Hahn Thomas W, Regner Caitlin, Metzger Emily, Zakletskaia Larissa, Birstler Jen
University of Wisconsin Department of Family Medicine and Community Health, Madison, WI.
Access Community Health Centers, Madison, WI.
PRiMER. 2022 Feb 14;6:2. doi: 10.22454/PRiMER.2022.716258. eCollection 2022.
Evidence-based medicine (EBM) teaching is most successful when integrated with patient care, but finding time for teaching on inpatient rotations is difficult. Obstetrics (OB)-Newborn TEACH (Teaching Evidence-based medicine And Clinical topics in the Hospital) Cards is a curricular tool for efficient teaching sessions on maternity care rotations. We evaluated the impact of OB-Newborn TEACH Cards on resident EBM attitudes and skills, exposure to clinical topics, and patient management.
OB-Newborn TEACH Cards includes 56 cards on obstetrics and newborn topics with background and foreground discussion questions. Residents on a family medicine maternal-child service completed pre- and postrotation surveys to assess the cards' impact on EBM attitudes and skills. Faculty and residents also completed point-of-care surveys to assess the self-reported influence on management decisions.
Of 24 potential resident participants, 58% completed pre- and postrotation surveys, which showed significant increase in perceived EBM skills like applying evidence to a clinical scenario (=.04), but a decrease in reported attitudes that EBM is realistic (=.028) and useful (=.025). Residents agreed the cards exposed them to a variety of topics. Point-of-care surveys (n=58) indicated that 57% of the time respondents used a card to learn about a topic not related to a specific patient. When used to learn about specific patients, the cards influenced self-reported patient care 44% of the time.
OB-Newborn TEACH Cards are a promising inpatient teaching tool for improving perceived EBM clinical application, exposing residents to maternal-child topics, and influencing patient care decisions.
循证医学（EBM）教学与患者护理相结合时最为成功，但在住院医师轮转期间安排教学时间很困难。妇产科-新生儿TEACH（医院循证医学与临床主题教学）卡片是一种用于妇产科轮转高效教学课程的工具。我们评估了妇产科-新生儿TEACH卡片对住院医师循证医学态度和技能、临床主题接触以及患者管理的影响。
妇产科-新生儿TEACH卡片包括56张关于妇产科和新生儿主题的卡片，并配有背景和前景讨论问题。在家庭医学母婴服务部门轮转的住院医师完成了轮转前后的调查，以评估卡片对循证医学态度和技能的影响。教员和住院医师还完成了即时护理调查，以评估自我报告的对管理决策的影响。
在24名潜在的住院医师参与者中，58%完成了轮转前后的调查，结果显示在将证据应用于临床场景等循证医学技能方面有显著提高（P =.04），但在循证医学是现实可行的（P =.028）和有用的（P =.025）报告态度方面有所下降。住院医师们一致认为这些卡片使他们接触到了各种主题。即时护理调查（n = 58）表明，57%的情况下，受访者使用卡片了解与特定患者无关的主题。当用于了解特定患者时，卡片在44%的时间里影响了自我报告的患者护理。
妇产科-新生儿TEACH卡片是一种有前景的住院教学工具，可提高循证医学临床应用的认知度，使住院医师接触母婴主题，并影响患者护理决策。
