Weill Cornell Medicine in Qatar, Education City, P.O. Box 24144, Doha, Qatar.
Hamad Medical Corporation, Doha, Qatar.
BMC Med Educ. 2020 Nov 10;20(1):414. doi: 10.1186/s12909-020-02341-9.
The aims of Evidence-Based medicine (EBM) are to promote critical thinking and produces better patients' outcome (Profetto-McGrath J, J Prof Nurs Off J Am Assoc Coll Nurs 21:364-371, 2005). Accreditation Council for Graduate Medical Education (ACGME) competencies require trainees to locate, appraise and apply clinical evidence to patients' care. Despite the emphasis that ACGME place on EBM, few organizations provide adequate training in EBM. This is even more critical in regions where medical trainees matriculate from diverse backgrounds of undergraduate medical education, where EBM may not be emphasized nor taught at all. EBM practice has a history of research in the West, however, EBM has not been widely studied in the Middle East.
Clinicians and trainees at Hamad Medical Corporation (HMC) matriculate from many countries in the Middle East and North Africa (MENA) and Asia. Because trainees in Graduate Medical Education (GME) come to HMC from a variety of geographic backgrounds, it is assumed that they also have a variety of experiences and aptitudes in EBM. To assess trainees EBM attitudes and knowledge in the internal medicine department at HMC in Doha, Qatar, the authors surveyed residents and fellows using a two-part survey. The first part was adapted from the evidence-based practice inventory by Kaper to assess trainees' attitudes and perceptions of EBM. Trainees were also asked to complete the Assessing Competency in Evidence Based Medicine (ACE) tool to evaluate their aptitude in different elements of EBM. The results from the two parts were analyzed.
The average score on the ACE tool among the participants was 8.9 (±1.6). Most participants rated themselves as beginners or intermediate in their EBM capabilities. Higher ACE scores were observed from participants with educational background from South Asia, and among those with more favorable attitudes towards EBM. There was no clear pattern that early incorporation of EBM into practice will result in better ACE score. Participants also reported reasonable abilities in EBM tasks and a favorable work atmosphere for EBM implementation. Lack of knowledge, resources, and time were the most reported barriers to utilizing EBM.
While it is clear that participants are enthusiastic about EBM and see it as a useful method for clinical decision making, their aptitude in EBM is not optimal and there are gaps and barriers for them to practice.
循证医学（EBM）的目的是促进批判性思维并改善患者的预后（Profetto-McGrath J，J Prof Nurs Off J Am Assoc Coll Nurs 21：364-371，2005）。研究生医学教育认证委员会（ACGME）的能力要求学员定位、评估和应用临床证据来为患者提供护理。尽管 ACGME 强调循证医学，但很少有组织提供足够的循证医学培训。在医学学员来自不同本科医学教育背景的地区，这一点更为关键，在这些地区，循证医学可能根本没有得到强调或教授。循证医学实践在西方已有研究历史，但在中东地区尚未得到广泛研究。
哈马德医疗保健公司（HMC）的临床医生和学员来自中东和北非（MENA）以及亚洲的许多国家。由于研究生医学教育（GME）的学员来自各种地理背景，因此假设他们在循证医学方面也具有各种经验和能力。为了评估卡塔尔多哈 HMC 内科住院医师和研究员的循证医学态度和知识，作者使用两部分调查对住院医师和研究员进行了调查。第一部分改编自 Kaper 的循证实践清单，以评估学员对循证医学的态度和看法。学员还被要求完成评估循证医学能力的 ACE 工具，以评估他们在循证医学不同要素中的能力。分析了两部分的结果。
参与者在 ACE 工具上的平均得分为 8.9（±1.6）。大多数参与者认为自己在循证医学能力方面处于初学者或中级水平。来自南亚的参与者和对循证医学持更有利态度的参与者的 ACE 得分较高。没有明显的模式表明早期将循证医学纳入实践将导致 ACE 得分更高。参与者还报告了他们在循证医学任务方面的合理能力，以及有利于实施循证医学的工作氛围。缺乏知识、资源和时间是他们利用循证医学的最大障碍。
虽然很明显，参与者对循证医学充满热情，并将其视为临床决策的有用方法，但他们在循证医学方面的能力并不理想，并且他们在实践中存在差距和障碍。
