Osser David N, Patterson Robert D, Levitt James J
Department of Psychiatry, Brockton Veteran's Administration Medical Center, 940 Belmont St., Brockton, MA 02301, USA.
Acad Psychiatry. 2005 May-Jun;29(2):180-6. doi: 10.1176/appi.ap.29.2.180.
The authors describe a course of instruction for psychiatry residents that attempts to provide the cognitive and informational tools necessary to make scientifically grounded decision making a routine part of clinical practice.
In weekly meetings over two academic years, the course covers the psychopharmacology of various psychiatric disorders in 32 3-hour modules. The first half of each module is a case conference, and the second is a literature review of papers related to the case. The case conference focuses on the extent to which past treatment has been consistent with evidence-supported guidelines and algorithms, and the discussants make recommendations that take the relevant scientific evidence into consideration. The second half of each module focuses on two papers: 1) a published guideline, algorithm, or review article and 2) a research study.
Residents absorb a comprehensive overview of recommended clinical practices and acquire skills in assessing knowledge that affects decision making. Satisfaction with the course is rated highly.
The course appears useful by its face validity, but research comparing the attitudes and practice outcomes of graduates of this course compared with recipients of other training methods is needed.
作者描述了一门针对精神病学住院医师的教学课程,该课程试图提供必要的认知和信息工具,以使基于科学依据的决策成为临床实践的常规组成部分。
在两个学年的每周会议中,该课程通过32个3小时的模块涵盖各种精神疾病的精神药理学。每个模块的前半部分是病例讨论会,后半部分是与该病例相关的文献综述。病例讨论会聚焦于过去的治疗在多大程度上符合循证指南和算法,讨论者会考虑相关科学证据提出建议。每个模块的后半部分聚焦于两篇论文:1)一篇已发表的指南、算法或综述文章,以及2)一项研究。
住院医师全面了解了推荐的临床实践,并获得了评估影响决策的知识的技能。对该课程的满意度很高。
从表面效度来看,该课程似乎很有用,但需要进行研究,比较该课程毕业生与接受其他培训方法者的态度和实践结果。