最佳证据医学教育（BEME）系统评价：在临床实习中使用移动（手持）设备为卫生专业学生提供教育支持，哪种方法效果最佳？BEME 指南第 52 号。
A Best Evidence Medical Education (BEME) systematic review of: What works best for health professions students using mobile (hand-held) devices for educational support on clinical placements? BEME Guide No. 52.
机构信息
a Department of Public Health & Policy , The University of Liverpool , Liverpool , UK.
b School of Medicine , The University of Liverpool , Liverpool , UK.
出版信息
Med Teach. 2019 Feb;41(2):125-140. doi: 10.1080/0142159X.2018.1508829. Epub 2018 Nov 28.
BACKGROUND
Ingrained assumptions about clinical placements (clerkships) for health professions students pursuing primary basic qualifications might undermine best educational use of mobile devices.
QUESTION
What works best for health professions students using mobile (hand-held) devices for educational support on clinical placements?
METHODS
A Best Evidence Medical Education (BEME) effectiveness-review of "justification" complemented by "clarification" and "description" research searched: MEDLINE, Educational Resource Information Center, Web of Science, Cumulative Index to Nursing and Allied Health Literature, PsycInfo, Cochrane Central, Scopus (1988-2016). Reviewer-pairs screened titles/abstracts. One pair coded, extracted, and synthesized evidence, working within the pragmatism paradigm.
SUMMARY OF RESULTS
From screening 2279 abstracts, 49 articles met inclusion-criteria, counting four systematic reviews for context. The 45 articles of at least Kirkpatrick K2 primary research mostly contributed K3 (39/45, 86.7%), mixed methods (21/45, 46.7%), and S3-strength (just over one-half) evidence. Mobile devices particularly supported student: assessment; communication; clinical decision-making; logbook/notetaking; and accessing information (in about two-thirds). Informal and hidden curricula included: concerns about: disapproval; confidentiality and privacy; security;-distraction by social connectivity and busy clinical settings; and mixed messages about policy.
DISCUSSION AND CONCLUSION
This idiosyncratic evidence-base of modest robustness suggested that mobile devices provide potentially powerful educational support on clinical placement, particularly with student transitions, metalearning, and care contribution. Explicit policy must tackle informal and hidden curricula though, addressing concerns about transgressions.
背景
对于正在攻读初级基础资格的医疗专业学生来说，他们对临床实习（ clerkships ）的固有假设可能会破坏移动设备在最佳教育中的使用。
问题
对于在临床实习中使用移动（手持）设备接受教育支持的医疗专业学生来说，什么方法效果最好？
方法
一项最佳证据医学教育（BEME）的有效性评价，对“理由”进行了“澄清”和“描述”研究搜索：MEDLINE、教育资源信息中心、Web of Science、护理学和联合健康文献累积索引、PsycInfo、Cochrane 中心、Scopus（1988-2016）。审查员对标题/摘要进行了筛选。有一对审查员对证据进行了编码、提取和综合，在实用主义范式内进行工作。
结果总结
从筛选的 2279 篇摘要中，有 49 篇文章符合纳入标准，其中包括 4 篇系统综述作为背景。至少有 Kirkpatrick K2 级主要研究的 45 篇文章主要提供了 K3 级（39/45，86.7%）、混合方法（21/45，46.7%）和 S3 级（超过一半）的证据。移动设备特别支持学生：评估；沟通；临床决策；日志/笔记记录；以及获取信息（约三分之二）。非正式和隐性课程包括：对以下方面的担忧：不赞成；保密性和隐私；安全；社交联系和繁忙的临床环境造成的分心；以及关于政策的矛盾信息。
讨论与结论
这一独特的证据基础具有适度的稳健性，表明移动设备在临床实习中提供了潜在强大的教育支持，特别是在学生过渡、元学习和护理贡献方面。然而，必须通过明确的政策来解决非正式和隐性课程问题，解决对违规行为的担忧。
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