Evidence Based Medicine: A Review of Basic Concepts, Learning Theories, Teaching Approaches and Assessment Methods

Abstract

Background: Evidence-based medicine is the conscientious explicit and judicious use of current best evidence in combination with clinical experience in making decisions about the care of individual patients. Training on asking clinical questions, effective database searches and critical appraisal of scientific research is necessary to practice evidence-based medicine. The lack of knowledge and skills is one of the important factors that hinder the practice of evidence-based medicine. For this reason, national and international educational organizations and boards emphasize that evidence-based medicine training should be included in the medical school curriculum. However, no consensus has yet been reached on the most effective training methods and assessment-evaluation methods, and a gold standard has not been established. The general approach of medical faculties is to develop the most effective education program in line with their educational programs, goals and objectives and the needs of their students by considering the current education strategies.
Methods: This review is a narrative review. Systematic reviews and meta-analyzes, which are accepted as the highest level of evidence in evidence-based practice, have been systematically searched in the MEDLINE, Cochrane Library and Google Scholar databases using predefined search strategies for the preparation of the review. In addition, original research articles examining evidence-based medicine training in medical education and current conceptual frameworks are examined.
Results: The review provides a comprehensive literature review on the general applications of Evidence-Based Medicine training in the world, the education methods used, the evaluation of education programs and the assessment and measurement methods.
Conclusions: Although there is no strong evidence to provide standardization of evidence-based medicine training in under- and postgraduate medical education, common suggestions from existing studies are to start at the early stages of medical education, covering all steps of evidence-based medicine, being clinically integrated and interactive and using measurement and evaluation tools with strong psychometric properties specific to this area.

Keywords

• Evidence-Based Medicine
• Medical Education
• Learning Theories

Kanıta Dayalı Tıp: Temel Kavramlar, Öğrenme Teorileri, Eğitim Yaklaşımları ve Ölçme-Değerlendirme Yöntemleri ile İlgili Derleme

Abstract

Amaç: Kanıta dayalı tıp; hekimlerin, hastalarla ilgili tıbbi kararlar verirken klinik deneyimlerinin yanı sıra bilimsel kanıtı da dürüst, açık ve mantıklı şekilde kullanmalarıdır. Kanıta dayalı tıbbı uygulayabilmek için klinik soru oluşturma, veri tabanlarında etkin arama yapma ve bilimsel araştırmaların eleştirel olarak değerlendirilmesi gibi konularda bilgi ve beceriye sahip olmak gereklidir. Kanıta dayalı tıp uygulamalarını engelleyen önemli faktörlerden birisi yeterince bilgi ve beceriye sahip olunmamasıdır. Bu nedenle ulusal ve uluslararası eğitim organizasyonları tıp fakültesi eğitim programlarında kanıta dayalı tıp eğitimlerine yer verilmesi gerektiğini vurgulamaktadır. Ancak gerek en etkin eğitim yöntemi gerekse ölçme-değerlendirme yöntemleri konusunda henüz fikir birliğine varılamamış ve altın standart belirlenmemiştir. Genel yaklaşım tıp fakültelerinin güncel eğitim stratejilerini göz önünde bulundurarak eğitim programları, amaç ve hedefleri ve öğrencilerinin gereksinimleri doğrultusunda kendileri için en etkin olabilecek eğitim programını geliştirmeleri yönündedir. Geleneksel derleme olarak hazırlanan bu makalede kanıta dayalı tıp eğitim programları geliştirilirken göz önünde bulundurulması gereken temel prensiplerin incelenmesi amaçlanmıştır.
Gereç ve Yöntem: Derleme türü geleneksel derlemedir. Derlemenin hazırlanması için önceden belirlenen arama stratejileri kullanılarak MEDLINE, Cochrane ve Google Scholar veri tabanında sistematik tarama yapılmış, kanıta dayalı tıp uygulamalarında en üst kanıt düzeyi olarak kabul edilen sistematik derleme ve meta-analizlere ulaşılarak makalede sonuçlarına yer verilmiştir. Ek olarak tıp eğitiminde kanıta dayalı tıp eğitimlerini inceleyen orijinal araştırma makaleleri ve konu ilgili mevcut kavramsal çerçeveler incelenmiştir.
Bulgular: Derleme Kanıta Dayalı Tıp eğitimlerinin dünyadaki genel uygulamaları, kullanılan eğitim yöntemleri, eğitim programlarının değerlendirilmesi ve ölçme-değerlendirme yöntemlerine ilişkin geniş bir literatür incelemesi sunmaktadır.
Sonuç: Tıp eğitiminde mezuniyet öncesi ve sonrası dönemde uygulanan kanıta dayalı tıp eğitimlerinin standardizasyonu sağlayacak şekilde güçlü kanıtlar mevcut olmamakla birlikte, mevcut çalışmalardan elde edilen ortak öneriler: Kanıta dayalı tıp eğtimlerinin tıp eğitiminin erken dönemlerinde başlaması, kanıta dayalı tıbbın tüm basamaklarını kapsaması, klinikle entegre, interaktif olması ve bu alana özel güçlü psikometrik özelliklere sahip ölçme-değerlendirme araçlarının kullanılması yönündedir. 

Keywords

• Kanıta Dayalı Tıp
• Tıp Eğitimi
• Öğrenme Teorileri

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