Analysis of Orthopedic Resident Ability to Apply Levels of Evidence Criteria to Scientific Articles

详细信息    查看全文

• 作者：Louis C. Grandizio ; DO^* ; ^{clgrandizio@geisinger.edu" class="auth_mail" title="E-mail the corresponding author} ; Stephanie S. Shim ; BS^* ; Jove Graham ; PhD^* ; Callista Costopoulos ; DO^* ; ^&dagger ; ; Gerard Cush ; MD^* ; Joel C. Klena ; MD^*
• 关键词：orthopedics ; levels of evidence ; resident education ; research
• 刊名：Journal of Surgical Education
• 出版年：2016
• 出版时间：May-June 2016
• 年：2016
• 卷：73
• 期：3
• 页码：381-385
• 全文大小：188 K

文摘

In the era of evidence-based medicine, understanding study design and levels of evidence (LoE) criteria is an important component of resident education and aids practicing surgeons in making informed clinical decisions. The purpose of this study is to analyze the ability of orthopedic residents to accurately determine LoE criteria for published articles compared with medical students.

Design

Basic science article.

Setting

Geisinger Medical Center (Danville, PA), tertiary referral center.

Participants

Overall, 25 U.S. orthopedic residents and 15 4th year medical students interviewing for a residency position in orthopedic surgery voluntarily participated and provided baseline demographic information. A total of 15 articles from the American Volume of Journal of Bone and Joint Surgery were identified. Study participants were provided with the article title, the abstract, and the complete methods section. The assigned LoE designation was withheld and access to the LoE criteria used by Journal of Bone and Joint Surgery was provided. Each participant was assigned a study type and LoE designation for each article.

Results

There were more correct responses regarding the article type (67%) than for LoE designation (39%). For LoE, the intraclass correlation coefficient was 0.30.

The percentage of correct responses for article type and LoE increased with more years of training (p = 0.005 and p = 0.002). Although residents had a higher proportion of correct LoE responses overall than medical students, this difference did not reach statistical significance (42% vs. 35%, p = 0.07).

Conclusions

Although improvements in accurately determining both article type and LoE were seen among residents with increasing years of training, residents were unable to demonstrate a statistically significant improvement for determining LoE or article type when compared with medical students. Strategies to improve resident understanding of LoE guidelines need to be incorporated into orthopedic residencies, especially when considering the increased emphasis on evidence-based medicine.