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循证牙医学与三年级牙科学员的临床实践。

Evidence-based dentistry and clinical implementation by third-year dental students.

机构信息

Department of Comprehensive Care, School of Dental Medicine, Case Western Reserve University, 2124 Cornell Rd., Cleveland, OH 44106;.

出版信息

J Dent Educ. 2013 Oct;77(10):1286-99.

Abstract

Over the last two decades, the concept of evidence-based medicine (EBM) has become the standard of medical care. Defined by Sackett et al. as "the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients," EBM recognizes that the practitioner should combine individual clinical expertise with the best available external evidence for optimal care. Consideration of the patient's needs and preferences is also an integral component of the clinical application. Dental educators have to account for the fact that not all dental treatment outcomes have been researched with randomized clinical trials. Dogmas in dentistry still exist regarding restorative treatments and methods taught to next generations of practitioners, while limited evidence is available. The purpose of this study was to determine how third-year dental students at one U.S. dental school select articles to provide supportive evidence related to treatment planning. The results show that knowledge provided in a three-week course in evidence-based dentistry (EBD) for first-year dental students was not efficiently applied when the students reached their third year. A significant percentage of the students perceived the use of literature as not beneficial for sustaining clinical aspects of a treatment plan, and they did not use appropriate tools to access best available resources. As a result of these findings, the article proposes incorporation of specific learning objectives related to EBD principles throughout the curriculum and a simplified method to search for best available evidence that has the advantage of not requiring knowledge and training in rigorous formulation of clinical questions.

摘要

在过去的二十年中,循证医学(EBM)的概念已成为医疗保健的标准。Sackett 等人将其定义为“在为个体患者的护理做出决策时,审慎、明确和明智地使用当前最佳证据”,EBM 认识到医生应将个体临床专业知识与最佳可用外部证据相结合,以实现最佳护理。考虑患者的需求和偏好也是临床应用的一个组成部分。牙科教育者必须认识到并非所有牙科治疗结果都经过了随机临床试验的研究。关于修复治疗和教授给下一代从业者的方法,牙科学中仍然存在一些教条,而可用的证据有限。本研究的目的是确定美国一所牙科学校的三年级牙科学生如何选择文章,为治疗计划提供支持性证据。结果表明,当学生进入三年级时,一年级牙科学生在为期三周的循证牙科(EBD)课程中获得的知识并未得到有效应用。相当一部分学生认为使用文献对维持治疗计划的临床方面没有好处,并且他们没有使用适当的工具来获取最佳可用资源。基于这些发现,本文提出在整个课程中纳入与 EBD 原则相关的具体学习目标,并提出一种简化的方法来搜索最佳可用证据,这种方法的优点是不需要在严格制定临床问题方面的知识和培训。

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