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一项焦点小组讨论研究,探讨英国普通外科住院医师对其培训项目中循证医学的看法。

A Focus Group Discussion Study Exploring General Surgery Trainees' Views on Evidence-Based Medicine Within Their Training Program in the United Kingdom.

作者信息

Tokidis Evripidis, Vivekananda-Schmidt Pirashanthie, Balasubramanian Saba P

机构信息

Clinical Medicine, School of Medicine and Population Health, University of Sheffield, Sheffield, South Yorkshire, United Kingdom, S10 2TN.

Clinical Medicine, School of Medicine and Population Health, University of Sheffield, Sheffield, South Yorkshire, United Kingdom, S10 2TN.

出版信息

J Surg Educ. 2025 Jan;82(1):103348. doi: 10.1016/j.jsurg.2024.103348. Epub 2024 Nov 23.

Abstract

INTRODUCTION

Evidence-based Medicine (EBM) is fundamental to modern healthcare and its integration into postgraduate curricula is strongly advocated. Despite its relevance, incorporating EBM in postgraduate training, specifically in general surgery, is fraught with challenges. This study aims to explore the perceptions of general surgical trainees regarding EBM, focusing on the process of achieving competency, assessment and its associated challenges.

METHODS

Four semi-structured focus group discussions were conducted, involving participants with varying experience in general surgery. Sessions were audio-recorded, de-identified and transcribed verbatim to facilitate data analysis. Thematic analysis was employed to identify recurring patterns and themes within the dataset, ensuring rigor and reliability in the findings. Saturation was achieved when no new themes or codes emerged from the data.

RESULTS

Eighteen trainees at different levels of training, academic experience and from different regions of the UK took part. The discussions were thematically analysed. Four key themes were identified: "Knowledge and understanding of EBM," "Developing EBM competencies," "Assessment in EBM," and "Barriers for EBM." Thematic saturation was achieved by the fourth focus group.

CONCLUSION

This study provides insights into the landscape of EBM in general surgery in the United Kingdom. Trainees demonstrated knowledge and understanding of EBM and the process of achieving relevant competencies. EBM assessment was perceived to be part of their training. Nevertheless, systemic barriers and inherent challenges appear to hinder the development of EBM competencies within postgraduate general surgical training. Achieving this requires a participatory approach to engage stakeholders to further develop the existing competency-based curriculum.

摘要

引言

循证医学(EBM)是现代医疗保健的基础,强烈主张将其纳入研究生课程。尽管其具有相关性,但将循证医学纳入研究生培训,特别是普通外科培训,充满了挑战。本研究旨在探讨普通外科住院医师对循证医学的看法,重点关注获得能力的过程、评估及其相关挑战。

方法

进行了四次半结构化焦点小组讨论,参与者在普通外科方面有不同经验。会议进行了录音、去识别处理并逐字转录以促进数据分析。采用主题分析来识别数据集中反复出现的模式和主题,确保研究结果的严谨性和可靠性。当数据中没有出现新的主题或代码时,达到了饱和状态。

结果

来自英国不同地区、处于不同培训水平和学术经验的18名住院医师参与了研究。对讨论进行了主题分析。确定了四个关键主题:“循证医学的知识与理解”、“培养循证医学能力”、“循证医学评估”和“循证医学的障碍”。第四个焦点小组实现了主题饱和。

结论

本研究为英国普通外科循证医学的现状提供了见解。住院医师展示了对循证医学及其获得相关能力过程的知识和理解。循证医学评估被视为他们培训的一部分。然而,系统性障碍和内在挑战似乎阻碍了普通外科研究生培训中循证医学能力的发展。要实现这一点,需要一种参与式方法来促使利益相关者进一步完善现有的基于能力的课程。

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