Objective  To explore the training effect of evidence-based medicine (EBM) courses on clinical thinking ability of medical postgraduates and its influencing factors.

Methods  The clinical thinking ability assessment scale was used to investigate the clinical thinking ability of medical postgraduates before and after the EBM course. SPSS 25.0 software was used for statistical analysis, Mann-Whitney U test and Kruskal-Wallis H test were used for comparison between groups, and Pearson correlation coefficient was used for correlation analysis, and multiple linear regression was used to analyze the influencing factors of clinical thinking ability of medical graduate students.

Results  A total of 383 medical postgraduates were included. The total score of clinical thinking ability of medical postgraduates increased from 70.14 (65.07, 76.06) points before the course to the 71.27 (64.51, 79.72) points after carrying out EBM courses (P<0.001). In all dimensions, except for that of systematic thinking ability (P=0.448), the scores of critical thinking ability and evidence-based thinking ability were significantly higher after class than before class (P<0.001). Gender, knowledge of EBM, weekly duration of EBM practice and satisfaction of EBM course were the factors influencing clinical thinking ability of medical graduate students.

Conclusion  Carrying out EBM courses has obvious effect on cultivating clinical thinking ability of medical postgraduates. Medical colleges and universities should pay attention to improving the clinical thinking ability of medical postgraduates by carrying out EBM curriculum.

1.Martin B, Greenawalt JA, Palmer E, et al. Teaching circle to improvenursing clinical judgment in an undergraduate nursing program[J]. J Nurs Educ, 2020, 59(4): 218-221. DOI: 10.3928/01484834-20200323-08.

2.陈明琪, 祁艳波, 姚业祥, 等. 基于三导向人才培养模式下医学生临床思维培养的思考[J]. 科技创新导报, 2018, 15(14): 210-211. [Chen MQ, Qi YB, Yao YX, et al. Thinking on the cultivation of clinical thinking of medical students under the three-oriented talent training mode[J]. Science and Technology Innovation Herald, 2018, 15(14): 210-211.] DOI: 10.16660/j.cnki.1674-098X.2018.14.210.

3.Djulbegovic B, Guyatt GH. Progress in evidence-based medicine: a quarter century on[J]. Lancet, 2017, 390(10092): 415-423. DOI: 10.1016/S0140-6736(16)31592-6.

4.宋俊岩. 医学生临床思维能力评价指标体系的建立及实证研究[D]. 青岛: 青岛大学, 2015. [Song JY. A study on the evaluation index system of clinical thinking ability of medical students and demonstration[D]. Qingdao: Qingdao University, 2015.] https://d.wanfangdata.com.cn/thesis/ChhUaGVzaXNOZXdTMjAyNDA5MjAxNTE3MjUSB0Q3MDU2NzQaCHM5c3o4YnEx.

5.杨光媚, 韦慧燕, 万乐平, 等. 简化版批判性思维量表在医学生中的信效度分析[J]. 郑州大学学报(医学版), 2022, 57(3): 330-335. [Yang GM, Wei HY, Wan LP, et  al. Reliability and validity of a simplified critical thinking scale applied to medical students[J]. Journal of Zhengzhou University (Medical Sciences), 2022, 57(3): 330-335.] DOI: 10.13705/j.issn.1671-6825.2021.07.104.

6.周晓美. 中文版护生循证实践能力评估量表的修订及其初步应用[D].济南: 泰山医学院, 2016. [Zhou XM. Development of Chinese version of evidence-based practice competence questionnaire among nursing students and preliminary application[D]. Jinan: Taishan Medical College, 2016.] https://d.wanfangdata.com.cn/thesis/D01330963.

7.宋清洁, 彭俊秋, 操传斌, 等. 护理实习生临床思维能力现状调查及影响因素[J]. 当代护士(中旬刊), 2020, 27(7): 157-159. [Song QJ, Peng JQ, Cao CB, et al. Investigation on clinical thinking ability of nursing interns and its influencing factors[J]. Modern Nurse, 2020, 27(7): 157-159.] DOI: 10.19792/j.cnki.1006-6411.2020.20.064.

8.郜文秀, 戴朝福, 夏海月, 等. 循证医学教学对培养医学本科生批判性思维能力效果的研究[J]. 中国高等医学教育, 2020, (2): 73-75. [Gao WX, Dai CF, Xia  HY, et al. Study on the effect of evidence-based medicine teaching on cultivating critical thinking ability of medical undergraduates[J]. Chinese Higher Medical Education, 2020, (2): 73-75.] DOI: 10.3969/j.issn.1002-1701. 2020. 02.038.

9.Liu F, Qu S, Fan Y, et al. Scientific creativity and innovation ability and its determinants among medical postgraduate students in Fujian province of China: a cross sectional study[J]. BMC Med Educ, 2023, 23(1): 444. DOI: 10.1186/s12909-023-04408-9.

10.王艳蕊, 高建梅, 张从飞, 等. 护理本科实习生临床思维能力现况及影响因素研究[J]. 卫生职业教育, 2024, 42(1): 137-141. [Wang YR, Gao JM, Zhang CF, et  al. Study on the status and influencing factors of clinical thinking ability of undergraduate nursing interns[J]. Health Vocational Education, 2024, 42(1): 137-141.] DOI: 10.20037/j.issn.1671-1246.2024.01.40.

11.张奇, 钱寒, 李欣悦, 等. 不同性别临床医学生个性的差异分析[J]. 中国高等医学教育, 2019, (4): 45-46. [Zhang Q, Qian H, Li XY, et al. Analysis of personality differences of clinical medical students of different genders[J]. China Higher Medical Education, 2019, (4): 45-46.] DOI: 10.3969/j.issn.1002-1701.2019.04.023.

12.吴振,张玉丽,李振华,等. 关于临床医学专业学位硕士研究生科研能力培养的探讨[J]. 医学理论与实践, 2023, 36(24): 4310-4313. [Wu Z, Zhang YL, Li ZH, et al. Discussion on the cultivation of scientific research ability of postgraduate students in clinical medicine[J]. The Journal of Medical Theory and Practice, 2023, 36(24): 4310-4313.] DOI: 10.19381/j.issn.1001-7585.2023.24.067.

13.陈小芳, 马金香, 廖剑锋, 等. 参与科研有助于提高医学生批判性思维[J]. 重庆医学, 2016, 45(10): 1427-1429. [Chen XF, Ma JX, Liao JF, et al. Participation in scientific research can improve medical students' critical thinking[J]. Chongqing Medicine, 2016, 45(10): 1427-1429.] DOI: 10.3969/j.issn.1671-8348.2016.10.047.

14.李忠彦, 张意, 周晴, 等. 吉林省某高校医学实习生临床思维能力现状及影响因素分析[J]. 中国高等医学教育, 2020, (9): 30-31. [Li ZY, Zhang Y, Zhou Q, et  al. Current situation and influencing factors of clinical thinking ability of medical interns in a university of Jilin province[J]. China Higher Medical Education, 2020, (9): 30-31.] DOI: 10.3969/j.issn.1002-1701.2020.09.015.

15.曲靓靓, 崔雅玲. 护理硕士生临床思维与循证护理实践能力调查研究[J]. 中国医学教育技术, 2022, 36(4): 503-508. [Qu LL, Cui YL. Investigation on clinical thinking and evidence-based nursing practice ability of nursing master students[J]. China Medical Education Technology, 2022, 36(4): 503-508.] DOI: 10.13566/j.cnki.cmet.cn61-1317/g4.202204023.

16.苏伟, 赵劲民, 刘军廷. 应用循证医学理念培养医学研究生临床实践能力[J]. 广西医科大学学报(社会科学版), 2006, (S1): 51-52. [Su W, Zhao JM, Liu JT, et al. Training clinical practice ability of medical postgraduates with evidence-based medicine concept[J]. Journal of Guangxi Medical University (Social Sciences Edition), 2006, (S1): 51-52.] DOI: 10.16190/j.cnki.45-1211/r.2006.s1.022.

17.陶涛, 陈小芳, 马金香, 等. 医学生循证意识的影响因素分析 [J]. 现代商贸工业, 2018, 39(24): 68-70. [Tao  T, Chen  XF, Ma JX, et al. Analysis of influencing factors of evidence-based awareness of medical students[J]. Modern Business Trade Industry, 2018, 39(24): 68-70.] DOI: 10.19311/j.cnki. 1672-3198.2018.24.030.

18.陈进, 陈燕玲, 郑会贤, 等. 以核心能力为导向, 循证医学为载体, 终身学习为目的的医学人才培养模式研究(一)—医学生批判性思维现状[J]. 中国循证医学杂志, 2010, 10(3): 298-302. [Chen J, Chen YL, Zheng  HX, et al. Medical education model with core competency as guide, evidence-based medicine as carrier and lifelong learning as purpose (1): current status of critical thinking on medical students[J]. Chinese Journal of Evidence-Based Medicine, 2010, 10(3): 298-302.] DOI: 10.3969/j.issn.1672-2531.2010.03.011.