Nieman Linda Z, Cheng Lee, Foxhall Lewis E
Department of Family and Community Medicine, The University of Texas Medical School at Houston, Houston, TX 77030, USA.
Fam Med. 2009 May;41(5):332-6.
Our objective was to describe and evaluate an educational intervention for teaching preclinical medical students enrolled in a family medicine preceptorship to use evidence-based medicine (EBM) techniques.
In a brief workshop, 94 preclinical students, enrolled in a 4?week family medicine preceptorship, learned an EBM approach to clinical decision making. Students were responsible for completing four patient case summaries to document that they had searched selected databases and obtained feedback from their preceptors. We then evaluated (1) the percent of students documenting EBM processes, (2) the students' perceived self-efficacy, (3) the level of the students' EBM learning, and (4) preceptors' attitudes toward using the EBM project as the focus of their feedback.
All students succeeded in identifying the factual knowledge that they had used to convert information from patient encounters into searchable clinical questions. The preceptors provided case-specific, written feedback to all students. Students gave lesser ratings of importance to EBM and self-efficacy in using EBM after the preceptorship as compared to after the brief introductory workshop. Preceptors acknowledged that the project helped them to focus their feedback and to reconsider patient management practices.
Students learned to use an EBM process and became more familiar with and more realistic about their self-efficacy in using EBM. Preceptors and preclinical medical students can learn and hone EBM skills together.
我们的目标是描述和评估一项针对参加家庭医学实习的临床前医学生的教育干预措施,以教授他们使用循证医学(EBM)技术。
在一个简短的研讨会上,94名参加为期4周家庭医学实习的临床前学生学习了一种循证医学的临床决策方法。学生们负责完成四份患者病例总结,以证明他们已检索选定的数据库并获得了带教老师的反馈。然后,我们评估了:(1)记录循证医学过程的学生百分比;(2)学生感知到的自我效能感;(3)学生的循证医学学习水平;(4)带教老师对将循证医学项目作为反馈重点的态度。
所有学生都成功识别出他们用于将患者诊疗信息转化为可检索临床问题的事实性知识。带教老师为所有学生提供了针对具体病例的书面反馈。与简短的入门研讨会后相比,学生们在实习后对循证医学及其使用循证医学的自我效能感的重要性评价较低。带教老师承认,该项目有助于他们集中反馈,并重新考虑患者管理实践。
学生学会了使用循证医学流程,并且对自己使用循证医学的自我效能感更加熟悉且更加现实。带教老师和临床前医学生可以共同学习和磨练循证医学技能。