Library, Macquarie University, Sydney, New South Wales, Australia
Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia.
BMJ Open. 2022 Apr 25;12(4):e057335. doi: 10.1136/bmjopen-2021-057335.
This scoping review aims to synthesise the current evidence on the inclusion and effectiveness of integrating evidence-based medicine (EBM) and shared decision-making (SDM) into training courses for doctors in training to enhance patient care. Both EBM and SDM appear to be taught separately and their combined role in providing high-quality patient care has not yet been explored.
Scoping review of literature from January 2017 to June 2021.
Any setting where doctors in training could undertake EBM and/or SDM courses (hospitals, universities, clinics and online).
Doctors in training (also known as junior doctors, residents, registrars, trainees, fellows) defined as medical graduates undertaking further training to establish a career pathway.
Searches were conducted in the databases Medline, Embase, Scopus and Cochrane Library. Bibliographies of included articles and their cited references were hand searched and assessed for inclusion. Included studies described training and outcomes of either EBM, SDM or both. Reported outcomes included EBM knowledge and skill tests, attitude surveys, SDM checklists and surveys and patient and doctor experience data obtained from surveys, focus groups and interviews.
Of the 26 included studies, 15 described EBM training courses, 10 described SDM training courses and 1 course combined both EBM and SDM. Courses were heterogeneous in their content and outcomes, making comparisons difficult. EBM courses prioritised quantitative outcome assessments and linked knowledge and skills, such as critical appraisal, but overlooked other key elements of patient-centred care including SDM.
SDM and EBM are taught separately in most training courses. The inclusion of SDM, evaluated by qualitative assessments, is currently omitted, yet could provide a more person-centred care focus in EBM courses and should be investigated to increase our knowledge of the effectiveness of such courses and their role in improving doctors' skills and patient care.
A protocol for this review has been published and contains further details of the methodology.
本范围综述旨在综合目前关于将循证医学（EBM）和共享决策（SDM）纳入医学生培训课程以增强患者护理的证据，这些课程将 EBM 和 SDM 分开教授，其在提供高质量患者护理方面的综合作用尚未得到探索。
对 2017 年 1 月至 2021 年 6 月的文献进行范围综述。
医学生可参加 EBM 和/或 SDM 课程的任何环境（医院、大学、诊所和在线）。
医学生（也称为初级医生、住院医师、住院医师、受训者、研究员），定义为正在接受进一步培训以建立职业道路的医学毕业生。
在 Medline、Embase、Scopus 和 Cochrane Library 数据库中进行了检索。手工搜索并评估了纳入文章的参考文献和引用文献的纳入情况。纳入的研究描述了 EBM、SDM 或两者的培训和结果。报告的结果包括 EBM 知识和技能测试、态度调查、SDM 检查表和调查以及从调查、焦点小组和访谈中获得的患者和医生经验数据。
在 26 项纳入的研究中，15 项描述了 EBM 培训课程，10 项描述了 SDM 培训课程，1 项课程同时结合了 EBM 和 SDM。课程在内容和结果上存在差异，使得比较变得困难。EBM 课程侧重于定量结果评估，并将知识和技能（如批判性评估）联系起来，但忽略了患者为中心护理的其他关键要素，包括 SDM。
大多数培训课程中，SDM 和 EBM 是分开教授的。目前，通过定性评估来评估 SDM 的纳入情况被忽略了，但它可以在 EBM 课程中提供更以患者为中心的护理重点，应该进行调查，以增加我们对这些课程的有效性及其在提高医生技能和患者护理方面的作用的了解。
本综述的方案已经发布，其中包含了方法学的更多详细信息。
