中华医学教育杂志

中华医学教育杂志 ›› 2017, Vol. 37 ›› Issue (4): 601-606.DOI: 10.3760/cma.j.issn.1673-677X.2017.04.027

• 住院医师培训 • 上一篇    下一篇

关于基地培训住院医师循证医学临床实践的基本情况调查

闫秀娥, 张琪, 王晔, 曾琳, 陶立元, 王迎春, 黄永辉   

  1. 100191 北京大学第三医院消化科(闫秀娥、王晔、王迎春、黄永辉),教育处(张琪),流行病学与循证医学中心(曾琳、陶立元)
  • 出版日期:2017-04-01 发布日期:2020-12-09
  • 通讯作者: 黄永辉, Email:13911765322@163.com
  • 基金资助:
    2014年北京大学医学部教育教学研究课题(2014-12)

Investigation on the basic situation of the clinical practice of evidence-based medicine in the training of the resident physician

Yan Xiue, Zhang Qi, Wang Ye, Zeng Lin, Tao Liyuan, Wang Yingchun, Huang Yonghui   

  1. Department of Gastroenterology, Peking University Third Hospital, Beijing 100191, China(Yan XE, Wang Y, Wang YC, Huang YH);
    Department of Education, Peking University Third Hospital, Beijing 100191, China(Zhang Q);
    Evidence-based Medicine and Epidemiology Center, Peking University Third Hospital, Beijing 100191, China(Zeng L, Tao LY)
  • Online:2017-04-01 Published:2020-12-09
  • Contact: Huang Yonghui, Email:13911765322@163.com

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摘要： 目的 对即将进入北京大学第三医院进行基地轮转培训的住院医师进行循证医学课程基本情况的调查和摸底,为制定循证临床实践课程的进度和内容提供依据。方法 采用问卷调查方法,以封闭式问题与开放式问题相结合,对2015年9月即将进入北京大学第三医院进行基地轮转培训的120名住院医师进行调查。结果 共发出调查问卷120份,回收有效问卷112份,有效问卷回收率93.3%。调查结果显示,有72名住院医师在大学期间学习过循证医学理论课程,将其设为A组,再将其余未学习过循证医学理论课程的40名住院医师设为B组。比较分析两组住院医师在文献检索工具的使用和检索策略方面的差异是否具有统计学意义。两组住院医师在遇到实际临床问题时的解决方法,文献检索的主动性,文献检索的语言以及常用的检索工具方面的差异均无统计学意义(均P＞0.05)。A组在遇到实际问题时,优先阅读的文献前3位分别为临床指南、综述和高质量单项研究报告,B组前3位分别为临床指南、综述和教科书。B组中不查文献,等待上级医师指示的医师比例要高于A组。A组住院医师国内外临床指南均阅读的比例相对高于B组,B组住院医师只阅读国内临床指南的比例高于A组。两组住院医师应用临床指南的情况和频率类似。结论 循证医学理论课程的学习,在一定程度上提高了住院医师主动检索文献的意识,但存在理论课程学习与临床实践相脱节等问题,迫切需要用一门桥梁课程将两者有机衔接。

关键词: 循证医学, 临床实践, 文献检索, 指南

Abstract: Objective To provide a basis for formulating the content of clinical practice of evidence-based medicine course through investigating the basic situation in the training of the resident physician.Methods Resident physician were investigated who came to Peking University Third Hospital in 9th 2015 through the questionnaire.Results (1)120 questionnaires were sent and 112 efficient copies were recalled. The recovery rate is 93.3%. Resident physician were divided into two groups according to whether they took the theoretical course of evidence-based medicine or not. Group A had a total 72 physicians who had taken the theoretical course of evidence-based medicine, and group B had a total 40 physicians who had not. The differences about the literature retrieval and strategy between the two groups was compared. (1) There was no significant difference about literature retrieval activity, language used to search literature, common retrieval tools between the two groups. The residents in group A prefer to read guideline, review and high quality research, meanwhile, residents in group B prefer to read guideline, review, textbooks. The proportion of waiting for instructions from superior doctors in group B(10.0%) is higher than group A(1.4%). (3) The proportion of reading bilingual guideline in group A(54.2%) is higher than group B(40%). On the contrary, the proportion of reading Chinese guideline only in group B(52.5%) is higher than group A(36.1%). The situation and frequency in both groups are similar.Conclusions The learning of evidence-based medicine theory course improves the awareness of active retrieval literature to some extent. However, there is a gap between the theory and clinical practice. It is urgent to build a bridge course to combine them.

Key words: Evidence-based medicine, Clinical practice, Literature review, Guideline