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Training of patient and consumer representatives in the basic competencies of evidence-based medicine: a feasibility study

机译：对患者和消费者代表进行循证医学基本能力的培训：可行性研究

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Background Evidence-based medicine (EBM) has become standard approach in medicine. Patients and health authorities increasingly claim active patient roles in decision making. Education to cope with these roles might be useful. We investigated the feasibility, acceptability and possible impact of EBM training courses for patient and consumer representatives. Methods We designed a generic one-week EBM course based on previous experience with EBM courses for non-medical health professionals. A course specific competence test has been developed and validated to measure EBM skills. Formative and summative evaluation of the course comprised: 1) EBM skills; 2) individual learning goals; 3) self-reported implementation after six months using semi-structured interviews; 4) group-based feedback by content analysis. EBM skills' achievement was compared to results gathered by a group of undergraduate University students of Health Sciences and Education who had attended a comparable EBM seminar. Results Fourteen EBM courses were conducted including 161 participants without previous EBM training (n = 54 self-help group representatives, n = 64 professional counsellors, n = 36 patient advocates, n = 7 others); 71% had a higher education degree; all but five finished the course. Most participants stated personal learning goals explicitly related to practicing EBM such as acquisition of critical appraisal skills (n = 130) or research competencies (n = 67). They rated the respective relevance of the course on average with 80% (SD 4) on a visual analogue scale ranging from 0 to 100%. Participants passed the competence test with a mean score of 14.7 (SD 3.0, n = 123) out of 19.5 points. The comparison group of students achieved a mean score of 14.4 (SD 3.3, n = 43). Group-based feedback revealed increases of self confidence, empowerment through EBM methodology and statistical literacy, and acquisition of new concepts of patient information and counselling. Implementation of EBM skills was reported by 84 of the 129 (65%) participants available for follow-up interviews. Barriers included lack of further support, limited possibilities to exchange experiences, and feeling discouraged by negative reactions of health professionals. Conclusions Training in basic EBM competencies for selected patient and consumer representatives is feasible and accepted and may affect counselling and advocacy activities. Implementation of EBM skills needs support beyond the training course.
机译：背景技术循证医学（EBM）已成为医学界的标准方法。患者和卫生当局越来越多地要求患者在决策中发挥积极作用。应对这些角色的教育可能会有用。我们调查了EBM培训课程对患者和消费者代表的可行性，可接受性以及可能产生的影响。方法我们根据以往针对非医疗保健专业人员的EBM课程设计经验，设计了一个通用的为期一周的EBM课程。已经开发了针对特定课程的能力测验并通过了验证，以衡量EBM技能。该课程的形成性和总结性评估包括：1）EBM技能; 2）个人学习目标; 3）六个月后使用半结构化访谈自我报告实施情况; 4）通过内容分析进行基于小组的反馈。将EBM技能的成就与一组参加过类似的EBM研讨会的健康科学与教育大学本科生的研究结果进行了比较。结果进行了14次EBM课程，包括161名未接受过EBM培训的参与者（n = 54个自助小组代表，n = 64个专业咨询师，n = 36位患者代言人，n =其他7位）; 71％具有较高的学历;除五人外，其余全部完成了课程。大多数参与者表示与练习EBM明确相关的个人学习目标，例如获得批判性评估技能（n = 130）或研究能力（n = 67）。他们以0％至100％的视觉模拟量表平均评估了课程的相关性，平均为80％（SD 4）。参加者通过了能力测试，平均得分为14.7分（标准差3.0，n = 123）为14.7。对照组的学生平均得分为14.4（SD 3.3，n = 43）。基于小组的反馈显示出增强的自信，通过EBM方法论和统计素养的能力以及对患者信息和咨询新概念的获取。 129名可进行后续访谈的参与者中有84名（65％）报告了EBM技能的实施情况。障碍包括缺乏进一步的支持，交流经验的机会有限以及由于卫生专业人员的负面反应而灰心。结论对选定的患者和消费者代表进行基本的EBM能力培训是可行的并且可以接受，并且可能影响咨询和倡导活动。实施循证医学技能需要培训课程以外的支持。

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