Husnoo Nilofer, Johnston Judith, Harikrishnan Athur
Department of Colorectal Surgery, Northern General Hospital, Sheffield Teaching Hospitals NHS Trust, Herries Road, Sheffield, S10 4NH UK.
Indian J Surg. 2022 Apr;84(Suppl 1):31-34. doi: 10.1007/s12262-021-03038-z. Epub 2021 Jul 24.
Surgeons have historically learned their craft through the apprenticeship model from their mentors. Knowledge and practices acquired this way can rapidly become outdated. Providing high-quality care to patients requires surgeons to keep their knowledge up to date in line with evolving new evidence. The principles of evidence-based medicine (EBM) and its application to surgery, evidence-based surgery (EBS), are pivotal in updating and refining surgical practice. Changing from the conventional practice of surgical education to a structured evidence-based format requires a transformative process in all the levels of surgical practice encompassing trainees and trainers. Equally important is providing an optimal environment to review the evidence and deliver the surgical teaching and incorporate effective assessment tools to monitor the process. In this article, we revisit the levels of evidence and explore the different issues related to EBS such as barriers to EBS, incorporation of EBS to the surgical curriculum and discuss practical ways to implement EBS in the surgical curriculum.
从历史上看,外科医生是通过师从导师的学徒模式来学习其技艺的。通过这种方式获得的知识和实践可能很快就会过时。为患者提供高质量的护理要求外科医生根据不断发展的新证据来更新他们的知识。循证医学(EBM)的原则及其在外科手术中的应用,即循证外科(EBS),对于更新和完善外科手术实践至关重要。从传统的外科教育实践转变为结构化的循证模式,需要在包括学员和培训师在内的所有外科实践层面进行变革。同样重要的是提供一个最佳环境来审查证据、开展外科教学并纳入有效的评估工具以监测这一过程。在本文中,我们重新审视证据级别,探讨与循证外科相关的不同问题,如循证外科的障碍、将循证外科纳入外科课程,并讨论在外科课程中实施循证外科的实际方法。