Helwig A, Bower D, Wolff M, Guse C
Medical College of Wisconsin, Milwaukee, USA.
Fam Med. 1998 Jun;30(6):431-5.
Information regarding clinical practice guideline (CPG) use in residency education is limited. We surveyed a regional population of family practice residents to determine use, attitudes, and curricular needs for practice guidelines.
A written survey was developed that measured residents' exposure to, frequency of use, attitudes, access, and knowledge about use of CPGs. The survey was mailed to 114 family practice residents.
The response rate was 75%. The most frequently seen guidelines were immunization schedules, cancer screening, hyperlipidemia, and hypertension management. The residents reported positive attitudes toward CPGs; 75% thought CPGs were easy to use, 80% thought they improved their efficiency, 78% thought they improved their residency education, and 75% thought they improved patient care. Barriers to effective use of practice guidelines were also identified; 20% knew where to find guidelines in their clinic, 35% had faculty modeling, and 22% knew how to evaluate the validity of a guideline. Eighty-nine percent of respondents desired instruction on CPG use and interpretation.
The surveyed family practice residents have similar usage rates for CPGs as the literature reports for practicing physicians, but residents report more positive attitudes. Barriers that prevent effective use of CPGs in training environments include lack of critical appraisal abilities and faculty role modeling.
关于临床实践指南（CPG）在住院医师培训教育中的应用信息有限。我们对一个地区的家庭医学住院医师群体进行了调查，以确定实践指南的使用情况、态度及课程需求。
设计了一份书面调查问卷，用于衡量住院医师对CPG的接触情况、使用频率、态度、获取途径以及使用知识。该问卷被邮寄给114名家庭医学住院医师。
回复率为75%。最常看到的指南是免疫接种时间表、癌症筛查、高脂血症和高血压管理。住院医师对CPG持积极态度；75%的人认为CPG易于使用，80%的人认为它们提高了工作效率，78%的人认为它们改善了住院医师培训教育，75%的人认为它们改善了患者护理。还确定了有效使用实践指南的障碍；20%的人知道在其诊所何处可找到指南，35%的人有教员示范，22%的人知道如何评估指南的有效性。89%的受访者希望获得关于CPG使用和解读的指导。
接受调查的家庭医学住院医师对CPG的使用率与文献报道的执业医师相似，但住院医师的态度更为积极。在培训环境中阻碍有效使用CPG的障碍包括缺乏批判性评估能力和教员的示范作用。
