Division of General Surgery, Mount Sinai Hospital, Toronto, Ontario, Canada.
J Surg Educ. 2012 Jan-Feb;69(1):91-100. doi: 10.1016/j.jsurg.2011.07.004. Epub 2011 Oct 2.
Systematic reviews were performed to assess methods of teaching the evidence-based medicine (EBM) process and determine which format or what components of journal club appear to be most effective in teaching critical appraisal skills to surgical residents and have the highest user satisfaction.
MEDLINE, Embase, Web of Science, AMED, PsychINFO, PubMed, Cochrane Library, and Google scholar were searched to identify relevant articles. To be included, studies had to provide details about the format of their EBM curriculum or journal club and report on the effectiveness or participant satisfaction. Potentially relevant articles were independently reviewed by 2 authors and data were extracted on separate data forms.
Seven studies met the inclusion criteria for assessment of teaching EBM and 8 studies (including 3 in the EBM systematic review) met criteria for assessment of journal club format. Overall, study quality was poor. Only 2 studies were randomized controlled trials. Five were before-after studies, which showed significant improvement in critical appraisal skills or statistical knowledge following an EBM course or journal club. The 2 randomized controlled trials (RCTs) compared teaching EBM or critical appraisal skills in lecture format or journal club to online learning. There was no significant difference in mean scores in 1 study whereas the other reported significantly better scores in the journal club format. Four studies reported high participant satisfaction with the EBM course or journal club format.
There is some evidence that courses with or without the addition of journal clubs lead to improved knowledge of the EBM process although the impact on patient care is unknown. Journal clubs seem to be the preferred way of teaching critical appraisal skills but while some components of journal clubs are favored by participants, it remains unclear which elements are most important for resident learning.
系统评价旨在评估循证医学（EBM）过程的教学方法，并确定哪种期刊俱乐部的形式或组成部分似乎最能有效地教授外科住院医师批判性评价技能，并获得最高的用户满意度。
通过 MEDLINE、Embase、Web of Science、AMED、PsychINFO、PubMed、Cochrane Library 和 Google scholar 检索相关文章。纳入的研究必须详细说明其 EBM 课程或期刊俱乐部的形式，并报告其有效性或参与者满意度。潜在相关文章由 2 位作者独立进行审查，并在单独的数据表格上提取数据。
有 7 项研究符合评估 EBM 教学的纳入标准，有 8 项研究（包括 3 项在 EBM 系统评价中）符合评估期刊俱乐部形式的标准。总体而言，研究质量较差。仅有 2 项研究为随机对照试验。5 项为前后对照研究，表明在 EBM 课程或期刊俱乐部后，批判性评价技能或统计学知识有显著提高。2 项随机对照试验（RCT）将以讲座形式或期刊俱乐部形式教授 EBM 或批判性评价技能与在线学习进行了比较。1 项研究中平均分数无显著差异，而另一项研究报告期刊俱乐部形式的分数显著更高。有 4 项研究报告了对 EBM 课程或期刊俱乐部形式的高参与度满意度。
有一些证据表明，有或没有期刊俱乐部的课程都可以提高对 EBM 过程的认识，尽管对患者护理的影响尚不清楚。期刊俱乐部似乎是教授批判性评价技能的首选方式，但尽管参与者喜欢期刊俱乐部的某些组成部分，但仍不清楚哪些要素对住院医师学习最重要。
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