Appraising and applying evidence about a diagnostic test during a performance-based assessment.
Appraising and applying evidence about a diagnostic test during a performance-based assessment.
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DOI：
10.1186/1472-6920-4-20
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发表时间：
2004-10-13
影响因子：
3.6
通讯作者：
Feld R
中科院分区：
文献类型：
--
作者：
Bergus G;Vogelgesang S;Tansey J;Franklin E;Feld R
循证医学的实践要求临床医生评估已发表研究的有效性，然后将结果应用于患者护理。我们想要评估我们即将毕业的医学生是否能够在临床环境中评估和应用诊断测试的研究，并将我们的学生与在其他机构受过培训的同龄人进行比较。本研究的对象为四年级医学生，这些学生之前在概率修正方面表现出了一定的能力，并且刚刚开始一年级的内科住院医师。在遇到模拟患者后，受试者批判性地评价一篇关于适用诊断测试的论文，并根据测试结果修改患者的预测概率。医学生和住院医生在批判性评价方面表现出相似的技能，分别正确回答了6个问题中的4.7和4.9 （p = 0.67）。28名医学生中只有1人（3%）能够正确完成概率修正任务，15名住院医师中没有人能够正确完成概率修正任务（p = 1.00）。这项研究发现，大多数医学院毕业的学生能够评价一篇关于诊断测试的文章，但很少有人能够将文章中的信息应用到病人身上。这些发现提出了关于在诊断测试领域毕业的医学生所拥有的EBM技能的临床有用性的问题。
The practice of Evidence-based Medicine requires that clinicians assess the validity of published research and then apply the results to patient care. We wanted to assess whether our soon-to-graduate medical students could appraise and apply research about a diagnostic test within a clinical context and to compare our students with peers trained at other institutions. 4th year medical students who previously had demonstrated competency at probability revision and just starting first-year Internal Medicine residents were used for this research. Following an encounter with a simulated patient, subjects critically appraised a paper about an applicable diagnostic test and revised the patient's pretest probability given the test result. The medical students and residents demonstrated similar skills at critical appraisal, correctly answering 4.7 and 4.9, respectively, of 6 questions (p = 0.67). Only one out of 28 (3%) medical students and none of the 15 residents were able to correctly complete the probability revision task (p = 1.00). This study found that most students completing medical school are able to appraise an article about a diagnostic test but few are able to apply the information from the article to a patient. These findings raise questions about the clinical usefulness of the EBM skills possessed by graduating medical students within the area of diagnostic testing.