Aneese Andrew M, Nasr Justine A, Halalau Alexandra
Department of Internal Medicine, Beaumont Health, Royal Oak, MI 48073, USA.
Department of Internal Medicine, Oakland University William Beaumont School of Medicine, Rochester, MI 48309, USA.
Adv Med Educ Pract. 2019 Jul 22;10:533-546. doi: 10.2147/AMEP.S203334. eCollection 2019.
Evidence based medicine (EBM) skills are often lacking in the general internal medicine physician population. Our aim is to evaluate the impact of our internal medicine EBM curriculum on the residents' EBM skills and knowledge through mixed methods.
A prospective study was performed that evaluated the EBM curriculum: quantitatively, with pre/posttests and qualitatively through a focus group that addressed residents' opinion on the educational and clinical impact of each aspect of the curriculum.
A total of 60 internal medicine residents were surveyed. Short-term EBM skills: therapy workshops (N=25) median pretest score of 8 (IQR): [6-9]) vs posttest 8 (IQR: [8-9]), (=0.006); diagnosis (N=16) pretest score of 6 (IQR: [3-6]) vs posttest 7 (IQR: [6-9]), (=0.006); systematic review (N=13) pretest score of 4 (IQR: [4-6]) vs posttest 7 (IQR: [6-8]), (=0.002); and harm (N=16) pretest score of 6 (IQR: [5-7]) vs posttest 7 (IQR: [7-8]), (=0.004). Long-term EBM skills: Fresno test of competence in EBM, pretest median score of 110.5/212 (IQR: 96.0-124.0) and a median posttest score of 115/212 (IQR: 100.0-130.0) (=0.60). Having previous EBM training, being actively involved in research and being the first author on a publication was associated with higher Fresno test scores. Focus group provided qualitative feedback on the residents' EBM curriculum perception.
This curriculum adds a significant contribution to the current field of medical education as it fills an important educational gap, through defining ways of effectively delivering EBM concepts which led to improvement in residents' ability to evaluate and apply medical literature. The EBM curriculum was overall well received by the residents.
普通内科医生群体往往缺乏循证医学（EBM）技能。我们的目标是通过混合方法评估我们的内科循证医学课程对住院医师循证医学技能和知识的影响。
进行了一项前瞻性研究，对循证医学课程进行评估：定量方面，通过前后测试；定性方面，通过焦点小组，该小组讨论了住院医师对课程各方面教育和临床影响的看法。
共对60名内科住院医师进行了调查。短期循证医学技能：治疗研讨会（N = 25），前测中位数分数为8（四分位间距：[6-9]），后测为8（四分位间距：[8-9]），（P = 0.006）；诊断（N = 16），前测分数为6（四分位间距：[3-6]），后测为7（四分位间距：[6-9]），（P = 0.006）；系统评价（N = 13），前测分数为4（四分位间距：[4-6]），后测为7（四分位间距：[6-8]），（P = 0.002）；以及危害（N = 并16），前测分数为6（四分位间距：[5-7]），后测为7（四分位间距：[7-8]），（P = 0.004）。长期循证医学技能：循证医学能力弗雷斯诺测试，前测中位数分数为110.5/212（四分位间距：96.0 - 124.0），后测中位数分数为115/212（四分位间距：100.0 - 130.0）（P = 0.60）。之前接受过循证医学培训、积极参与研究以及作为出版物的第一作者与较高的弗雷斯诺测试分数相关。焦点小组提供了关于住院医师对循证医学课程认知的定性反馈。
该课程通过定义有效传授循证医学概念的方法，填补了重要的教育空白，从而提高了住院医师评估和应用医学文献的能力，为当前医学教育领域做出了重大贡献。循证医学课程总体上受到住院医师的好评。
