Department of Emergency Medicine, The George Washington University, Washington, DC, USA.
Acad Emerg Med. 2013 Mar;20(3):295-9. doi: 10.1111/acem.12089.
Despite the growing emphasis of evidence-based medicine (EBM) in the medical school curriculum, and the recognition of EBM's role in the practice of emergency medicine (EM), there are no current guidelines on how to teach EBM to fourth-year medical students during their EM rotations. The goal was to create a unique EM clerkship curriculum that teaches students to incorporate EBM into their clinical decision-making and complies with the core curriculum recommendations of the Clerkship Directors in Emergency Medicine (CDEM).
Prior to a scheduled, case-based small group discussion, students are provided with a clinically relevant question to investigate. Case discussions are led by EM faculty with each case highlighting a core EM topic developed by CDEM. During the case discussion, the assigned clinical question is addressed and a plan of care is presented based on the tenets of EBM. Faculty members function as moderators for these discussions and provide individual feedback regarding search strategies, appraisal of the literature findings, and applicability to the patient population. This multifaceted approach to EBM through the incorporation of individual student literature searches, clinical vignettes, small group discussion with consensus building, and faculty moderation with timely feedback is an innovative educational technique. Future educational research must explore the efficacy of this curriculum and whether or not the model produces greater long-term understanding of EBM by students and if similar curricula can be executed at other institutions.
The authors have developed a novel fourth-year EM clerkship curriculum that integrates EBM through the use of a highly interactive, faculty-led, small group-learning environment that encourages students to develop the necessary skills to integrate EBM into their clinical practice.
尽管循证医学（EBM）在医学院课程中的重要性日益增加，并且已经认识到 EBM 在急诊医学（EM）实践中的作用，但目前尚无关于如何在 EM 轮转期间向四年级医学生教授 EBM 的指南。目标是创建一个独特的 EM 实习课程，教授学生将 EBM 融入他们的临床决策，并符合急诊医学主任（CDEM）的核心课程建议。
在预定的基于案例的小组讨论之前，学生将获得一个需要调查的临床相关问题。案例讨论由急诊医学教师领导，每个案例都突出了 CDEM 开发的一个核心 EM 主题。在案例讨论中，解决指定的临床问题，并根据 EBM 的原则提出护理计划。教师作为这些讨论的主持人，提供有关搜索策略、文献发现评估和对患者人群的适用性的个人反馈。通过将学生个人文献搜索、临床小插曲、小组讨论和共识建立以及教师及时反馈相结合的这种多方面的 EBM 方法是一种创新的教育技术。未来的教育研究必须探索该课程的效果，以及该模式是否能使学生对 EBM 有更长期的理解，以及类似的课程是否可以在其他机构实施。
作者开发了一种新颖的四年级 EM 实习课程，通过使用高度互动的、以教师为导向的小组学习环境来整合 EBM，鼓励学生发展将 EBM 融入临床实践所需的技能。
