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医学生对循证医学能力的认知:培训期间的变化以及与客观指标的一致性

Perceptions of competency with evidence-based medicine among medical students: changes through training and alignment with objective measures.

作者信息

Clode Nicholas J, Danielson Kirsty, Dennett Elizabeth

机构信息

Department of Surgery and Anaesthesia, University of Otago Wellington, Wellington, New Zealand; Therapies Department, Hutt Valley DHB, Lower Hutt, New Zealand.

Department of Surgery and Anaesthesia, University of Otago Wellington, Wellington, New Zealand.

出版信息

N Z Med J. 2021 Mar 12;134(1531):63-75.

Abstract

AIMS

To identify whether medical students' self-perception of competence with evidence-based medicine (EBM) increases throughout their senior years of medical training. Furthermore, to identify whether their self-perception aligns with their true competence measured using a validated tool. This investigation also outlines whether students report observation of and participation in the process of EBM in clinical practice.

METHODS

A cross-sectional survey was undertaken with a convenience sample of medical students in their fourth, fifth and sixth years of training at one campus site of Otago Medical School between February and April 2018. Self-perceived competence with EBM was measured using a 10-item questionnaire. True competence was measured using the Assessing Competency in Evidence-Based Medicine (ACE) tool. Students were asked to self-report their observation of and participation in the process of EBM in clinical settings.

RESULTS

Out of 99 students invited to participate, we received a response rate of 97%. Participants included 37 fourth-year, 32 fifth-year and 27 sixth-year students. Mean self-perceived EBM competence was higher in sixth-year compared to fourth-year students. True competence was not significantly different between year groups. Medical students reported little observation of EBM in clinical settings, and few students reported to have participated in the process of EBM during clinical encounters.

CONCLUSION

The lack of explicit role modelling of EBM in clinical environments may be a barrier to students improving EBM competence in the senior years of medical training.

摘要

目的

确定医学生在医学培训的高年级阶段对循证医学(EBM)能力的自我认知是否会提高。此外,确定他们的自我认知是否与使用经过验证的工具所衡量的实际能力相符。本调查还概述了学生是否报告在临床实践中观察到并参与了循证医学过程。

方法

于2018年2月至4月,在奥塔哥医学院一个校区对四、五、六年级的医学生进行了便利抽样横断面调查。使用一份包含10个条目的问卷来衡量学生对循证医学的自我感知能力。使用循证医学能力评估(ACE)工具来衡量实际能力。要求学生自我报告他们在临床环境中对循证医学过程的观察和参与情况。

结果

在邀请参与的99名学生中,我们收到了97%的回复率。参与者包括37名四年级、32名五年级和27名六年级学生。与四年级学生相比,六年级学生自我感知的循证医学能力平均更高。不同年级组之间的实际能力没有显著差异。医学生报告在临床环境中很少观察到循证医学,很少有学生报告在临床接触中参与了循证医学过程。

结论

临床环境中缺乏循证医学的明确榜样作用可能是医学生在医学培训高年级阶段提高循证医学能力的一个障碍。

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