Nicholson Laura J, Warde Carole M, Boker John R
University of California, San Diego, School of Medicine, San Diego, CA 92130, USA.
J Contin Educ Health Prof. 2007 Winter;27(1):28-33. doi: 10.1002/chp.90.
Evidence-based medicine (EBM) integrates published clinical evidence with patient values and clinical expertise, the output of which is informed medical decision making. Key skills for evidence-based practice include acquisition and appraisal of clinical information. Faculty clinicians often lack expertise in these skills and are therefore unable to demonstrate this process for students and residents.
We conducted a yearlong case-based EBM workshop for 28 clinician educators, with precourse and postcourse evaluations of EBM resource use and literature appraisal skills.
Of the original 28 participants, 26 completed the course. Self-assessed EBM resource use improved significantly. Self-reported EBM knowledge correlated with measured skill (r = 0.45), and both improved with the intervention (both p < .001). Higher EBM skills scores correlated with time logged on the course's EBM Web sites (r = 0.56; p < .05), workshop attendance rates (r = 0.55; p = .003), and fewer years since medical school graduation (r = -0.56; p < .005).
An interactive, longitudinal, EBM course derived from a needs assessment can improve 2 skills important for evidence-based practice: online literature retrieval and critical appraisal skills.
循证医学（EBM）将已发表的临床证据与患者价值观及临床专业知识相结合，其成果是基于信息的医疗决策。循证实践的关键技能包括临床信息的获取与评估。临床教师往往缺乏这些技能方面的专业知识，因此无法向学生和住院医师展示这一过程。
我们为28名临床教育工作者举办了为期一年的基于案例的循证医学研讨会，并在课程前后对循证医学资源使用情况和文献评估技能进行了评估。
最初的28名参与者中，26人完成了课程。自我评估的循证医学资源使用情况有显著改善。自我报告的循证医学知识与实测技能相关（r = 0.45），且二者在干预后均有所提高（p均 < .001）。更高的循证医学技能得分与在课程循证医学网站上的登录时间相关（r = 0.56；p < .05）、与研讨会出勤率相关（r = 0.55；p = .003），以及与医学院毕业后的年限较少相关（r = -0.56；p < .005）。
基于需求评估得出的交互式、纵向循证医学课程可以提高循证实践中两项重要技能：在线文献检索和批判性评估技能。
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