PDF(Pubmed)
Abstract：
BACKGROUND: Incorporating emerging knowledge into Emergency Medical Service (EMS) competency assessments is critical to reflect current evidence-based out-of-hospital care. However, a standardized approach is needed to incorporate new evidence into EMS competency assessments because of the rapid pace of knowledge generation.
OBJECTIVE: The objective was to develop a framework to evaluate and integrate new source material into EMS competency assessments.
METHODS: The National Registry of Emergency Medical Technicians (National Registry) and the Prehospital Guidelines Consortium (PGC) convened a panel of experts. A Delphi method, consisting of virtual meetings and electronic surveys, was used to develop a Table of Evidence matrix that defines sources of EMS evidence. In Round One, participants listed all potential sources of evidence available to inform EMS education. In Round Two, participants categorized these sources into: (a) levels of evidence quality; and (b) type of source material. In Round Three, the panel revised a proposed Table of Evidence. Finally, in Round Four, participants provided recommendations on how each source should be incorporated into competency assessments depending on type and quality. Descriptive statistics were calculated with qualitative analyses conducted by two independent reviewers and a third arbitrator.
RESULTS: In Round One, 24 sources of evidence were identified. In Round Two, these were classified into high- (n = 4), medium- (n = 15), and low-quality (n = 5) of evidence, followed by categorization by purpose into providing recommendations (n = 10), primary research (n = 7), and educational content (n = 7). In Round Three, the Table of Evidence was revised based on participant feedback. In Round Four, the panel developed a tiered system of evidence integration from immediate incorporation of high-quality sources to more stringent requirements for lower-quality sources.
CONCLUSIONS: The Table of Evidence provides a framework for the rapid and standardized incorporation of new source material into EMS competency assessments. Future goals are to evaluate the application of the Table of Evidence framework in initial and continued competency assessments.
OBJECTIVE: The objective was to develop a framework to evaluate and integrate new source material into EMS competency assessments.
METHODS: The National Registry of Emergency Medical Technicians (National Registry) and the Prehospital Guidelines Consortium (PGC) convened a panel of experts. A Delphi method, consisting of virtual meetings and electronic surveys, was used to develop a Table of Evidence matrix that defines sources of EMS evidence. In Round One, participants listed all potential sources of evidence available to inform EMS education. In Round Two, participants categorized these sources into: (a) levels of evidence quality; and (b) type of source material. In Round Three, the panel revised a proposed Table of Evidence. Finally, in Round Four, participants provided recommendations on how each source should be incorporated into competency assessments depending on type and quality. Descriptive statistics were calculated with qualitative analyses conducted by two independent reviewers and a third arbitrator.
RESULTS: In Round One, 24 sources of evidence were identified. In Round Two, these were classified into high- (n = 4), medium- (n = 15), and low-quality (n = 5) of evidence, followed by categorization by purpose into providing recommendations (n = 10), primary research (n = 7), and educational content (n = 7). In Round Three, the Table of Evidence was revised based on participant feedback. In Round Four, the panel developed a tiered system of evidence integration from immediate incorporation of high-quality sources to more stringent requirements for lower-quality sources.
CONCLUSIONS: The Table of Evidence provides a framework for the rapid and standardized incorporation of new source material into EMS competency assessments. Future goals are to evaluate the application of the Table of Evidence framework in initial and continued competency assessments.
摘要：
背景：将新兴知识纳入急诊医疗服务（EMS）能力评估对于反映当前基于证据的院外护理至关重要。然而,由于知识生成的速度很快，因此需要一种标准化的方法来将新的证据纳入EMS能力评估。
目的：目的是开发一个框架来评估新的源材料并将其整合到EMS能力评估中。
方法：国家急诊医疗技术人员注册中心（国家注册中心）和院前指南联盟（PGC）召集了一个专家小组。Delphi方法,包括虚拟会议和电子调查，用于开发定义EMS证据来源的证据矩阵表。在第一轮中,参与者列出了可用于EMS教育的所有潜在证据来源.在第二轮中,参与者将这些来源分为：（a）证据质量水平；（b）来源材料的类型。在第三回合中,小组修订了一份拟议的证据表。最后,在第四轮，参与者就如何根据类型和质量将每种来源纳入能力评估提供了建议。描述性统计数据是通过两名独立审查员和第三名仲裁员进行的定性分析计算得出的。
结果：在第一轮中，确定了24个证据来源。在第二轮中,这些被分类为高(n=4)，介质（n=15），和低质量（n=5）的证据，然后按目的分类为提供建议(n=10)，主要研究(n=7)，和教育内容(n=7)。在第三回合中,根据参与者反馈修订了《证据表》.在第四轮中,小组开发了一个分层的证据整合系统，从立即纳入高质量来源到对低质量来源的更严格要求。
结论：证据表提供了一个框架，用于将新的源材料快速和标准化地纳入EMS能力评估。未来的目标是评估证据表框架在初始和持续能力评估中的应用。
目的：目的是开发一个框架来评估新的源材料并将其整合到EMS能力评估中。
方法：国家急诊医疗技术人员注册中心（国家注册中心）和院前指南联盟（PGC）召集了一个专家小组。Delphi方法,包括虚拟会议和电子调查，用于开发定义EMS证据来源的证据矩阵表。在第一轮中,参与者列出了可用于EMS教育的所有潜在证据来源.在第二轮中,参与者将这些来源分为：（a）证据质量水平；（b）来源材料的类型。在第三回合中,小组修订了一份拟议的证据表。最后,在第四轮，参与者就如何根据类型和质量将每种来源纳入能力评估提供了建议。描述性统计数据是通过两名独立审查员和第三名仲裁员进行的定性分析计算得出的。
结果：在第一轮中，确定了24个证据来源。在第二轮中,这些被分类为高(n=4)，介质（n=15），和低质量（n=5）的证据，然后按目的分类为提供建议(n=10)，主要研究(n=7)，和教育内容(n=7)。在第三回合中,根据参与者反馈修订了《证据表》.在第四轮中,小组开发了一个分层的证据整合系统，从立即纳入高质量来源到对低质量来源的更严格要求。
结论：证据表提供了一个框架，用于将新的源材料快速和标准化地纳入EMS能力评估。未来的目标是评估证据表框架在初始和持续能力评估中的应用。
