Evidence-based Practice Knowledge and Skills in Undergraduate Medical Students: A Pilot Study

Chih-Wei Chang ； Sheng-Han Tsai ； Ya-Min Cheng ； Yi-Chun Chen ； Pei-Ying Wu ； Ting-Yu Yang ； Jing-Jane Tsai ； Yu-Fang Huang

《Journal of Medical Education》 24卷2期 (2020/06) Pp. 93-106

https://doi.org/10.6145/jme.202006_24(2).0005

摘要

Purpose: Instructors' perspectives on students' evidence-based practice (EBP) competencies may not reflect their true performance. Using an objective assessment tool, this pilot study explored the effectiveness of EBP teaching for undergraduate year (UGY) medical students at the beginning of UGY5-7 levels, and offered important suggestions for developing an EBP curriculum. Methods: An assessment programme was conducted for novice (UGY5) and advanced beginner-1 (UGY6) and -2 (UGY7) students with the Knowledge of Research Evidence Competencies (K-REC) instrument. Students' performance on EBP knowledge and skills were scored and analysed. Results: A low proportion of novice and advanced beginner-1 students were discovered to be competent at understanding biostatistics and Boolean search strategies. Critical appraisal skills were found to be undeveloped in ＞ 50% of novice level students, while advanced beginner-1 students obtained significantly higher scores than novice level students. Novice level students in 2013 had significantly higher scores than novice level students in 2012, specifically in the categories of problems, interventions, comparisons and outcomes formation, study design knowledge, search strategy, critical appraisal, and levels of evidence processes. A significant improvement in EBP competencies was observed in the cohort over the duration of their novice to advanced beginner-2 levels. However, there was no significant enhancement in their medical subject headings search strategy and biostatistics. No change in total scores was recorded for two advanced beginner-2 cohorts between 2014 and 2016. Conclusions: The K-REC assessment results of the achievements and insufficiencies of EBP learning at novice and advanced beginner stages are helpful for curriculum reform. Teaching of research biostatistics, search strategies, and critical appraisal skills should be incorporated at the UGY4 level or sooner. EBP competencies after curriculum reform and resource coordination are being investigated.

關鍵字

evidence-based health care ； evidence-based medicine ； evidence-based practice ； undergraduate year ； curriculum development ； knowledge of research evidence competencies instrument

參考文獻

Wu PY, Chang CW, Yang TY, et al.: Evidence-based health care (EBHC) Teaching and teachers' perspectives towards teaching EBHC for undergraduate medical students: a nationwide survey in Taiwan. J Med Education (Taiwan) 2019; 23: 85–99 (doi:10.6145/jme.201906_23(2).0003)

Hung HY, Wang YW, Feng JY, et al.: Evidence-based practice curriculum development for undergraduate nursing students: the preliminary results of an action research study in Taiwan. J Nurs Res. 2019;27:e30. doi:10.1097/jnr.0000000000000298

Dawes M, Summerskill W, Glasziou P, et al.: Sicily statement on evidence-based practice. BMC Med Educ. 2005;5:1. Published 2005 Jan 5. doi:10.1186/1472-6920-5-1

Riba AL: Evidence-based performance and quality improvement in the acute cardiac care setting. Crit Care Clin. 2008;24:201–x. doi:10.1016/j.ccc.2007.09.002

Glasziou P, Ogrinc G, Goodman S: Can evidence-based medicine and clinical quality improvement learn from each other?. BMJ Qual Saf. 2011;20 Suppl 1:i13–i17. doi:10.1136/bmjqs.2010.046524