评估循证实践能力：当前实践工具的优缺点。
Assessing competency in Evidence Based Practice: strengths and limitations of current tools in practice.
机构信息
Monash Institute of Health Services Research, Monash University, Clayton, VIC 3168, Australia.
出版信息
BMC Med Educ. 2009 Aug 6;9:53. doi: 10.1186/1472-6920-9-53.
BACKGROUND
Evidence Based Practice (EBP) involves making clinical decisions informed by the most relevant and valid evidence available. Competence can broadly be defined as a concept that incorporates a variety of domains including knowledge, skills and attitudes. Adopting an evidence-based approach to practice requires differing competencies across various domains including literature searching, critical appraisal and communication. This paper examines the current tools available to assess EBP competence and compares their applicability to existing assessment techniques used in medicine, nursing and health sciences.
DISCUSSION
Only two validated assessment tools have been developed to specifically assess all aspects of EBP competence. Of the two tools (Berlin and Fresno tools), only the Fresno tool comprehensively assesses EBP competency across all relevant domains. However, both tools focus on assessing EBP competency in medical students; therefore neither can be used for assessing EBP competency across different health disciplines. The Objective Structured Clinical Exam (OSCE) has been demonstrated as a reliable and versatile tool to assess clinical competencies, practical and communication skills. The OSCE has scope as an alternate method for assessing EBP competency, since it combines assessment of cognitive skills including knowledge, reasoning and communication. However, further research is needed to develop the OSCE as a viable method for assessing EBP competency.
SUMMARY
Demonstrating EBP competence is a complex task - therefore no single assessment method can adequately provide all of the necessary data to assess complete EBP competence. There is a need for further research to explore how EBP competence is best assessed; be it in written formats, such as the Fresno tool, or another format, such as the OSCE. Future tools must also incorporate measures of assessing how EBP competence affects clinician behaviour and attitudes as well as clinical outcomes in real-time situations. This research should also be conducted across a variety of health disciplines to best inform practice.
背景
循证实践（EBP）涉及根据现有最相关和最有效的证据做出临床决策。能力可以广义地定义为一个概念，它包含了包括知识、技能和态度等多种领域。采用循证实践方法需要在各个领域具备不同的能力，包括文献检索、批判性评价和沟通。本文研究了目前可用于评估 EBP 能力的工具，并比较了它们在医学、护理和健康科学中现有的评估技术的适用性。
讨论
只有两种经过验证的评估工具被开发出来，专门评估 EBP 能力的各个方面。在这两种工具（柏林工具和弗雷斯诺工具）中，只有弗雷斯诺工具全面评估了所有相关领域的 EBP 能力。然而，这两种工具都侧重于评估医学生的 EBP 能力；因此，它们都不能用于评估不同健康学科的 EBP 能力。客观结构化临床考试（OSCE）已被证明是一种可靠且多功能的工具，可用于评估临床能力、实践和沟通技能。OSCE 有潜力作为评估 EBP 能力的替代方法，因为它结合了对认知技能的评估，包括知识、推理和沟通。然而，需要进一步研究来开发 OSCE 作为评估 EBP 能力的可行方法。
总结
展示 EBP 能力是一项复杂的任务——因此，没有单一的评估方法可以充分提供评估完整 EBP 能力所需的所有数据。需要进一步研究来探索如何最好地评估 EBP 能力；无论是在书面格式（如弗雷斯诺工具）还是其他格式（如 OSCE）。未来的工具还必须纳入评估 EBP 能力如何实时影响临床医生行为和态度以及临床结果的措施。这项研究还应在各种健康学科中进行，以最好地为实践提供信息。
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