Ramjaun Aliya, Sudarshan Monisha, Patakfalvi Laura, Tamblyn Robyn, Meguerditchian Ari N
McGill Clinical and Health Informatics Research Group, McGill University, 140 Pine Avenue West, Montreal, Canada.
Department of Surgery, McGill University Health Centre, Montreal, Canada.
BMC Med Educ. 2015 Mar 7;15:33. doi: 10.1186/s12909-015-0306-5.
Effective medication reconciliation is critical in reducing the risk of preventable adverse drug events. Medical trainees are often responsible for medication reconciliation on admission, transfer and discharge of the most vulnerable patients; therefore, it is important that trainees are educated on this aspect of quality care.
We conducted a systematic review using MEDLINE and EMBASE databases to identify education initiatives targeted at improving trainee skill and knowledge in carrying out medication reconciliation. Studies published in English or French between July 1980 and July 2013, where the primary focus of the article was the role of medical trainees in conducting medication reconciliation, and where trainee-specific data was reported, were included. Included articles must have reported trainee-specific data. Given the anticipated heterogeneity and array of outcomes, we were unable to employ a specific tool in assessing the risk of bias across studies.
Seven studies met pre-specified eligibility criteria, indicating the lack of published education initiatives targeted towards improving trainee knowledge and experience. Four described an education intervention targeted towards students completing internal medicine clerkship, while the remaining 3 were implemented among residents. Although no two interventions were the same, 5 out of 7 included an experiential component.
Varying success was achieved with medication reconciliation education interventions. While some noted improved competence and/or confidence amongst trainees, namely undergraduate medical students, others noted little effect resulting from the intervention.
有效的用药核对对于降低可预防的药物不良事件风险至关重要。医学实习生通常负责对最脆弱患者进行入院、转科和出院时的用药核对;因此,对实习生进行这一优质护理方面的教育很重要。
我们使用MEDLINE和EMBASE数据库进行了一项系统评价,以确定旨在提高实习生进行用药核对技能和知识的教育举措。纳入1980年7月至2013年7月期间以英文或法文发表的研究,这些研究的主要重点是医学实习生在进行用药核对中的作用,并且报告了针对实习生的具体数据。纳入的文章必须报告针对实习生的具体数据。鉴于预期的异质性和一系列结果,我们无法采用特定工具评估各项研究的偏倚风险。
七项研究符合预先设定的纳入标准,这表明缺乏针对提高实习生知识和经验的已发表教育举措。四项研究描述了针对完成内科实习的学生的教育干预措施,其余三项是在住院医师中实施的。虽然没有两项干预措施是相同的,但七项研究中有五项包含体验式部分。
用药核对教育干预措施取得了不同程度的成功。一些研究指出实习生(即本科医学生)的能力和/或信心有所提高,而另一些研究则指出干预措施效果甚微。