Anderson Caitlin R, Haydek John, Golub Lucas, Leong Traci, Smith Dustin T, Liebzeit Jason, Dressler Daniel D
Department of Medicine, Emory University School of Medicine, 49 Jesse Hill Jr. Drive SE, Atlanta, GA 30303 USA.
CareMore Health, Atlanta, GA USA.
Med Sci Educ. 2020 May 13;30(2):885-890. doi: 10.1007/s40670-020-00970-9. eCollection 2020 Jun.
Medical information is expanding at exponential rates. Practicing physicians must acquire skills to efficiently navigate large bodies of evidence to answer clinical questions daily. How best to prepare medical students to meet this challenge remains unknown. The authors sought to design, implement, and assess a pragmatic evidence-based medicine (EBM) course engaging students at the transition from undergraduate to graduate medical education.
An elective course was offered during the required 1-month Capstone medical school curriculum. Participants included one hundred sixty-eight graduating fourth-year medical students at Emory University School of Medicine who completed the course from 2012 to 2018. Through interactive didactics, small groups, and independent work, students actively employed various electronic tools to navigate medical literature and engaged in structured critical appraisal of guidelines and meta-analyses to answer clinical questions.
Assessment data was available for 161 of the 168 participants (95.8%). Pre- and post-assessments demonstrated students' significant improvement in perceived and demonstrated EBM knowledge and skills ( < 0.001), consistent across gender and specialty subgroups.
The Capstone EBM course empowered graduating medical students to comfortably navigate electronic medical resources and accurately appraise summary literature. The objective improvement in knowledge, the perceived improvement in skill, and the subjective comments support this curricular approach to effectively prepare graduating students for pragmatic practice-based learning as resident physicians.
医学信息正以指数级速度增长。执业医师必须掌握相关技能,以便每天能高效地在大量证据中查找答案来解决临床问题。如何最好地让医学生做好应对这一挑战的准备仍是未知的。作者试图设计、实施并评估一门实用的循证医学(EBM)课程,让处于从本科医学教育向研究生医学教育过渡阶段的学生参与其中。
在医学院校必修的为期1个月的顶点课程期间开设了一门选修课。参与者包括埃默里大学医学院168名即将毕业的四年级医学生,他们于2012年至年完成了该课程。通过互动式教学、小组讨论和独立作业,学生积极使用各种电子工具查阅医学文献,并对指南和荟萃分析进行结构化的批判性评估以回答临床问题。
168名参与者中有161名(95.8%)有评估数据。课前和课后评估表明,学生在循证医学知识和技能的认知及实际表现方面有显著提高(<0.001),在性别和专业亚组中情况一致。
顶点循证医学课程使即将毕业的医学生能够自如地查阅电子医学资源并准确评估综述文献。知识的客观提高、技能的认知提高以及主观评价都支持这种课程方法,能有效地让即将毕业的学生为作为住院医师的基于实践的学习做好准备。