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本科医学生对循证医学的认知和使用:一项定性研究。

Undergraduate medical student perceptions and use of Evidence Based Medicine: a qualitative study.

机构信息

Monash Institute of Health Services Research, School of Public Health & Preventive Medicine, Monash University, Australia.

出版信息

BMC Med Educ. 2010 Aug 19;10:58. doi: 10.1186/1472-6920-10-58.

Abstract

BACKGROUND

Many medical schools teach the principles of Evidence Based Medicine (EBM) as a subject within their medical curriculum. Few studies have explored the barriers and enablers that students experience when studying medicine and attempting to integrate EBM in their clinical experience. The aim of this study was to identify undergraduate medical student perceptions of EBM, including their current use of its principles as students and perceived future use as clinicians.

METHODS

Third year medical students were recruited via email to participate in focus group discussions. Four focus groups were conducted separately across four hospital sites. All focus groups were conducted by the same facilitator. All discussions were transcribed verbatim, and analysed independently by the two authors according to the principles of thematic analysis.

RESULTS

Focus group discussions were conducted with 23 third-year medical students, representing three metropolitan and one rural hospital sites. Five key themes emerged from the analysis of the transcripts: (1) Rationale and observed use of EBM in practice, (2) Current use of EBM as students, (3) Perceived use of EBM as future clinicians, (4) Barriers to practicing EBM, and (5) Enablers to facilitate the integration of EBM into clinical practice. Key facilitators for promoting EBM to students include competency in EBM, mentorship and application to clinical disciplines. Barriers to EBM implementation include lack of visible application by senior clinicians and constraints by poor resourcing.

CONCLUSIONS

The principles and application of EBM is perceived by medical students to be important in both their current clinical training and perceived future work as clinicians. Future research is needed to identify how medical students incorporate EBM concepts into their clinical practice as they gain greater clinical exposure and competence.

摘要

背景

许多医学院将循证医学(EBM)原理作为医学课程的一门学科进行教学。很少有研究探讨学生在学习医学和尝试将 EBM 整合到临床经验中时所经历的障碍和促进因素。本研究旨在确定本科医学生对 EBM 的看法,包括他们作为学生目前对其原理的使用情况以及作为临床医生未来的使用预期。

方法

通过电子邮件招募三年级医学生参加焦点小组讨论。在四个医院地点分别进行了四个焦点小组。所有焦点小组都由同一位主持人进行。所有讨论都逐字记录下来,并由两位作者根据主题分析的原则进行独立分析。

结果

焦点小组讨论共进行了 23 名三年级医学生,代表三个城市医院和一个农村医院。对记录的转录本进行分析后出现了五个关键主题:(1)EBM 在实践中的基本原理和观察到的使用,(2)作为学生目前对 EBM 的使用,(3)作为未来临床医生对 EBM 的预期使用,(4)实践 EBM 的障碍,(5)促进将 EBM 整合到临床实践中的促进因素。促进学生 EBM 的关键因素包括 EBM 能力、指导和应用于临床学科。EBM 实施的障碍包括资深临床医生缺乏明显的应用和资源不足的限制。

结论

医学生认为 EBM 的原则和应用在他们目前的临床培训和未来作为临床医生的工作中都很重要。需要进一步研究如何让医学生在获得更多临床经验和能力的同时,将 EBM 概念融入到临床实践中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b37/2931522/d8f1fabe9302/1472-6920-10-58-1.jpg

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