Knowledge, skills and attitude of evidence-based medicine among obstetrics and gynaecology trainees: a questionnaire survey

Self-perceived competencies on evidence-based medicine in medical students and physicians registered in a virtual course: a cross-sectional study

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.

Knowledge, attitudes and practice of physicians toward evidence-based medicine: A systematic review

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.