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研究生医学教育学术活动倡议:系统评价和荟萃分析。

Graduate medical education scholarly activities initiatives: a systematic review and meta-analysis.

机构信息

Affiliated Anesthesiologists, Oklahoma City, OK, USA.

Department of Medicine, Indiana University, Indianapolis, IN, USA.

出版信息

BMC Med Educ. 2018 Dec 22;18(1):318. doi: 10.1186/s12909-018-1407-8.

Abstract

BACKGROUND

According to the Accreditation Council for Graduate Medical Education residents "should participate in scholarly activity." The development of a sustainable, successful resident scholarship program is a difficult task faced by graduate medical education leadership.

METHODS

A medical librarian conducted a systematic literature search for English language articles published on scholarly activities initiatives in Graduate Medical Education (GME) between January 2003 and March 31 2017. Inclusion criteria included implementing a graduate medical education research curriculum or initiative designed to enhance intern, resident, or fellow scholarly activities using a control or comparison group. We defined major outcomes as increases in publications or presentations. Random effects meta-analysis was used to compare the rate of publications before and after implementation of curriculum or initiative.

RESULTS

We identified 32 relevant articles. Twenty-nine (91%) reported on resident publications, with 35% (10/29) reporting statistically significant increases. Fifteen articles (47%) reported on regional, national, or international presentations, with only 13% (2/15) reporting a statistically significant increase in productivity. Nineteen studies were eligible for inclusion in the meta-analysis; for these studies, the post-initiative publication rate was estimated to be 2.6 times the pre-intervention rate (95% CI: 1.6 to 4.3; p < 0.001).

CONCLUSIONS

Our systematic review identified 32 articles describing curricula and initiatives used by GME programs to increase scholarly activity. The three most frequently reported initiatives were mentors (88%), curriculum (59%), and protected time (59%). Although no specific strategy was identified as paramount to improved productivity, meta-analysis revealed that the publication rate was significantly higher following the implementation of an initiative. Thus, we conclude that a culture of emphasis on resident scholarship is the most important step. We call for well-designed research studies with control or comparison groups and a power analysis focused on identifying best practices for future scholarly activities curricula and initiatives.

摘要

背景

根据研究生医学教育认证委员会的规定,住院医师“应参与学术活动”。建立一个可持续的、成功的住院医师奖学金项目是研究生医学教育领导层面临的一项艰巨任务。

方法

一名医学图书馆员对 2003 年 1 月至 2017 年 3 月 31 日期间发表的关于研究生医学教育(GME)中学术活动计划的英文文献进行了系统的文献检索。纳入标准包括实施一项旨在通过对照或比较组提高住院医师、住院医师或研究员学术活动的研究生医学教育研究课程或计划。我们将主要结果定义为出版物或演讲数量的增加。采用随机效应荟萃分析比较课程或计划实施前后的出版率。

结果

我们确定了 32 篇相关文章。29 篇(91%)报告了住院医师的出版物,其中 35%(10/29)报告了统计学上显著的增加。15 篇文章(47%)报告了区域性、全国性或国际性演讲,只有 13%(2/15)报告了生产力的统计学上显著提高。19 项研究符合纳入荟萃分析的条件;对于这些研究,干预后出版物的比率估计为干预前的 2.6 倍(95%置信区间:1.6 至 4.3;p<0.001)。

结论

我们的系统评价确定了 32 篇描述研究生医学教育计划用于增加学术活动的课程和计划的文章。报告最多的三项举措是导师(88%)、课程(59%)和保护时间(59%)。虽然没有确定任何特定策略对提高生产力至关重要,但荟萃分析显示,在实施计划后,出版物的比率显著提高。因此,我们得出结论,强调住院医师奖学金的文化是最重要的一步。我们呼吁开展有对照组或对比组的精心设计的研究,并进行具有足够功效分析的研究,以确定未来学术活动课程和计划的最佳实践。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e1e/6303993/ee30262f972b/12909_2018_1407_Fig1_HTML.jpg

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