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物理医学与康复(PM&R)中的证据“王牌”。

"ACEing" the Evidence Within Physical Medicine and Rehabilitation (PM&R).

机构信息

Resident Physician, Department of Physical Medicine and Rehabilitation, Loma Linda University School of Medicine.

Assistant Professor and Residency Program Director, Department of Physical Medicine and Rehabilitation, Loma Linda University School of Medicine.

出版信息

MedEdPORTAL. 2020 Dec 11;16:11051. doi: 10.15766/mep_2374-8265.11051.

Abstract

INTRODUCTION

While evidence-based medicine (EBM) is important in all fields of medicine, it can be specifically challenging for the field of physical medicine and rehabilitation (PM&R), a rapidly developing field where the standard hierarchy of evidence does not always apply and randomized controlled trials can be difficult to design. We developed an EBM curriculum for residents that improved EBM competency and was specific to the field of PM&R.

METHODS

We developed a blended learning longitudinal approach to EBM designed specifically for PM&R residents, with a pre- and postcourse assessment by the Evidence-Based Practice Questionnaire (EBPQ) and Assessing Competency in EBM (ACE) tool. Interactive presentations paired with structured presession assignments were held for five introductory sessions, followed by monthly EBM and journal club sessions over 1 academic year.

RESULTS

Fourteen residents of varying postgraduate years of training participated in the EBM curriculum from 2018 to 2019. EBPQ scores after completion of 1 academic year of this EBM curriculum were significantly improved compared to precurriculum EBPQ scores. Comparison of pre- and post-EBPQ and ACE tool scores stratified by postgraduate year did not show a significant correlation between resident levels and self-reported prior EBM education.

DISCUSSION

This longitudinal blended learning EBM curriculum resulted in an increase in residents' self-reported behaviors and knowledge/skills regarding EBM. The curriculum was also effective in advancing competency of the residents to an EBM Advanced level using the ACE tool. The curriculum can be easily replicated in other PM&R residency programs.

摘要

简介

循证医学(EBM)在医学的各个领域都很重要,但对于物理医学与康复(PM&R)领域来说,这可能是特别具有挑战性的,因为该领域发展迅速,标准证据等级并不总是适用,且设计随机对照试验可能具有难度。我们为住院医师开发了循证医学课程,提高了循证医学的能力,并且专门针对 PM&R 领域。

方法

我们开发了一种针对 PM&R 住院医师的混合式纵向循证医学学习方法,通过循证实践问卷(EBPQ)和评估循证医学能力(ACE)工具进行课前和课后评估。共进行了五次入门课程,包括互动演示和结构化的课前作业,然后在 1 个学年中每月进行循证医学和期刊俱乐部课程。

结果

2018 年至 2019 年期间,共有 14 名不同研究生年级的住院医师参加了循证医学课程。与课前 EBPQ 相比,完成 1 学年该循证医学课程后的 EBPQ 评分显著提高。按研究生年级分层比较课前和课后 EBPQ 和 ACE 工具评分,并未显示住院医师水平与自我报告的先前循证医学教育之间存在显著相关性。

讨论

这种纵向混合式学习循证医学课程提高了住院医师对循证医学的自我报告行为、知识/技能。该课程还通过 ACE 工具有效地提高了住院医师的循证医学高级水平能力。该课程可以很容易地在其他 PM&R 住院医师培训计划中复制。

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Evidence in Rehabilitation Medicine: Between Facts and Prejudices.康复医学中的证据:事实与偏见之间。
Am J Phys Med Rehabil. 2019 Feb;98(2):88-96. doi: 10.1097/PHM.0000000000001033.
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Barriers to evidence-based medicine: a systematic review.循证医学的障碍:一项系统综述。
J Eval Clin Pract. 2014 Dec;20(6):793-802. doi: 10.1111/jep.12222. Epub 2014 Aug 18.

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