Department of Pediatrics, Division of Pediatric Emergency Medicine, Columbia University, New York, NY 10032, USA.
Acad Pediatr. 2010 Jul-Aug;10(4):260-5. doi: 10.1016/j.acap.2010.03.009. Epub 2010 May 27.
The principles of evidence-based practice (EBP) are a mandated component of the pediatric residency curriculum; however, a pediatrics-based assessment tool validated with pediatric residents does not exist.
We designed an assessment instrument composed of items in 4 categories: 1) demographics; 2) comfort level; 3) self-reported practice of EBP; and 4) EBP knowledge. This last section required participants to identify best evidence and most appropriate study design by using pediatric-based scenarios, develop searchable questions, and use existing published research to address diagnostic and treatment issues. Four groups completed the instrument: preclinical medical students (MS-2), incoming pediatric interns (PGY-1), incoming second- and third-year pediatric residents (PGY2-3), and expert tutors (expert). We determined internal consistency, interrater reliability, content validity, item difficulty, and construct validity.
Fifty-six subjects completed tests (MS-2, n = 13; PGY-1, n = 13; PGY2-3, n = 22; expert, n = 8). Internal reliability was good, with Cronbach's alpha = .80. Interrater reliability was high (kappa = 0.94). Items were free of floor or ceiling effects. Comfort level and self-reported practice of EBP increased with expertise level and prior EBP experience (P < .01). Scores on the knowledge section (out of 50 +/- SD) rose with training level (MS-2: 14.8 +/- 5.7; PGY-1: 22.2 +/- 3.4; PGY2-3: 31.7 +/- 6.1; experts: 43 +/- 4.0; P < .01). Scores also correlated with prior EBP education.
We have developed a reliable and valid instrument to assess knowledge and skill in EBP taught to pediatric residents. This instrument can aid pediatric educators in monitoring the impact of the EBP curriculum.
循证实践（EBP）原则是儿科学住院医师课程的必修组成部分；然而，目前还没有针对儿科住院医师进行验证的基于儿科的评估工具。
我们设计了一种评估工具，由 4 个类别中的项目组成：1）人口统计学；2）舒适度；3）自我报告的 EBP 实践；4）EBP 知识。最后一部分要求参与者通过使用基于儿科的场景来识别最佳证据和最合适的研究设计，制定可搜索的问题，并利用现有已发表的研究来解决诊断和治疗问题。有 4 个组完成了该工具：临床医学专业的二年级医学生（MS-2）、即将进入儿科实习的医学生（PGY-1）、即将进入第二年和第三年儿科住院医师的医学生（PGY2-3）和专家导师（专家）。我们确定了内部一致性、评分者间信度、内容有效性、项目难度和结构有效性。
共有 56 名受试者完成了测试（MS-2，n = 13；PGY-1，n = 13；PGY2-3，n = 22；专家，n = 8）。内部可靠性良好，克朗巴赫系数为.80。评分者间信度较高（kappa = 0.94）。项目没有地板或天花板效应。舒适度和自我报告的 EBP 实践随着专业水平和之前的 EBP 经验的提高而增加（P <.01）。知识部分的得分（满分 50 分，±标准差）随着培训水平的提高而升高（MS-2：14.8 ± 5.7；PGY-1：22.2 ± 3.4；PGY2-3：31.7 ± 6.1；专家：43 ± 4.0；P <.01）。得分也与之前的 EBP 教育相关。
我们开发了一种可靠有效的工具，用于评估教授给儿科住院医师的 EBP 知识和技能。该工具可以帮助儿科教育工作者监测 EBP 课程的影响。
