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在初级医生培训项目中,循证医学与共同决策之间有哪些联系?一项范围综述方案。

What are the links between evidence-based medicine and shared decision-making in training programs for junior doctors? A scoping review protocol.

作者信息

Simons Mary, Rapport Frances, Zurynski Yvonne, Cullis Jeremy, Davidson Andrew

机构信息

Library, Macquarie University, North Ryde, New South Wales, Australia

Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia.

出版信息

BMJ Open. 2020 May 12;10(5):e037225. doi: 10.1136/bmjopen-2020-037225.

Abstract

INTRODUCTION

Patient-centred care is pivotal to clinical practice and medical education. The practice of evidence-based medicine (EBM) and shared decision-making (SDM) are complementary aspects of patient-centred care, but they are frequently taught and reported as independent entities. To effectively perform all steps of EBM, clinicians need to include patients in SDM conversations, however, the uptake of this has been slow and inconsistent. A solution may be the incorporation of SDM into EBM training programmes, but such programmes do not routinely include SDM skills development. This scoping review will survey the literature on the kinds of EBM and SDM educational programmes that exist for recently qualified doctors, programmes that incorporate the teaching of both EBM and SDM skills, as well as identifying research gaps in the literature.

METHODS AND ANALYSIS

Literature searches will be conducted in the databases Medline, Embase, Scopus and Cochrane Library. Bibliographies of key articles and their citing references will also be hand-searched and assessed for inclusion. Selected grey literature will be included. Papers must be written in English, or provide English abstracts, and date from 1996 to the present day.Two independent reviewers will screen titles and abstracts, check full texts of selected papers for eligibility and extract the data. Any disagreement will be resolved, and consensus reached, if necessary, with the assistance of a third reviewer. Qualitative and quantitative studies that address educational interventions for either EBM, SDM or both will be included. Data extraction tables will present bibliographic information, populations, interventions, context and outcomes. Data will be summarised using tables and figures and a description of findings.

ETHICS AND DISSEMINATION

This review will synthesise information from publicly available publications and does not require ethics approval. The results will be disseminated via conference presentations and publications in medical journals.

摘要

引言

以患者为中心的医疗是临床实践和医学教育的关键。循证医学(EBM)实践和共同决策(SDM)是以患者为中心的医疗的互补方面,但它们经常被作为独立的实体进行教学和报道。为了有效地执行循证医学的所有步骤,临床医生需要让患者参与共同决策的讨论,然而,这方面的进展一直缓慢且不一致。一种解决方案可能是将共同决策纳入循证医学培训项目,但此类项目通常不包括共同决策技能的培养。本范围综述将调查有关为刚获得资格的医生提供的循证医学和共同决策教育项目的文献,包括同时教授循证医学和共同决策技能的项目,并找出文献中的研究空白。

方法与分析

将在Medline、Embase、Scopus和Cochrane图书馆数据库中进行文献检索。还将人工检索关键文章的参考文献及其引用文献,并评估是否纳入。将纳入选定的灰色文献。论文必须用英文撰写或提供英文摘要,时间范围为1996年至今。两名独立评审员将筛选标题和摘要,检查选定论文的全文是否符合资格并提取数据。如有分歧,将在必要时在第三位评审员的协助下解决并达成共识。将纳入涉及循证医学、共同决策或两者的教育干预的定性和定量研究。数据提取表将呈现书目信息、人群、干预措施、背景和结果。数据将用表格和图表进行总结,并对研究结果进行描述。

伦理与传播

本综述将综合公开出版物中的信息,无需伦理批准。研究结果将通过会议报告和医学期刊发表进行传播。

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