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补充和替代医学教育在医疗专业中的应用:系统评价。

Complementary and alternative medicine education for medical profession: systematic review.

机构信息

School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong.

出版信息

Evid Based Complement Alternat Med. 2012;2012:656812. doi: 10.1155/2012/656812. Epub 2012 Apr 30.

Abstract

Purpose. To help integrate traditional, complementary and alternative medicine (TCAM) into health systems, efforts are being made to educate biomedical doctors (BMD) and medical students on TCAM. We systematically evaluated the effect of TCAM education on BMD and medical students' attitude, knowledge, and behavior towards TCAM utilization and integration with biomedical medicine. Methods. Evaluative studies were identified from four databases. Methodological quality was assessed using the Medical Education Research Study Quality Instrument (MERSQI). Study outcomes were classified using Kirkpatrick's hierarchy. Results. 3122 studies were identified and 12 studies of mediocre quality met inclusion criteria. Qualitative synthesis showed usage of diverse approaches including didactic, experiential learning, varying length, teacher background and intensity of exposure. More positive attitudes and improved knowledge after intervention were noted especially when teachers were BM trained. However, few studies assessed behavior change objectively. Finally, longer-term objective outcomes such as impact on patient care were not assessed. Conclusions. Lack of use of objective and reliable instruments preclude firm conclusion on the effect of TCAM education on study participants. However, positive changes, although mostly subjectively reported, were noted in most studies. Future evaluation should use validated or objective outcome assessments, and the value of using dual trained instructors.

摘要

目的。为了帮助将传统医学、补充医学和替代医学(TCAM)融入医疗体系,目前正在努力对生物医学医生(BMD)和医学生进行 TCAM 教育。我们系统地评估了 TCAM 教育对 BMD 和医学生对 TCAM 的使用以及与生物医学整合的态度、知识和行为的影响。

方法。从四个数据库中确定了评估性研究。使用医学教育研究学习质量工具(MERSQI)评估方法学质量。使用 Kirkpatrick 层次结构对研究结果进行分类。

结果。共确定了 3122 项研究,其中 12 项质量中等的研究符合纳入标准。定性综合表明,使用了多种方法,包括说教式、体验式学习、不同的长度、教师背景和接触强度。干预后,参与者的态度更加积极,知识得到提高,尤其是当教师接受过 BM 培训时。然而,很少有研究客观地评估行为变化。最后,没有评估对患者护理的长期客观结果。

结论。由于缺乏使用客观可靠的工具,无法确定 TCAM 教育对研究参与者的影响。然而,尽管大多数是主观报告的,但大多数研究都注意到了积极的变化。未来的评估应使用经过验证或客观的结果评估,以及使用双重培训教师的价值。

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