2022 年在埃塞俄比亚对医学研究生进行临床综合短期循证医学培训的效果：一项随机对照试验。

Effectiveness of clinical integrated short course training of evidence based medicine for postgraduate medical specialty students in Ethiopia in 2022: A randomized control trial.

机构信息

Department of Surgery, Addis Ababa University, Addis Ababa, Ethiopia.

Department of Public Health, Jimma University, Jimma, Oromia, Ethiopia.

出版信息

PLoS One. 2023 Jan 20;18(1):e0277886. doi: 10.1371/journal.pone.0277886. eCollection 2023.

DOI:10.1371/journal.pone.0277886

PMID:36662833

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9858829/

Abstract

BACKGROUND

Evidence based medicine (EBM) is a newly emerged philosophy of medical education and health care service which brings quality of health service, efficient use of materials, and patient satisfaction.

OBJECTIVE

To investigate the effectiveness of clinical integrated short course training of EBM for post-graduation medical specialty students in Ethiopia, 2022.

METHOD

Randomized, single blind, superiority trial, and multi-centric experimental study design employed. The eligible candidates randomly assigned to the interventional group and the control group (waitlisted). The allocation of the participant concealed from the principal investigator and participant. Sample size was determined with a two-sided test and α level of 5% and 80% power with the total of 52 calculated sample size and 44 (21 for intervention and 23 for control group) students were used for final analysis. Mann Whitney U test and Independent Sample T test used to test mean difference between intervention and control group after checking normality distributions to estimates the amount by which the training changes the outcome on average compared with the control. The result of the final model expressed in terms of adjusted mean difference and 95% CI; statistical significance declared if the P-value is less than 0.05.

RESULTS

Among 44 postgraduate students, only 29.5% practices EBM during delivering of clinical services. Overall EBM knowledge was changed with adjusted mean difference (Mean±SD 17.55 (13.9, 21.3), p<000). This training provided significant change in all main domain of EBM, more in validity evaluation of the study (Mean±SD, 3.8(1.3, 6.2), p<0.0018) and impact of study design (Mean±SD, 3.8(2.6, 5.1), p<0.000). There was also significant change of overall attitude with adjusted mean difference (Mean±SD, -8.2(-9.6,-6.7), p = 000).

CONCLUSION

Clinical integrated EBM training brought significant change of knowledge and skills of principles and foundations of EBM. Adopting principles of EBM into curricula of postgraduate specialty students would assure the quality of medical care and educations.

摘要

背景

循证医学（EBM）是一种新兴的医学教育和医疗服务理念，它能提高医疗服务质量、提高资源利用效率并增加患者满意度。

目的

探讨 2022 年在埃塞俄比亚对医学研究生进行临床综合短期循证医学培训的效果。

方法

采用随机、单盲、优效性试验和多中心实验研究设计。合格的候选人被随机分配到干预组和对照组（候补）。从主要研究者和参与者那里对参与者的分配进行隐藏。根据双侧检验和 80%的功效，确定了样本量为 52 个，并使用了 44 个（干预组 21 个，对照组 23 个）学生进行最终分析。使用 Mann-Whitney U 检验和独立样本 T 检验来检验干预组和对照组之间的均值差异，以检验培训对平均结果的改变程度。最终模型的结果以调整后的均值差异和 95%CI 表示；如果 P 值小于 0.05，则表示具有统计学意义。

结果

在 44 名研究生中，只有 29.5%在提供临床服务时实践循证医学。总体循证医学知识发生了变化，调整后的平均差异为（Mean±SD 17.55（13.9，21.3），p<000）。这种培训在循证医学的所有主要领域都提供了显著的变化，在研究有效性评估方面更为明显（Mean±SD，3.8（1.3，6.2），p<0.0018）和研究设计的影响（Mean±SD，3.8（2.6，5.1），p<0.000）。总体态度也发生了显著变化，调整后的平均差异为（Mean±SD，-8.2（-9.6，-6.7），p=000）。