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Ngusie HS, Ahmed MH, Mengiste SA, Kebede MM, Shemsu S, Kanfie SG, Kassie SY, Kalayou MH, Gullslett MK. The effect of capacity building evidence-based medicine training on its implementation among healthcare professionals in Southwest Ethiopia: a controlled quasi-experimental outcome evaluation. BMC Med Inform Decis Mak 2023; 23:172. [PMID: 37653419 PMCID: PMC10472735 DOI: 10.1186/s12911-023-02272-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 08/21/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND Evidence-based medicine (EBM) bridges research and clinical practice to enhance medical knowledge and improve patient care. However, clinical decisions in many African countries don't base on the best available scientific evidence. Hence, this study aimed to determine the effect of training interventions on background knowledge and awareness of EBM sources, attitude, competence, and practice of EBM among healthcare professionals. METHOD We designed a controlled group quasi-experimental pre-post test study to evaluate the effect of capacity-building EBM training. A total of 192 healthcare professionals were recruited in the study (96 from the intervention and 96 from the control group). We used a difference-in-differences (DID) analysis to determine the effect of the training. Along the way, we used a fixed effect panel-data regression model to assess variables that could affect healthcare professionals' practice of EBM. The cut point to determine the significant effect of EBM training on healthcare professionals' background knowledge and awareness of EBM sources, attitude, and competence was at a P-value < 0.05. RESULT The DID estimator showed a significant net change of 8.0%, 17.1%, and 11.4% at P < 0.01 on attitude, competence, and practice of EBM, respectively, whereas no significant increment in the background knowledge and awareness of EBM sources. The fixed effect regression model showed that the attitude [OR = 2.288, 95% CI: (1.049, 4.989)], competence [OR = 4.174, 95% CI: 1.984, 8.780)], technical support [OR = 2.222, 95% CI: (1.043, 3.401)], and internet access [OR = 1.984, 95% CI: (1.073, 4.048)] were significantly affected EBM practice. CONCLUSION The capacity-building training improved attitude, competence, and EBM practice. Policymakers, government, and other concerned bodies recommended focusing on a well-designed training strategy to enhance the attitude, competence, and practice towards EBM among healthcare professionals. It was also recommended to enhance internet access and set mechanisms to provide technical support at health facilities.
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Affiliation(s)
- Habtamu Setegn Ngusie
- Department of Health Informatics, School of Public Health, College of Medicine and Health Sciences, Woldia University, Woldia, Ethiopia.
| | - Mohammadjud Hasen Ahmed
- Department of Health Informatics, College of Health Sciences, Mettu University, Mettu, Ethiopia
| | | | | | - Shuayib Shemsu
- Department of Public Health, College of Health Sciences, Mettu University, Mettu, Ethiopia
| | - Shuma Gosha Kanfie
- Department of Health Informatics, College of Health Sciences, Mettu University, Mettu, Ethiopia
| | - Sisay Yitayih Kassie
- Department of Health Informatics, College of Health Sciences, Mettu University, Mettu, Ethiopia
| | - Mulugeta Hayelom Kalayou
- Department of Health Informatics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
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Shibabaw AA, Walle AD, Wubante SM, Butta FW, Demsash AW, Sisay MM, Kebede SD, Mengistie MB, Mamo DN. Knowledge and attitude toward evidence-based medicine and associated factors among health science students in Mettu University southwest Ethiopia: A cross-sectional study. INFORMATICS IN MEDICINE UNLOCKED 2023. [DOI: 10.1016/j.imu.2023.101228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023] Open
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Romero-Robles MA, Soriano-Moreno DR, García-Gutiérrez FM, Condori-Meza IB, Sing-Sánchez CC, Bulnes Alvarez SP, Alarcon-Ruiz CA, Taype-Rondan A, Viteri‐García A. Self-perceived competencies on evidence-based medicine in medical students and physicians registered in a virtual course: a cross-sectional study. MEDICAL EDUCATION ONLINE 2022; 27:2010298. [PMID: 34919030 PMCID: PMC8725743 DOI: 10.1080/10872981.2021.2010298] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 11/17/2021] [Accepted: 11/19/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Evidence-based medicine (EBM) is defined as the integration of the best available evidence from scientific studies with clinical experience (and context) and with patients' values and preferences. The objective of the present study was to describe self-perceived EBM competencies in physicians and medical students enrolled in a massive virtual EBM course. METHODS Analytical cross-sectional study. People interested in a free virtual EBM course fulfilled their data in a virtual form for their registration in September 2020. In this form, 22 competencies related to four dimensions of EBM were evaluated: asking a clinical question, search, analysis, and application; using a 5-option Likert scale. The resulting database was analyzed, selecting people who claimed to be physicians or medical students of 18 years or more. RESULTS 1793 participants were included: 1130 medical students and 663 physicians; more than 80% lived in Peru. The frequency of participants who agreed or strongly agreed with feeling qualified in each competence ranged: from 39.2% to 57.8% for the competencies of the 'Asking a clinical question' dimension, from 39.2% to 56.1% for 'Search,' from 19.9% to 32.0% for 'Analysis,' and from 19.6% to 29.9% for 'Application.' Both in physicians and students, the lowest frequencies were for the competencies of interpretation of impact measures, graphs, and results of systematic reviews; as well as shared decision making and calculation of expected benefit. Physicians who graduated more recently scored better on competencies from search and analysis dimensions. CONCLUSION Among physicians and medical students enrolled in the course, self-perception of competencies was lower in the dimensions of analysis and application. More recently graduated physicians seem to have a greater self-perception of their research and analysis skills, probably due to curricular updates.List of abbreviations: EBM: Evidence-based medicine; CIMBE, for its acronym in Spanish: International Course on Evidence-Based Medicine; SOCIMEP, for its acronym in Spanish: Peruvian Medical Student Scientific Society.
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Affiliation(s)
- Milton A. Romero-Robles
- Escuela de Medicina, Universidad Nacional Del Santa, Nuevo Chimbote, Ancash, Perú
- Comité Permanente Académico, Sociedad Científica Médico Estudiantil Peruana, Lima, Perú
| | - David R. Soriano-Moreno
- Comité Permanente Académico, Sociedad Científica Médico Estudiantil Peruana, Lima, Perú
- Escuela de Medicina, Universidad Peruana Unión, Lima, Perú
| | - Fabrizio M. García-Gutiérrez
- Comité Permanente Académico, Sociedad Científica Médico Estudiantil Peruana, Lima, Perú
- Escuela de Medicina, Universidad Nacional de Trujillo, Trujillo, Perú
| | - I. Benjamín Condori-Meza
- Comité Permanente Académico, Sociedad Científica Médico Estudiantil Peruana, Lima, Perú
- Escuela de Medicina, Universidad Peruana Unión, Lima, Perú
| | - Caroline C. Sing-Sánchez
- Escuela de Medicina, Universidad Nacional Del Santa, Nuevo Chimbote, Ancash, Perú
- Comité Permanente Académico, Sociedad Científica Médico Estudiantil Peruana, Lima, Perú
| | - Sandy P. Bulnes Alvarez
- Comité Permanente Académico, Sociedad Científica Médico Estudiantil Peruana, Lima, Perú
- Escuela de Medicina, Universidad César Vallejo, Piura, Perú
| | - Christoper A. Alarcon-Ruiz
- Unidad de Investigación Clínica y Epidemiológica, Escuela de Medicina, Universidad Peruana Unión, Lima, Perú
| | - Alvaro Taype-Rondan
- Unidad de Investigación Clínica y Epidemiológica, Escuela de Medicina, Universidad Peruana Unión, Lima, Perú
| | - Andres Viteri‐García
- Centro de Investigación de Salud Pública Y Epidemiología Clínica (Cispec). Facultad de Ciencias de La Salud Eugenio Espejo, Universidad Ute, Quito, Ecuador
- Fundación Epistemonikos, Santiago, Chile
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Knowledge, Attitude, and Practice of Evidence-Based Medicine among Emergency Doctors in Kelantan, Malaysia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111297. [PMID: 34769813 PMCID: PMC8583382 DOI: 10.3390/ijerph182111297] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 10/15/2021] [Accepted: 10/24/2021] [Indexed: 11/16/2022]
Abstract
This study aimed to determine the prevalence of high levels of knowledge, positive attitude, and good practice on evidence-based medicine (EBM) and identify the associated factors for practice score on EBM among emergency medicine doctors in Kelantan, Malaysia. This cross-sectional study was conducted in government hospitals in Kelantan. The data were collected from 200 emergency physicians and medical officers in the emergency department using the Noor Evidence-Based Medicine Questionnaire. Simple and general linear regressions analyses using SPSS were performed. A total of 183 responded, making a response rate of 91.5%. Of them, 49.7% had a high level of knowledge, 39.9% had a positive attitude and 2.1% had good practice. Sex, race, the average number of patients seen per day, internet access in workplace, having online quick reference application, and attitude towards EBM were significantly associated with EBM practice scores. It is recommended that appropriate authorities provide emergency doctors with broader access to evidence resources. EBM skill training should be enhanced in the current medical school curriculums.
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Yehualashet DE, Yilma TM, Jemere AT, Gedlu NM. Factors Associated with Practicing Evidence-Based Medicine Among Medical Interns in Amhara Regional State Teaching Hospitals, Northwest Ethiopia: A Cross-Sectional Study. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2021; 12:843-852. [PMID: 34354384 PMCID: PMC8331116 DOI: 10.2147/amep.s320425] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 07/19/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Evidence-based medicine (EBM) is an important component of modern medicine and is essential for the provision of high-quality health services. Little is known about the level of EBM use among Ethiopian medical students. This study aimed to assess the factors associated with EBM practice among medical interns in teaching hospitals in northwestern Ethiopia. METHODS A cross-sectional study was conducted using a random sample of medical interns in teaching hospitals of northwest Ethiopia. Binary logistic regression analysis was used to identify factors associated with EBM practice. The strength of the interaction between variables was calculated using the adjusted odds ratio (AOR) with a 95% confidence interval (CI). RESULTS Completed questionnaire was obtained from 403 (95.3%) of 423 medical interns. About 48.4% of respondents had a good EBM practice. EBM knowledge (AOR = 1.86, 95% CI = 1.220-2.835), attitude to EBM (AOR = 2.05, 95% CI = 1.318-3.193), ability to appraise evidence (AOR = 2.35, 95% CI = 1.570-3.517), and having sufficient time to search for evidence (AOR = 1.67, 95% CI = 1.065-2.627) were factors significantly associated to EBM practice. CONCLUSION This study demonstrates that the main factors affecting medical intern's practice of EBM were lack of critical appraisal skill, lack of knowledge needed to practice EBM, negative attitudes toward EBM, and insufficient time to search for evidence. Providing EBM training to the needs of medical interns would overcome the barriers identified in this study, as well as assist medical interns and other clinical staffs to ensure the correct application of EBM in to clinical practice.
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Affiliation(s)
| | - Tesfahun Melese Yilma
- Department of Health Informatics, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Adamu Takele Jemere
- Department of Health Informatics, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Nebiyu Mesfin Gedlu
- Department of Internal Medicine, School of Medicine, University of Gondar, Gondar, Ethiopia
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Emwodew D, Melese T, Takele A, Mesfin N, Tariku B. Knowledge and Attitude Toward Evidence-Based Medicine and Associated Factors Among Medical Interns in Amhara Regional State Teaching Hospitals, Northwest Ethiopia: Cross-sectional Study. JMIR MEDICAL EDUCATION 2021; 7:e28739. [PMID: 34185012 PMCID: PMC8277356 DOI: 10.2196/28739] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 04/09/2021] [Accepted: 05/16/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Evidence-based medicine (EBM) is widely accepted in medicine. It is necessary to improve the knowledge and attitudes of medical students in the use of evidence. In Ethiopia, little is known about medical students' knowledge and attitudes toward EBM. OBJECTIVE This study aimed to assess the knowledge and attitudes toward EBM and its associated factors among medical interns in teaching hospitals. METHODS A cross-sectional survey was conducted using a random sample of medical interns in teaching hospitals in Ethiopia. Multivariable logistic regression analyses were used to identify the factors associated with the knowledge and attitudes toward EBM. Adjusted odds ratio (AOR) with 95% confidence interval and P≤.05 was used to quantify strength of association between variables. RESULTS Out of a sample of 423 medical interns, 403 completed the questionnaire (95.3% response rate). Overall, 68.0% (274/403 of respondents had a favorable attitude toward EBM and 57.1% (230/403) had good knowledge of EBM. The majority (355/403, 88.1%) of participants had internet access. Only 19.6% (79/403) of respondents had received EBM-related training. Respondents' knowledge of EBM was associated with previous EBM training (AOR 2.947, 95% CI 1.648-5.268, P<.001), understanding of sensitivity (AOR 2.836, 95% CI 1.824-4.408, P=.003), and internet access (AOR 2.914, 95% CI 1.494-5.685, P=.002). The use of an electronic database as a source of information (AOR 1.808, 95% CI 1.143-2.861, P=.01) and understanding of absolute risk reduction (AOR 2.750, 95% CI 1.105-6.841, P=.03) were predictors of positive attitudes. CONCLUSIONS This study demonstrates a lack of formal EBM training and awareness of basic concepts of EBM among medical interns. Medical intern attitudes toward EBM are relatively good. To enhance EBM knowledge and skills, formal teaching of EBM should be integrated into medical education.
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Affiliation(s)
| | - Tesfahun Melese
- Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Adamu Takele
- Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Nebiyu Mesfin
- School of Medicine, University of Gondar, Gondar, Ethiopia
| | - Binyam Tariku
- School of Public Health, Dilla University, Dilla, Ethiopia
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Zanaridah MN, Norhayati MN, Rosnani Z. Knowledge, attitude and practice of evidence-based medicine among primary care practitioners in Malaysia: a cross-sectional study. BMJ Open 2021; 11:e044372. [PMID: 34078635 PMCID: PMC8173288 DOI: 10.1136/bmjopen-2020-044372] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES To determine the level of knowledge and practice of evidence-based medicine (EBM) and the attitudes towards it and to identify the factors associated with its practice among primary care practitioners in Selangor, Malaysia. SETTING This cross-sectional study was conducted in randomly selected health clinics in Selangor. Data were collected from primary care physicians using self-administered questionnaires on knowledge, practice and attitudes regarding EBM. PARTICIPANTS The study included 225 respondents working in either government or private clinics. It excluded house officers and those working in public and private universities or who were retired from practice. RESULTS A total of 32.9% had a high level of EBM knowledge, 12% had a positive attitude towards EBM and 0.4% had a good level of its practice. The factors significantly associated with EBM practice were ethnicity, attitude, length of work experience as a primary care practitioner and quick access to online reference applications on mobile phones. CONCLUSIONS Although many physicians have suboptimal knowledge of EBM and low levels of practising it, majority of them have a neutral attitude towards EBM practice. Extensive experience as a primary care practitioner, quick access to online references on a mobile phone and good attitude towards EBM were associated with its practice.
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Affiliation(s)
- Mat Nawi Zanaridah
- Department of Family Medicine, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Malaysia
| | - Mohd Noor Norhayati
- Department of Family Medicine, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Malaysia
| | - Zakaria Rosnani
- Department of Family Medicine, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Malaysia
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Validity and reliability of the Noor Evidence-Based Medicine Questionnaire: A cross-sectional study. PLoS One 2021; 16:e0249660. [PMID: 33886615 PMCID: PMC8061909 DOI: 10.1371/journal.pone.0249660] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Accepted: 02/28/2021] [Indexed: 11/19/2022] Open
Abstract
Background Evidence-based medicine (EBM) is a widely accepted scientific advancement in clinical settings that helps achieve better, safer, and more cost-effective healthcare. However, presently, validated instruments to evaluate healthcare professionals’ attitude and practices toward implementing EBM are not widely available. Therefore, the present study aimed to determine the validity and reliability of a newly developed knowledge, attitude, and practice (KAP) questionnaire on EBM for use among healthcare professionals. Methods The Noor Evidence-Based Medicine Questionnaire was tested among physicians in a government hospital between July and August 2018. Exploratory factor analysis and internal consistency reliability-based Cronbach’s alpha statistic were conducted. Results The questionnaire was distributed among 94 physicians, and 90 responded (response rate of 95.7%). The initial number of items in the KAP domains of the Noor Evidence-Based Medicine Questionnaire were 15, 17, and 13, respectively; however, two items in the practice domain with communalities <0.25 and factor loadings <0.4 were removed. The factor structure accounted for 52.33%, 66.29%, and 55.39% of data variance in the KAP domains, respectively. Cronbach’s alpha values were 0.81, 0.81, and 0.84 for KAP domains, respectively, indicating high reliability. Conclusions This questionnaire can be used to evaluate the knowledge, attitudes, and behaviour of healthcare professionals toward EBM. Future testing of this questionnaire among other medical personnel groups will help expand the scope of this tool.
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Bello S, Ajayi DT, Bamgboye EA, Mpama EA. Is evidence-based medicine a mirage in resource-constrained settings? A survey among resident doctors in selected teaching hospitals in Nigeria. J Evid Based Med 2020; 13:17-24. [PMID: 32072768 DOI: 10.1111/jebm.12374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Accepted: 02/02/2020] [Indexed: 01/11/2023]
Abstract
AIM The study aimed to assess the self-rated knowledge, attitude toward, and practice (KAP) of evidence-based medicine (EBM) among resident doctors in Nigeria. METHODS This was a cross-sectional web-based survey among 238 resident doctors in four selected teaching hospitals in southern Nigeria. Survey questionnaire contained items assessing the KAP of EBM, familiarity with and understanding of key EBM terms, the use of EBM in decision making, barriers militating against EBM and ways to improve EBM adoption. Proportions and summary statistics were reported for the distribution of survey items. RESULTS Mean number of years in clinical practice was 9.3 ± 4.5 years. Respondents were uniformly distributed in major clinical specialties. The majority (70.5%) were senior registrars. Respondents' understanding of EBM components included; current best clinical evidence (98.3%), clinical expertise (65.5%), and patients' choices (36.6%). Self-rated familiarity with EBM terms was high while perceived understanding of the terms was lower. The least understood concept was heterogeneity (20.6%). The attitude toward EBM was generally positive. Only about half (53.6%) had used medical bibliographic databases within the last 6 months prior to the survey. Barriers against EBM included lack of time (47.1%) and lack of requisite skills (32.4%). Suggestions to improve EBM adoption included training (58.1%), provision of free Wi-Fi, and free access to bibliographic databases (25.2%) and increased political will (23.1%). CONCLUSION A further understanding of the EBM concept, provision of enabling infrastructure, regular clinical audit and advocacy to hospital management and clinical consultants, may improve the level of adoption of EBM.
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Affiliation(s)
- Segun Bello
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - David Taiwo Ajayi
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Eniola Adetola Bamgboye
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Enagu Akwa Mpama
- Department of Community Medicine, College of Health Sciences, University of Calabar, Calabar, Nigeria
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Csertő M, Berényi K, Decsi T, Lohner S. Self-reported attitudes, knowledge and skills of using evidence-based medicine in daily health care practice: A national survey among students of medicine and health sciences in Hungary. PLoS One 2019; 14:e0225641. [PMID: 31881036 PMCID: PMC6934312 DOI: 10.1371/journal.pone.0225641] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 11/08/2019] [Indexed: 11/18/2022] Open
Abstract
In order to map attitudes, knowledge and skills related to evidence-based medicine (EBM) in students of medical and health sciences faculties, we performed an online survey during the spring semester 2019 in all medical and health sciences faculties in Hungary. In total, 1080 students of medicine and 911 students of health sciences completed the online questionnaire. The attitude towards EBM was generally positive; however, only a small minority of students rated their EBM-related skills as advanced. There were large differences in the understanding of different EBM-related terms, with 'sample size' as the term with the highest (65%) and 'intention-to-treat analysis' with the lowest (7%) proportion of medical students being able to properly explain the meaning of the expression. Medical students who already participated in some EBM training rated their skills in searching and evaluating medical literature and their knowledge of EBM-related terms significantly better and had a more positive attitude towards using EBM in the practice than students without previous EBM training. EBM trained medical students were more likely to choose online journals (17.5% compared to 23.9%, p<0.05) and professional guidelines (15.4% compared to 6.1%, p<0.001) instead of printed books (33.6% compared to 52.6, p<0.001) as the main source of healthcare information retrieval and used Pubmed/Medline, Medscape and the Cochrane Library to a significant higher rate than students without any previous EBM training. Healthcare work experience (OR = 1.59; 95% CI = 1.01–2.52), conducting student research (OR = 2.02; 95% CI = 1.45–2.82) and upper year university students (OR = 1.65; 95% CI = 1.37–1.98) were other factors significantly influencing EBM-related knowledge. We conclude that the majority of students of medical and health sciences faculties are keen to acquire EBM-related knowledge and skills during their university studies. Significantly higher EBM-related knowledge and skills among EBM trained students underline the importance of targeted EBM education, while parallel increase of knowledge and skills with increasing number of education years highlight the importance of integrating EBM terminology and concepts also into the thematic of other courses.
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Affiliation(s)
- Mónika Csertő
- Cochrane Hungary, Clinical Centre of the University of Pécs, Medical School, University of Pécs, Pécs, Hungary
| | - Károly Berényi
- Department of Public Health Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Tamás Decsi
- Cochrane Hungary, Clinical Centre of the University of Pécs, Medical School, University of Pécs, Pécs, Hungary
| | - Szimonetta Lohner
- Cochrane Hungary, Clinical Centre of the University of Pécs, Medical School, University of Pécs, Pécs, Hungary
- * E-mail:
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Cochrane, evidence-based medicine and associated factors: A cross-sectional study of the experiences and knowledge of Ethiopian specialists in training. Afr J Emerg Med 2019; 9:70-76. [PMID: 31193814 PMCID: PMC6543079 DOI: 10.1016/j.afjem.2019.01.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 11/09/2018] [Accepted: 01/04/2019] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Evidence-based healthcare is a core competency for practicing healthcare practitioners and those in speciality training. In sub-Saharan Africa, little is known about the teaching of evidence-based medicine (EBM) in residency program. This survey evaluated the experiences and knowledge of Cochrane, EBM and associated factors among Ethiopian specialists in training. METHODS A convenient sample of trainee specialists completed a pretested self-administered survey. The majority (93%) were ≤30 years old, males (63%) and 41% in paediatrics speciality. The associations of categorical variables with EBM knowledge was assessed by Fisher's exact or Chi-Square tests. Covariates contributing to EBM knowledge were identified using multivariate logistic regression analysis. RESULTS Eighty-three trainees participated in the survey (response rate 88.2%). About 75% have heard about Cochrane but no one recognized Cochrane South Africa. Only 25% of the trainees knew the Cochrane Library but none used it in clinical practice. Most (78%) have heard of EBM, 15% had attended EBM course, 96% wanted to attend EBM course and 81% had positive attitudes to EBM. Trainees EBM knowledge was associated with awareness of Cochrane [Adjusted odds ratio (AOR) = 8.5, 95% Confidence interval (CI) 1.3-54.6, P = 0.02], EBM (AOR = 51.2, 95% CI 2.7-960.8, P = 0.009), and being in third year training (AOR = 28.4, 95% CI 1.9-427.2, P = 0.02). The promotion of EBM in residency hospital (AOR = 22.2, 95% CI 2.2-223.8, P = 0.008) and being aware of Cochrane (AOR = 4.8, 95% CI 1.1-21.7, P = 0.04) were predictors of positive attitude. Familiarity with Cochrane Library was influenced by EBM knowledge (AOR = 6.6, 95% CI 1.4-31.5, P = 0.02) and perceived organization barrier to accessing the resource (AOR = 3.2, 95% CI 1.03-10.1, P = 0.04). CONCLUSION Ethiopian trainee specialists lacked formal EBM training, awareness and use of the Cochrane Library. To improve the healthcare quality and patient outcomes, EBM education should be integrated into residency curricula.
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Barzkar F, Baradaran HR, Koohpayehzadeh J. Knowledge, attitudes and practice of physicians toward evidence-based medicine: A systematic review. J Evid Based Med 2018; 11:246-251. [PMID: 30430759 DOI: 10.1111/jebm.12325] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2017] [Accepted: 09/24/2018] [Indexed: 01/11/2023]
Abstract
AIM To assess knowledge, attitude, and practice of graduate physicians toward evidence-based medicine (EBM) and the barriers to the implementation of EBM worldwide. METHODS Relevant databases were searched systematically with appropriate search terms up to September 2017. References of the articles detected by the search were screened for any new articles. Risk of bias was assessed by two independent reviewers. Data were extracted from the full-text articles based on the study summary measures and were collected in a data table. RESULTS Fifty-seven articles were finally included in this systematic review. The studies were of variable and moderate quality. Based on our results, physicians have a generally positive attitude toward EBM and most of them believe that its implementation improves patient care. However, their self-reported awareness and knowledge regarding EBM concepts and the main databases are generally poor. The major barriers to the practice of EBM were related to patient overload and lack of personal time, knowledge, and skills rather than a lack of facilities and resources. However, this pattern varied among the studies. Most of the physicians in the included studies referred to their colleagues and textbooks to answer most of their clinical questions. CONCLUSION Although many physicians have poor EBM knowledge and skills, the majority of them have a positive attitude toward the implication of EBM. To overcome the barriers against the evidence-based practice, it is recommended that appropriate policies be adopted to decrease physicians' workload and to provide them with preappraised evidence.
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Affiliation(s)
- Farzaneh Barzkar
- Center for Educational Research in Medical Sciences (CERMS), Iran University of Medical Sciences, Tehran, Iran
| | - Hamid Reza Baradaran
- Center for Educational Research in Medical Sciences (CERMS), Iran University of Medical Sciences, Tehran, Iran
- Ageing Clinical & Experimental Research Team (ACER), Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | - Jalil Koohpayehzadeh
- Center for Educational Research in Medical Sciences (CERMS), Iran University of Medical Sciences, Tehran, Iran
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Abdulwadud O, Tadesse F, Yilma G, Midekssa M, Ibraghimova I. Knowledge and experience with cochrane and evidence based medicine among health professionals in Debreberhan Referral Hospital in Ethiopia: a cross-sectional survey. Pan Afr Med J 2018; 30:162. [PMID: 30455791 PMCID: PMC6235495 DOI: 10.11604/pamj.2018.30.162.14667] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 04/17/2018] [Indexed: 02/01/2023] Open
Abstract
Introduction Cochrane generates and disseminates high-quality systematic reviews through the cochrane library. We surveyed Ethiopian health professionals' knowledge and experience with cochrane, the cochrane library and Evidence Based Medicine (EBM). Methods A cross-sectional survey was conducted using a convenient sample of health professionals in DebreBerhan Referral hospital in Ethiopia. Participants completed a pre-tested self-administered survey before EBM training. Data were analyzed using Fisher's exact or Chi-Squared test with Yates' correction. The strength of association between variables was quantified using odds ratios with 95% confidence intervals. Results The response rate was 71.4% (35/49). Over half (54.3%) of the sample were males; 68.6% aged ≤ 30 years; 54.3% were physicians and 37.1% were nurses. Up to 65.7% had heard about Cochrane and only two knew cochrane South Africa as their reference centre. Nearly 48.6% were aware of the cochrane library, of whom 46% accessed it however; none used it for lacking awareness, search skills, access to internet and time constraints. Majority had a positive attitude towards EBM; 45.7% had heard of EBM; 74.3% rated their EBM knowledge as low; 74.3% lacked EBM training; and 88.6% were keen to attend EBM course. Adequate EBM knowledge was correlated with prior training (OR = 3.7, 95% CI 1.9-6.9, P<0.001], high self-assessment of EBM knowledge (OR = 0.27, 95% CI 0.14-0.51, P<0.001), male gender (P = 0.04), a positive attitude towards EBM (P = 0.001) and awareness of Cochrane (P = 0.004). Conclusion Ethiopian health professionals have unmet training needs and want support through professional development workshops and an improved education system to provide high-quality evidence-based healthcare.
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Affiliation(s)
- Omar Abdulwadud
- American International Health Alliance, HIV/AIDS Twinning Centre, Addis Ababa, Ethiopia
| | | | | | - Metti Midekssa
- American International Health Alliance, HIV/AIDS Twinning Centre, Addis Ababa, Ethiopia
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Mahmić-Kaknjo M, Kadić D, Hodžić H, Spahić-Sarajlić S, Hadžić E, Ademović E. Awareness, knowledge, use, and attitudes toward evidence based medicine in a developing country: survey of physicians in a canton in Bosnia and Herzegovina. Croat Med J 2016; 56:558-66. [PMID: 26718762 PMCID: PMC4707927 DOI: 10.3325/cmj.2015.56.558] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Aim To assess awareness, knowledge, use, and attitudes toward evidence-based medicine (EBM) and The Cochrane Library (CL) among physicians from Zenica-Doboj Canton (ZDC), Bosnia and Herzegovina. Methods In this cross-sectional study, a self-administered anonymous questionnaire was sent by post to all state owned health institutions (2 hospitals and 11 Primary Health Care Institutions) in ZDC. The main outcome measures were physicians’ awareness of the Cochrane, awareness and use of CL, access to EBM databases, and access to internet at work. 358 of 559 physicians responded (63.69%). Results 23.18% of respondents stated they had access to EBM databases, but only 3.91% named the actual EBM databases they used. The question on the highest level of evidence in EBM was correctly answered by 35.7% respondents, 34.64% heard about Cochrane and 32.68% heard about CL. They obtained information about CL mostly on the internet and from colleagues, whereas the information about EBM was obtained mainly during continuous medical education. Conclusion Although the attitudes toward EBM are positive, there is a low awareness of EBM among physicians in ZDC. Open access to the CL should be used more. Educational interventions in popularizing EBM and Cochrane are needed to raise awareness both among students and practicing physicians, and finally among lay audience.
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Affiliation(s)
- Mersiha Mahmić-Kaknjo
- Mersiha Mahmić-Kaknjo, Department of Clinical Pharmacology, Zenica Cantonal Hospital, Crkvice 67, 72000 Zenica, Bosnia and Herzegovina,
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Ranasinghe P, Jayawardena R, Katulanda P. The facts, figures, and reality of the diabetes epidemic in Sri Lanka: a systematic review. Int J Diabetes Dev Ctries 2015. [DOI: 10.1007/s13410-015-0326-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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kahouei M, Alaei S, Shariat Panahi SSG, Zadeh JM. Strategy of health information seeking among physicians, medical residents, and students after introducing digital library and information technology in teaching hospitals of Iran. J Evid Based Med 2015; 8:91-7. [PMID: 25955257 DOI: 10.1111/jebm.12154] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Accepted: 01/25/2015] [Indexed: 01/11/2023]
Abstract
OBJECTIVES It is important for physicians, medical students and health care organizations of developing countries to use reliable clinical information in order to deliver the best practice. Therefore, health sector of Iran endeavored to encourage physicians and medical students to integrate research findings into practice since 2005. Several educational interventions in the areas of information technology and databases were performed. Digital library was introduced in the teaching hospitals. The purpose of this study was to investigate whether these interventions increased the use of evidence-based health information resources among physicians, medical residents and students. METHODS This descriptive study involved 315 physicians, assistants and medical students in affiliated hospitals of Semnan University of medical sciences in 2013. RESULTS A total 52.9% of physicians and 79.5% of medical residents and students always used patient data. 81.3% of physicians and 67.1% of medical residents and students reported using their own experiences, 26.5% of physicians and 16.9% of medical residents and students always used databases such as PubMed and MEDLINE for patient care. CONCLUSION Our results revealed that in spite of providing educational and technical infrastructures for accomplishment of research utilization in medical education, the study subjects often identified and used what they regarded as reliable and relevant information from sources that do not truly represent the best evidence that is available.
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Affiliation(s)
- Mehdi kahouei
- Research Center for Social Determinants of Health, Health Information Management Department, Nursing and Allied Health Faculty, Semnan University of Medical Sciences, Semnan, Iran
| | - Safollah Alaei
- Surgery and Anesthesia Department, Nursing and Allied Health Faculty, Semnan University of Medical sciences, Semnan, Iran
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Ugolini D, Casanova G, Ceppi M, Mattei F, Neri M. Familiarity of physicians, translational researchers, nurses, and other health professionals with evidence-based medicine terms and resources. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2014; 29:514-21. [PMID: 24585401 DOI: 10.1007/s13187-014-0631-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Evidence-based medicine (EBM) is a central theme in health practice and training. The understanding of EBM technical terms and the familiarity with EBM resources were surveyed in four different health professional categories. A self-administered questionnaire on the familiarity with EBM terminology and resources was proposed to 218 health professionals (physicians, translational researchers, nurses, and others) working in the oncology field. Relationships between variable and familiarity were examined: Pearson χ(2) or exact Fisher test was used for the categorical variables and one-way ANOVA for the continuous ones. The odds of familiarity for subjects, who had followed or not at least one EBM course, were estimated fitting a multiple logistic regression model adjusted for age, gender, and profession. All subjects completed the questionnaire. The majority of health personnel seemed to lack a sound knowledge of key EBM terms and sources. Physicians showed the highest knowledge of terms, nurses the lowest. Physicians also declared the largest familiarity with the widest variety of resources, followed by others and the researchers. The most popular resource was PLNG, the Italian Guideline System. People who attended at least one EBM course showed consistently higher percentages of knowledge, but the association was irrelevant for nurses. The main perceived barrier to implement EBM in practice was a lack of personal time. Familiarity of health professionals with EBM terminology and resources is still limited to the medical field and needs to be improved. Increasing education may be pivotal, even if different approaches should be developed for different professional categories.
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Rezazadeh E, Hachesu PR, Rezapoor A, Alireza K. Evidence-based medicine: going beyond improving care provider viewpoints, using and challenges upcoming. J Evid Based Med 2014; 7:26-31. [PMID: 25155563 DOI: 10.1111/jebm.12083] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2013] [Accepted: 01/08/2014] [Indexed: 01/11/2023]
Abstract
OBJECTIVES Evidence Based Medicine (EBM) is proper and an efficient incorporation of the researches and experiences. This is study surveyed the attitudes, awareness, and practice of EBM with specific focus on the barriers to EBM, among clinical residents. METHODS We conducted a cross sectional survey during September 2012 to February 2013 at the teaching hospitals of Mazandaran University of Medical Sciences among 81 clinical providers from different medical specialties. A valid and reliable questionnaire consisted of five sections and 22 statements were used in this research. Most respondents (83%) completed the questionnaires voluntarily and anonymously. We input the data into Micro- soft Excel 2007. Data were analysed using SPSS 16.0 software. RESULTS Findings of the study showed that the knowledge of respondents about EBM is low. Their attitude towards EBM was positive but their knowledge and skills in regard to the evidence based medical information resources were mostly limited to PubMed and Google scholar. The main barrier was the lack of enough time to practicing EBM. There was no significant correlation between residency grade and familiarity and use of electronic EBM resources (Spearman, P = 0.116). CONCLUSIONS The attitude of the respondents towards EBM is fairly positive. But there is a deficit in knowledge and skills of EBM among respondents. Integration and implementation of training approaches like journal clubs or workshops in clinical practices is suggested.
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Affiliation(s)
- Esmaeil Rezazadeh
- Chancellor for treatment affaires, Mazandaran University of Medical Sciences, Sari, Iran
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Oude Rengerink K, Zwolsman SE, Ubbink DT, Mol BWJ, van Dijk N, Vermeulen H. Tools to assess Evidence-Based Practice behaviour among healthcare professionals. ACTA ACUST UNITED AC 2013; 18:129-38. [DOI: 10.1136/eb-2012-100969] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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