantial outcomes.
摘要
目的
评估循证医学中独立教学与临床整合教学对研究生各项学习成果的影响。
设计
对随机和非随机对照试验以及前后对照研究进行系统评价。
数据来源
医学文献数据库（Medline）、荷兰医学文摘数据库（Embase）、教育资源信息中心数据库（ERIC）、考克兰图书馆、循证医学数据库（DARE）、卫生技术评估数据库（HTA）、最佳证据数据库（Best Evidence）、循证医学教育协作网数据库（BEME）以及科学引文索引数据库（SCI）。
研究选择
23项研究，其中4项随机试验、7项非随机对照研究以及12项前后对照研究。18项研究（包括2项随机试验）评估了独立教学方法，5项研究（包括2项随机试验）评估了临床整合教学方法。
主要观察指标
知识、批判性评价技能、态度和行为。
结果
独立教学提高了知识水平，但未改善技能、态度或行为。临床整合教学提高了知识、技能、态度和行为水平。
结论
循证医学教学应从课堂转向临床实践，以实现实质性学习成果的提升。
相似文献
1
What is the evidence that postgraduate teaching in evidence based medicine changes anything? A systematic review.循证医学的研究生教学能改变什么？一项系统评价。
BMJ. 2004 Oct 30;329(7473):1017. doi: 10.1136/bmj.329.7473.1017.
2
Evidence based practice in postgraduate healthcare education: a systematic review.研究生医疗保健教育中的循证实践：一项系统综述。
BMC Health Serv Res. 2007 Jul 26;7:119. doi: 10.1186/1472-6963-7-119.
3
A systematic review of faculty development initiatives designed to improve teaching effectiveness in medical education: BEME Guide No. 8.旨在提高医学教育教学效果的教师发展举措的系统评价：BEME指南第8号
Med Teach. 2006 Sep;28(6):497-526. doi: 10.1080/01421590600902976.
4
Teaching critical appraisal skills in health care settings.在医疗环境中教授批判性评估技能。
Cochrane Database Syst Rev. 2001(3):CD001270. doi: 10.1002/14651858.CD001270.
5
A systematic review of postgraduate teaching in evidence-based medicine and critical appraisal.循证医学与批判性评价研究生教学的系统评价
Med Teach. 2003 Jan;25(1):77-81. doi: 10.1080/0142159021000061468.
6
Review of guidelines for good practice in decision-analytic modelling in health technology assessment.卫生技术评估中决策分析模型良好实践指南综述。
Health Technol Assess. 2004 Sep;8(36):iii-iv, ix-xi, 1-158. doi: 10.3310/hta8360.
7
Patient-doctor communication.医患沟通。
Med Clin North Am. 2003 Sep;87(5):1115-45. doi: 10.1016/s0025-7125(03)00066-x.
8
Individual-level interventions to reduce personal exposure to outdoor air pollution and their effects on people with long-term respiratory conditions.个体层面的干预措施以减少个人接触室外空气污染及其对长期呼吸系统疾病患者的影响。
Cochrane Database Syst Rev. 2021 Aug 9;8(8):CD013441. doi: 10.1002/14651858.CD013441.pub2.
9
Continuing education meetings and workshops: effects on professional practice and healthcare outcomes.继续教育会议和研讨会：对专业实践和医疗保健结果的影响。
Cochrane Database Syst Rev. 2021 Sep 15;9(9):CD003030. doi: 10.1002/14651858.CD003030.pub3.
10
Interventions for promoting habitual exercise in people living with and beyond cancer.促进癌症患者及康复者进行习惯性锻炼的干预措施。
Cochrane Database Syst Rev. 2018 Sep 19;9(9):CD010192. doi: 10.1002/14651858.CD010192.pub3.
引用本文的文献
1
Evaluation of an evidence-based practice continuing education course for Canadian Naturopathic Doctors.针对加拿大自然疗法医生的循证实践继续教育课程评估。
PLoS One. 2025 Jun 3;20(6):e0324452. doi: 10.1371/journal.pone.0324452. eCollection 2025.
2
Approaches to teaching evidence-based medicine in residency: a systematic review.住院医师阶段循证医学的教学方法：一项系统综述
Med Educ Online. 2025 Dec;30(1):2504467. doi: 10.1080/10872981.2025.2504467. Epub 2025 May 22.
3
Enhancing beliefs and implementation of evidence-based practice among undergraduate nurses using a multi-component educational programme: a pre-post study.使用多成分教育计划提高本科护士对循证实践的信念及其实践应用：一项前后对照研究
BMC Med Educ. 2025 Apr 14;25(1):531. doi: 10.1186/s12909-025-07121-x.
4
Evaluating an online stroke training programme for Saudi Arabian physiotherapists for improving their knowledge and confidence in long-term stroke care: a pilot mixed-methods study.评估一项针对沙特阿拉伯物理治疗师的在线中风培训计划，以提高他们在长期中风护理方面的知识和信心：一项混合方法试点研究。
BMC Med Educ. 2025 Feb 17;25(1):249. doi: 10.1186/s12909-025-06837-0.
5
Interventions for recurrent embryo implantation failure: An umbrella review.复发性胚胎植入失败的干预措施：一项伞状综述。
Int J Gynaecol Obstet. 2025 May;169(2):539-556. doi: 10.1002/ijgo.16066. Epub 2024 Dec 5.
6
Evidence-Based Medicine Culture, Curriculum, and Program Outcomes: A CERA Study.循证医学文化、课程与项目成果：一项CERA研究
Fam Med. 2024 Aug 23;56(10):631-40. doi: 10.22454/FamMed.2024.895739.
7
Let's talk about work: pilot study of an education program on discussing work participation with cancer patients for general practitioners in training.让我们谈谈工作：一项针对培训中的全科医生讨论癌症患者工作参与问题的教育项目的初步研究。
BMC Med Educ. 2024 Jul 9;24(1):739. doi: 10.1186/s12909-024-05705-7.
8
Measuring self-efficacy and outcome expectancy in evidence-based practice: A systematic review on psychometric properties.基于循证实践的自我效能感与结果期望测量：关于心理测量特性的系统评价
Int J Nurs Stud Adv. 2021 Mar 5;3:100024. doi: 10.1016/j.ijnsa.2021.100024. eCollection 2021 Nov.
9
Effectiveness of educational strategies to teach evidence-based dentistry to undergraduate dental students: a systematic review.教育策略在向本科生传授循证牙科学方面的有效性：系统评价。
Evid Based Dent. 2024 Mar;25(1):53-54. doi: 10.1038/s41432-023-00958-5. Epub 2024 Jan 5.
10
Medical student perceptions of research training on patient care during clerkship.医学生对实习期间患者护理研究培训的看法。
MedEdPublish (2016). 2020 May 21;9:107. doi: 10.15694/mep.2020.000107.1. eCollection 2020.
本文引用的文献
1
Postgraduate journal club as a means of promoting evidence-based obstetrics and gynaecology.研究生期刊俱乐部作为促进循证妇产科学的一种手段。
J Obstet Gynaecol. 1999 May;19(3):231-4. doi: 10.1080/01443619964968.
2
A systematic review of postgraduate teaching in evidence-based medicine and critical appraisal.循证医学与批判性评价研究生教学的系统评价
Med Teach. 2003 Jan;25(1):77-81. doi: 10.1080/0142159021000061468.
3
Teaching evidence-based medicine to surgical subspecialty residents.向外科专科住院医师传授循证医学
J Am Coll Surg. 2003 Aug;197(2):285-9. doi: 10.1016/S1072-7515(03)00114-5.
4
Incorporating the views of obstetric clinicians in implementing evidence-supported labour and delivery suite ward rounds: a case study.在实施循证支持的产房和分娩室查房中纳入产科临床医生的观点：一项案例研究
Health Info Libr J. 2003 Jun;20(2):86-94. doi: 10.1046/j.1471-1842.2003.00422.x.
5
Introducing an evidence-based medicine curriculum into a family practice residency--is it effective?将循证医学课程引入家庭医学住院医师培训项目——这样做有效吗？
Acad Med. 2003 Apr;78(4):412-7. doi: 10.1097/00001888-200304000-00019.
6
A method for real-time, evidence-based general medical attending rounds.一种基于证据的实时普通内科查房方法。
Acad Med. 2002 Nov;77(11):1150-2. doi: 10.1097/00001888-200211000-00019.
7
Real-time, evidence-based medicine instruction: a randomized controlled trial in a neonatal intensive care unit.实时循证医学指导：新生儿重症监护病房的一项随机对照试验
J Med Libr Assoc. 2002 Apr;90(2):194-201.
8
Teaching critical appraisal skills in health care settings.在医疗环境中教授批判性评估技能。
Cochrane Database Syst Rev. 2001(3):CD001270. doi: 10.1002/14651858.CD001270.
9
Teaching evidence-based medical care: description and evaluation.循证医疗教学：描述与评估
Fam Med. 2001 Sep;33(8):602-6.
10
Effect of an evidence-based medicine seminar on participants' interpretations of clinical trials: a pilot study.循证医学研讨会对参与者临床试验解读能力的影响：一项试点研究。
Acad Med. 2000 Dec;75(12):1212-4. doi: 10.1097/00001888-200012000-00019.
Zotero 插件