Les habiletés requises pour la lecture critique en médecine : un cadre de référence issu d'une recension des écrits

Abstract

Context: Increasingly, medical training programs incorporate the teaching of the scientific method and of the critical reading of scientific publications into school curricula. However, up to now, it seems that not a single frame of référence specifying the skills required to review scientific publications has been published. Goal : Based on a survey of the existing literature. to propose a frame of référence covering the skills required to review medical scientific publications. Methodology: A bibliographic search through MEDLINE from 1980 to 1996, through FAMLI, from 1980 to 1992, and through BRS-COLLEAGUES, from 1990 to 1993, led to the identification of 50 articles. Papers dealing with the evaluation of the effectiveness of the teaching of the critical reading of medical literature and with the characteristics of these skills, both in medicine and in cognitive psychology, were retained for analysis. Results: A survey of the literature (n = 27) allowed us to establish a list of skills required to review a medical scientific publication. From this list, we propose a frame of référence centered on the tasks performed by a clinician who reads scientific publications with the perspective of practice improvement. During this process, he must make five very important decisions. He starts by (1) deciding to read or not the article after (2) assessing just how relevant it is. Next, (3) he assesses the validity of the results before (4) deciding on their usefulness. Finally, (5) he decides whether of not to make changes to his practice based on his evaluation. Conclusion: The proposed frame of référence could be useful in helping to teach critical reading. Clinicians may use it as a basis for planning their continuing education activities in the field. However, an operational version of the proposed frame must be set up and validated before valid and effective training and search tools can be implemented.