In recent years, the rapid development of anti-tumor drugs has led to the accumulation of a large amount of evidence. High-level evidence has been incorporated into clinical guidelines but does not meet the needs of each patient in the real world. Oncology specialists need to conduct in-depth evidence-based thinking on issues that are encountered in clinic but not covered in the guidelines. From October 2019 to March 2023, the Oncology Department of Zhongshan Hospital Affiliated to Fudan University conducted intensive evidence-based thinking training for 17 physicians who were receiving standardized training for oncology specialists, focusing on developing their abilities in evaluating evidence quality, extracting and analyzing clinical data. This article elucidates the design and implementation process of the training and evaluates the training effect through evidence-based thinking assessment. Each physician has undergone at least 2 assessments. The results showed that the total average score of the 17 physicians in the second assessment increased by 9.6 points compared to the first assessment (P<0.001). The most significant improvement was observed in the ability to interpret literature deeply with the average score of the second assessment increasing by 2.4 points compared to the first assessment (P<0.001). We have established a preliminary evidence-based thinking training method for standardized training for oncology specialists to improve their ability to deeply interpret literature around clinical issues, and then extract effective data for clinical application.
Xu Xiaojing
,
Wang Yan
,
Guo Xi
,
Yu Shan
,
Li Qian
,
Yu Yiyi
,
Cui Yuehong
,
Zhou Yuhong
,
Liu Tianshu
. Exploration of the application of evidence-based thinking intensive training in standardized training for oncology specialists[J]. Chinese Journal of Medical Education, 2023
, 43(9)
: 692
-696
.
DOI: 10.3760/cma.j.cn115259-20221202-01518
[1] Shiravand Y, Khodadadi F, Kashani S, et al. Immune checkpoint inhibitors in cancer therapy[J].Curr Oncol,2022,29(5):3044-3060. DOI: 10.3390/curroncol29050247.
[2] Vere J, Gibson B. Evidence-based medicine as science[J].J Eval Clin Pract,2019,25(6):997-1002. DOI: 10.1111/jep.13090.
[3] Freddi G, Romàn-Pumar JL. Evidence-based medicine: what it can and cannot do[J].Ann Ist Super Sanita,2011,47(1):22-25. DOI: 10.4415/ANN_11_01_06.
[4] Labrie M, Brugge JS, Mills GB, et al. Therapy resistance: opportunities created by adaptive responses to targeted therapies in cancer[J].Nat Rev Cancer,2022,22(6):323-339. DOI: 10.1038/s41568-022-00454-5.
[5] Ciardiello F, Ciardiello D, Martini G, et al. Clinical management of metastatic colorectal cancer in the era of precision medicine[J].CA Cancer J Clin,2022,72(4):372-401. DOI: 10.3322/caac.21728.
[6] Rodrigues-Ferreira S, Nahmias C. Predictive biomarkers for personalized medicine in breast cancer[J].Cancer Lett,2022,545:215828. DOI: 10.1016/j.canlet.2022.215828.
[7] 王鹏, 江晓华, 耿浩非, 等. 迷你临床演练评估在肿瘤专科医师规范化培训中的应用[J].重庆医学,2021,50(12):2149-2152. DOI: 10.3969/j.issn.1671-8348.2021.12.038.
[8] 姚榕, 周磊磊, 岳顺, 等. PBL联合MDT的教学模式在肿瘤专科医师规范化培训中的应用[J].继续医学教育,2019,33(3):43-44. DOI: 10.3969/j.issn.1004-6763.2019.03.023.
[9] 石岩岩, 何旋, 卢贵胜, 等. 医学生见习阶段循证临床实践课程的设计和实施[J].中华医学教育杂志,2022,42(4):305-308. DOI: 10.3760/cma.j.cn115259-20210903-01117.
[10] 姚亚妮, 王玉玲, 杨新玲. 临床研究生循证医学教学改革实践[J].中华医学教育探索杂志,2015(2):155-157. DOI: 10.3760/cma.j.issn.2095-1485.2015.02.012.
[11] 陈亚男, 阮晓岚, 欧阳雯, 等. PBL结合EBM教学在住院医师规范化培训中应用的系统评价[J]. 中华医学教育探索杂志, 2022,21(6):722-726.DOI: 10.3760/cma.j.cn116021-20200601-00888.
[12] Mehmi I, Hamid O. Immunotherapy of cancer in the era of checkpoint inhibitor[J].Clin Exp Metastasis,2022,39(1):231-237. DOI: 10.1007/s10585-021-10132-9.
[13] Wu Z, Chen Q, Qu L, et al. Adverse events of immune checkpoint inhibitors therapy for urologic cancer patients in clinical trials: a collaborative systematic review and meta-analysis[J]. Eur Urol,2022,81(4):414-425. DOI: 10.1016/j.eururo.2022.01.028.
[14] Morganti S, Tarantino P, Ferraro E, et al. Next generation sequencing (NGS): a revolutionary technology in pharmacogenomics and personalized medicine in cancer[J].Adv Exp Med Biol,2019,1168:9-30. DOI: 10.1007/978-3-030-24100-1_2.
[15] Schiavenato M, Chu F. PICO: What it is and what it is not[J].Nurse Educ Pract,2021,56:103194. DOI: 10.1016/j.nepr.2021.103194.
[16] 周登远, 汪培山. 临床对照试验文献质量评价的发展与现状[J].药物流行病学杂志,2004,13(4):211-214. DOI: 10.3969/j.issn.1005-0698.2004.04.017.
[17] Filleron T, Gilhodes J, Delord JP, et al. Subgroup analysis and forest plots: limitations and interests[J].Bull Cancer,2017,104(1):92-100. DOI: 10.1016/j.bulcan.2016.09.023.