Mlika Mona, Mezni Faouzi, Zakhama Lilia, Labbene Iheb, Jouini Mohamed
University of Tunis El Manar. Faculty of Medicine of Tunis.
Department of Pathology. Trauma and major burn center. Ben Arous.
Tunis Med. 2023 Nov 5;101(11):845-851.
Skills in critical appraisal of medical literature are compulsory to achieve in medical practice. This step is the third step of the evidence-based medicine process whose main role is to bridge a gap between scientific evidence and practice. Acquiring skills in critical appraisal of the literature has been reported to be challenging for the trainees with different limits according to their levels, backgrounds or specialties.
To assess the limits and factors influencing the practice of appraising literature of different students from the same faculty. This faculty included training of biostatistics and preventive medicine in the curriculum during the first 2 years of medical education without linking this learning to the evidence-based medicine practice.
The authors performed a qualitative study including volunteers who attended voluntarily the same training about critical appraisal of medical literature. The study was based on a satisfaction questionnaire fulfilled by all the participants at the end of the training and on an individual semi-structured interviews programmed 3 months after the training. The satisfaction questionnaire was rated by the authors. The authors proceeded also to a content analysis of the interviews following 3 steps: pre-analysis, treatment of the results, and interpretation.
All the participants (95) fulfilled the questionnaire. The satisfaction's mean score revealed a general moderate satisfaction. Eleven students agreed to be interviewed: Five students from the third year of medical education, 2 students from the second year of medical education, 2 postgraduate students and 2 family doctors. The main themes discussed by the interviewees consisted of training organization, the assessment, the impact on research and the impact on the care process.
To promote EBM learning, medical students first need to actively participate to interactive learning, introduced early and gradually into the curriculum and integrating all specialties including postgraduate students.
医学文献批判性评价技能是医学实践中必须掌握的。这一步骤是循证医学过程的第三步，其主要作用是弥合科学证据与实践之间的差距。据报道，对于不同水平、背景或专业的学员来说，掌握文献批判性评价技能具有挑战性。
评估同一学院不同学生在文献评价实践中的限制因素和影响因素。该学院在医学教育的前两年课程中纳入了生物统计学和预防医学培训，但未将此学习与循证医学实践联系起来。
作者进行了一项定性研究，包括自愿参加医学文献批判性评价同一培训的志愿者。该研究基于培训结束时所有参与者填写的满意度问卷以及培训3个月后安排的个人半结构化访谈。满意度问卷由作者评分。作者还按照三个步骤对访谈进行了内容分析：预分析、结果处理和解释。
所有参与者（95人）都填写了问卷。满意度平均得分显示总体满意度中等。11名学生同意接受访谈：5名医学教育三年级学生、2名医学教育二年级学生、2名研究生和2名家庭医生。受访者讨论的主要主题包括培训组织、评估、对研究的影响以及对护理过程的影响。
为了促进循证医学学习，医学生首先需要积极参与互动式学习，这种学习应尽早并逐步引入课程，并涵盖包括研究生在内的所有专业。
