循证医学学习评估工具系统综述

A systematic review on the instrument for evaluating evidence-based practice competency

目的描述、评价并总结当前用于评估循证医学学习效果的工具,为循证医学教学和培训效果的评估提供数据。方法利用Pubmed、浙江中医药大学图书馆中国生物医学文献数据库(CBMdisc)、CNKI、Web of science数据资源,检索自2011年1月—2016年12月有关循证医学学习评估工具方面的文献,并由2位全科医学教授分别浏览和筛选,最终纳入的文献包含一种评估循证医学学习效果的工具,并含有对评估工具效度和信度指标的结果分析。结果筛选出15篇全文文献,9篇关于评估工具的开发,6篇关于评估工具的运用。其中,6个运用评估工具的研究都提示循证医学培训能显著提高受训者循证医学知识水平。结论结构效度、内部一致性是制作量表时常用的评估项目;就循证医疗5个步骤的能力评估,不同的评估工具具有不同的评估侧重;现有的循证医学能力评估工具中,弗雷斯诺量表最具有效性、可信度以及心理测量特质,且对循证医疗实施的前4个步骤的能力均有客观考量,可作为最佳候选评价工具用以评估我国全科医生循证医学能力。

Objective To describe, appraise and summarize currently available evaluating evidence-based practice（EBP） competency evaluation instruments for appraising evidence-based medicine （EBM） teaching and training outcomes. Methods We searched the Pubmed, CBMdisc, CNKI and Web of science to select the literatures published between April ,2011 and April,2016 regarding the instrument for evaluating evidence-based practice competency. Two professors of General Practice assessed independently all titles, abstracts, full texts and abstracted data. The studies involving EBP competency evaluation instruments and analysis on its validity and reliability were included. Results Total 15 articles were selected, including 9 studies describing the development of tools, and 6 tested and verified the tools through EBM interventions. These 6 studies reported that knowledge scores had been increased significantly after the intervention. Conclusions Construct validity and internal reliability are the most common assessment items when making scale. Instruments with reasonable validity are available for evaluating some domains of EBP（5 steps of EBP） and may be targeted to different evaluation needs. The Fresno test has been proved the best documentation of validity and reliability and psychometric properties, it evaluates the first four steps, and is the best candidate for evaluating Chinese general practitioners EBM competency.