醫師與其他臨床人員在實證工作坊表現之比較

Comparison of Physician and Healthcare Worker Performance during a Small Group Evidence-Based Workshop

10.6145/jme.201003_14(1).0005

楊宗翰(Chung-Han Yang)；陳勇志(Yung-Chih Chen)；楊甯貽(Ning-I Yang)；施昭寧(Jhao-Ning Shin)；余光輝(Kuang-Hui Yu)；王正旭(Cheng-Hsu Wang)

實證醫學 ； 醫學教育 ； 小組教學 ； 教學評估 ； evidence-based medicine ； medical education ； small group teaching ； evaluation

Journal of Medical Education

14卷1期（2010 / 03 / 01）

49 - 57

繁體中文

目的：本研究比較醫師與其他臨床人員在實證工作坊中的表現。研究方法：設計4小時的實證工作坊，以小組實作與互動討論進行，各類臨床人員隨機分散於各組內，藉由前、後測問卷進行課程效益評估，內容包括實證技能、對實證醫學的態度及課程滿意度調查。結果：共51位學員完成有效問卷。其中87.3%對授課模式滿意，認為課程有助臨床工作的有95.8%。在實證技能前後測的評估中，所有項目皆有顯著進步。在多項評估中，醫師的進步較優，特別是『查』的部分。雖然醫師的進步較多，但各類人員間對課程的滿意度並無顯著差異。結論：各類臨床工作人員一同參加課程，皆能有效地提升實證技能。雖各類人員進步不㆒，但對課程有著一樣的高滿意度。

Objective: The effectiveness of evidence-based medicine (EBM) education may vary between different groups of individuals. The performance of physicians and other healthcare workers during a small group evidence-based workshop were compared. Methods: We designed a four hour small group evidence-based workshop that used group discussions and interaction. Physicians and healthcare workers were allocated randomly into different groups. Each study group consisted of five to six members. The course included the formulating of answerable clinical questions, the developing of search strategies from such a question, and the critical appraisal of a selected article about an intervention. Each session started with a short introduction, and was followed by hands-on practice, discussion and various presentations. Self assessment questionnaires, which focused on attitudes and skills towards EBM and course satisfaction, were collected before and after the workshop. Results: A total of 54 participants attended the evidence-based workshops from March 2008 to July 2008, and 51 completed the questionnaire. Among the participants, 19 (35.1%) were physicians and 35 (64.8%) were other healthcare workers, the latter being made up of 17 nursing staff (48.6%), 6 pharmacists(17.1%), 6 medical technicians (17.1%), 2 dieticians(5.7%) and 4 therapists (11.4%). The average age and work seniority of physicians were 30.1±4.1 years-old and 2.2±2.7 years, respectively, compared to 38.2±6.3 years-old and 14.7±7.4 years for the other healthcare workers. Overall, 87.3% were satisfied with the teaching methods of the course and 95.8% felt that the course had been helpful to their daily clinical work. Before the course, most aspects of evidence-based skills did not differ significantly between the physicians and their counterparts. However, after the course, the individuals' attitudes towards EBM and all aspects of evidence-based skills had significantly improved, with the greatest improvement being seen among the physicians; this was especially evident with ”Search” skills. There was no obvious difference between the two groups in terms of course satisfaction. Conclusions: The inclusion of different fields of clinical workers in small group evidence-based workshop can effectively improve the participants' overall evidence-based skills. Although the degree of improvement varies between the different groups, a high level of course satisfaction was found overall.

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