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Systematic reviews of evidence in medical education and clinical medicine: Is the nature of evidence similar?

机译：在医学教育和临床医学中对证据进行系统的审查：证据的性质是否相似？

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Background: It is accepted worldwide that clinical and educational decisions should be informed by the best available evidence, not individual opinion only. Aims: This article discusses the epistemological basis of educational evidence, as compared with clinical evidence, looking at the different nature of the science behind each one. Method: Two models - BEME Reviews in medical education and Cochrane Reviews in clinical medicine - based on our own experience of a soon to be published BEME Review (BEMER) and several systematic reviews our group has published in clinical medicine - were used to identify similarities and differences between the two approaches. Key findings: The evidence to support clinical as well as educational decision making is different in its nature, as well as in its quality. However, their approach is similar in its fundamental steps (design a question, select evidence, critically appraise it, synthesize and apply), so the differences between BEME and Cochrane are perhaps more a matter of degree, than the existence of fundamental differences. Conclusions: Two fundamental principles - decision making should be supported by a hierarchy of evidence and evidence alone is never sufficient for sound practice - apply to BEME and Cochrane reviews. The capacity to transfer their results into practice is the most important factor in terms of success of both approaches.
机译：背景：全球公认，临床和教育决策应以现有的最佳证据为依据，而不仅仅是个人意见。目的：本文讨论了教育证据与临床证据相比的认识论基础，着眼于每种证据背后科学的不同性质。方法：根据我们自己即将出版的《 BEME评论》（BEMER）的经验以及我们小组在临床医学杂志上发表的一些系统评价，基于两种模型-医学教育中的BEME评论和临床医学中的Cochrane评论-用于确定相似性以及两种方法之间的差异。主要发现：支持临床和教育决策的证据在性质和质量上都不同。但是，他们的方法在基本步骤上相似（设计问题，选择证据，严格评估，综合和应用），因此BEME和Cochrane之间的差异可能是程度上的问题，而不是基本差异的存在。结论：两项基本原则-决策应由证据层次支持，仅凭证据不足以进行合理实践-适用于BEME和Cochrane审查。就两种方法的成功而言，将其结果转化为实践的能力是最重要的因素。

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