Leung Elaine Yl, Malick Sadia M, Khan Khalid S
Women's Health Research Unit, Centre of Public Health and Primary Care, Queen Mary, University of London, London E1 2AB;
Clin Biochem Rev. 2013 Aug;34(2):93-103.
Clinical scientists are at the unique interface between laboratory science and frontline clinical practice for supporting clinical partnerships for evidence-based practice. In an era of molecular diagnostics and personalised medicine, evidence-based laboratory practice (EBLP) is also crucial in aiding clinical scientists to keep up-to-date with this expanding knowledge base. However, there are recognised barriers to the implementation of EBLP and its training. The aim of this review is to provide a practical summary of potential strategies for training clinician-scientists of the next generation. Current evidence suggests that clinically integrated evidence-based medicine (EBM) training is effective. Tailored e-learning EBM packages and evidence-based journal clubs have been shown to improve knowledge and skills of EBM. Moreover, e-learning is no longer restricted to computer-assisted learning packages. For example, social media platforms such as Twitter have been used to complement existing journal clubs and provide additional post-publication appraisal information for journals. In addition, the delivery of an EBLP curriculum has influence on its success. Although e-learning of EBM skills is effective, having EBM trained teachers available locally promotes the implementation of EBM training. Training courses, such as Training the Trainers, are now available to help trainers identify and make use of EBM training opportunities in clinical practice. On the other hand, peer-assisted learning and trainee-led support networks can strengthen self-directed learning of EBM and research participation among clinical scientists in training. Finally, we emphasise the need to evaluate any EBLP training programme using validated assessment tools to help identify the most crucial ingredients of effective EBLP training. In summary, we recommend on-the-job training of EBM with additional focus on overcoming barriers to its implementation. In addition, future studies evaluating the effectiveness of EBM training should use validated outcome tools, endeavour to achieve adequate power and consider the effects of EBM training on learning environment and patient outcomes.
临床科学家处于实验室科学与一线临床实践的独特交汇点，以支持基于证据的临床实践的临床合作。在分子诊断和个性化医疗的时代，基于证据的实验室实践（EBLP）对于帮助临床科学家跟上这一不断扩展的知识库也至关重要。然而，EBLP的实施及其培训存在公认的障碍。本综述的目的是提供一份关于培训下一代临床科学家的潜在策略的实用总结。目前的证据表明，临床整合的循证医学（EBM）培训是有效的。量身定制的电子学习EBM课程包和基于证据的期刊俱乐部已被证明能提高EBM的知识和技能。此外，电子学习不再局限于计算机辅助学习课程包。例如，推特等社交媒体平台已被用于补充现有的期刊俱乐部，并为期刊提供额外的出版后评估信息。此外，EBLP课程的交付方式会影响其成功。虽然EBM技能的电子学习是有效的，但在当地有接受过EBM培训的教师可促进EBM培训的实施。现在有诸如“培训培训师”之类的培训课程，以帮助培训师识别并利用临床实践中的EBM培训机会。另一方面，同伴辅助学习和学员主导的支持网络可以加强临床科学家在培训中的EBM自主学习和研究参与度。最后，我们强调需要使用经过验证的评估工具来评估任何EBLP培训项目，以帮助确定有效EBLP培训的最关键要素。总之，我们建议进行EBM在职培训，并特别关注克服其实施过程中的障碍。此外，未来评估EBM培训效果的研究应使用经过验证的结果工具，努力获得足够的效力，并考虑EBM培训对学习环境和患者结果的影响。
