Caspi Opher, McKnight Patrick, Kruse Lillian, Cunningham Victoria, Figueredo Aurelio Jose, Sechrest Lee
Rabin Medical Center, Petah Tikva, Israel.
Med Teach. 2006 Jun;28(4):318-25. doi: 10.1080/01421590600624422.
Since at the time of graduation from medical school physicians are expected to demonstrate adequate professional competence including mastery of critical appraisal skills, we conducted a preliminary, cross-sectional, web-based study to examine the extent to which fourth year medical students in the US are competent in core areas of evidence-based medicine (EBM). Using self-assessment instruments, subjects (n = 150) were asked to demonstrate their ability to understand the practical meaning of key methodological and data analysis constructs as they relate to patient care, to rate their perceived competence in core areas of EBM and to disclose their attitudes toward critical appraisal of the literature and EBM. The mean score in our cohort was 55% suggesting that students may have knowledge gaps that interfere with their ability to critically appraise the medical literature. There was an apparent chasm between subjects' perceived competence and their actual performance on the assessment instrument. These findings, if corroborated in larger studies, (1) suggest that better education in EBM is needed so as to avoid the possibility that patient care may inadvertently be jeopardized; and (2) cast doubt on the use of self-assessed knowledge as a proxy for actual skills with respect to EBM and medical decision-making.
由于医学院校期望医生在毕业时能展现出足够的专业能力，包括掌握批判性评价技能，我们开展了一项初步的横断面网络研究，以调查美国四年级医学生在循证医学（EBM）核心领域的胜任程度。使用自我评估工具，要求受试者（n = 150）展示他们理解关键方法学和数据分析概念与患者护理相关的实际意义的能力，对他们在EBM核心领域的感知能力进行评分，并披露他们对文献批判性评价和EBM的态度。我们队列中的平均得分是55%，这表明学生可能存在知识差距，影响他们批判性评价医学文献的能力。受试者的感知能力与他们在评估工具上的实际表现之间存在明显差距。如果在更大规模的研究中得到证实，这些发现：（1）表明需要更好地开展EBM教育，以避免患者护理可能无意中受到损害的可能性；（2）对将自我评估知识用作EBM和医疗决策实际技能的替代指标提出质疑。
