Yew Kenneth S, Reid Alfred
Department of Family Medicine, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA.
Fam Med. 2008 Jan;40(1):24-31.
The long-term effect of teaching critical appraisal (CA) and evidence-based medicine (EBM) skills is unknown. This study explores long-term behaviors and learner satisfaction after a 3-year longitudinal CA/EBM curriculum.
Telephone interviews were conducted with 1996-1998 graduates of an academic family medicine residency program with an established CA/EBM curriculum. The graduates were all in clinical practice.
Ten of 17 graduates met inclusion criteria and consented to be interviewed. Their age range was 31-58, and all had been in practice 3 to 5 years. Six were female. Most participants did not regularly practice CA or use EBM skills. Instead, colleagues were the most commonly used information source. Time constraints and clinical production pressure were the primary barriers to practicing EBM. Despite not practicing CA and EBM, participants generally were satisfied with their training in these skills. Respondents said they used continuing education meetings and reading journals to keep current.
In this study, residents instructed in CA and EBM skills did not regularly practice these skills. Time and workload pressures appear to be major barriers to these behaviors. Those training residents to integrate EBM into clinical practice should evaluate short- and long-term clinically oriented behaviors to assure educational effectiveness.
批判性评价（CA）和循证医学（EBM）技能教学的长期效果尚不清楚。本研究探讨了在为期3年的纵向CA/EBM课程结束后的长期行为和学习者满意度。
对1996 - 1998年毕业于设有CA/EBM课程的学术家庭医学住院医师培训项目的学员进行电话访谈。这些毕业生均已从事临床工作。
17名毕业生中有10名符合纳入标准并同意接受访谈。他们的年龄在31 - 58岁之间，且均已从业3至5年。其中6名女性。大多数参与者未定期进行CA实践或使用EBM技能。相反，同事是最常用的信息来源。时间限制和临床工作量压力是实践EBM的主要障碍。尽管未实践CA和EBM，但参与者总体上对这些技能的培训感到满意。受访者表示他们通过参加继续教育会议和阅读期刊来紧跟前沿。
在本研究中，接受CA和EBM技能培训的住院医师未定期实践这些技能。时间和工作量压力似乎是这些行为的主要障碍。那些培训住院医师将EBM融入临床实践的人员应评估短期和长期的临床导向行为，以确保教育效果。
