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Javedani Masroor M, Rezaei S, Hashemi Kiapey SA, Hakiminezhad M, Ahmadi SAY. Knowledge, Attitude, and Practice (KAP) Status toward Clinical Reasoning and Evidence-Based Medicine among the Medical Interns and Gynecology Residents of Iran University of Medical Sciences. ScientificWorldJournal 2024; 2024:6546432. [PMID: 38510568 PMCID: PMC10954360 DOI: 10.1155/2024/6546432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 02/23/2024] [Accepted: 02/29/2024] [Indexed: 03/22/2024] Open
Abstract
Background Clinical reasoning and evidence-based medicine (EBM) are important concepts in modern medicine. Objective We performed this study to investigate the knowledge, attitude, and practice (KAP) status toward clinical reasoning and EBM among the medical interns and gynecology resident physicians of Iran University of Medical Sciences and related factors. Methods A cross-sectional study (Tehran, Iran, first half of 2022) was conducted based on two researcher-made questionnaires consisting of three components for each including clinical reasoning attitude (CR-A), clinical reasoning knowledge (CR-K), clinical reasoning practice (CR-P), EBM attitude (EBM-A), EBM knowledge (EBM-K), and EBM practice (EBM-P). The related factors were age, gender, educational level, score of general practice education, having research experience, and general practice experience. Results A total of 60 individuals participated. The mean score was good for CR-A, moderate for CR-K, moderate for CR-P, good for EBM-A, moderate for EBM-K, and moderate for EBM-P. The total score was moderate in both clinical reasoning and EBM. Among the related factors, CR-P was associated with higher educational levels and having experience in general practice (P < 0.05). Research experience was associated with better CR-K and all KAP components for EBM (P < 0.05). Conclusion The total score and many of the KAP components had moderate status for clinical reasoning and EBM. Planning on the associated factors should be regarded in the future. Such questionnaires are suggested to be validated for use in quasi-experimental studies.
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Affiliation(s)
- Mojgan Javedani Masroor
- Center for Educational Research in Medical Sciences (CERMS), Department of Medical Education, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
- Shahid AkbarAbadi Clinical Research Development Unit (SHACRDU), School of Medicine, Department of Obstetrics and Gynecology, Iran University of Medical Sciences, Tehran, Iran
| | - Saeid Rezaei
- Eye and Skull Base Research Centers, The Five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Ali Hashemi Kiapey
- Department of Surgery, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahdi Hakiminezhad
- Firoozgar Clinical Research Development Center (FCRDC), Department of Surgery, Iran University of Medical Sciences, Tehran, Iran
| | - Seyyed Amir Yasin Ahmadi
- Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran
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Prabath I, Xaviar S, Navabalan V, Mathaiyan J. A cross-sectional study evaluating the knowledge, attitude, and practice of evidence-based medicine among resident doctors of a health-care Institution of National Importance in India. Perspect Clin Res 2023; 14:172-179. [PMID: 38025287 PMCID: PMC10679567 DOI: 10.4103/picr.picr_172_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 03/25/2023] [Accepted: 04/11/2023] [Indexed: 12/01/2023] Open
Abstract
Background and Objectives Evidence-based medicine (EBM) promotes the integration of updated- best evidence with patient preferences and medical expertise for clinical decision-making. Despite the availability of high-quality evidence such as systematic review and meta-analysis, some clinicians manage their patients based on past experiences and expert opinion. Thus, this study was proposed to assess the knowledge, attitude, and practice of EBM among resident doctors at a tertiary care hospital in India. Participants and Methods This cross-sectional questionnaire-based study was conducted among senior residents and final-year postgraduates (PGs) who were independently involved in clinical decision-making. By convenience sampling method, the participants were recruited, and the validated EBM Questionnaire (EBMQ) was distributed online for assessing the knowledge, attitude, and practice of EBM. Descriptive statistics were represented as frequency and proportions. Results A total of 102 resident doctors participated with male preponderance (74.5%). Nearly, 96 (94.1%) participants were already practicing EBM and 21.6% had undergone EBM training. Textbooks (50%) were the most often referred sources for EBM information. Specific EBM databases such as MEDLINE and Cochrane were also utilized by 37.3% of participants. More than 70% of participants understood the terms such as a randomized controlled trial, case-control study, and P value. A higher proportion (80.4%) of participants showed a positive attitude about patient care improved by EBM. Conclusions The majority of the resident doctors exhibited good knowledge and a positive attitude toward applying EBM in clinical decision-making. Periodic training through workshops or courses and integration of EBM with the PG curriculum would potentially enhance the EBM practice.
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Affiliation(s)
- Indumathi Prabath
- Department of Pharmacology, SRM Medical College Hospital and Research Centre, SRM Institute of Science and Technology, Kattankulathur, Tamil Nadu, India
| | - Suja Xaviar
- Department of Pharmacology, JIPMER, Puducherry, India
| | - Vivekraj Navabalan
- Department of Pharmacology, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India
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Rodriguez D, Martinez-Alvarado JD, Garcia-Toto R, Genel-Rey TI. Teaching evidence-based medicine in Mexico: a systematic review of medical doctor curriculums at a national level. BMJ Evid Based Med 2023; 28:30-39. [PMID: 35688607 DOI: 10.1136/bmjebm-2021-111910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/12/2022] [Indexed: 01/25/2023]
Abstract
OBJECTIVES To assess the teaching of evidence-based medicine (EBM) in medical curriculums. As a secondary objective, we assessed the representativeness of science courses related to EBM. DESIGN AND SETTING Systematic review. Accredited curriculums by the Mexican Council for the Accreditation of Medical Education. MAIN OUTCOME MEASURES We provided a descriptive analysis of the required or elective EBM courses and EBM-related courses, academic credits and teaching period. EBM-related courses included research methodology, epidemiology, biostatistics, clinical research, public health, clinical epidemiology, scientific dissemination and health informatics to explore scientific education and training offered by medical schools. Additionally, we examined the curriculum's structure, location, type of institution, total programme duration and academic credits. Data collection occurred from December 2020 to February 2021. RESULTS We identified 171 registered curriculums, of which we assessed 60 unique programmes (50% public) in our analysis. We identified 16 EBM single courses on the fifth and sixth semesters, of which 12 (20%) were mandatory and 4 were electives (6.7%). The allocated academic credits for EBM courses are minimal, without difference between public or private institutions, representing 0.08% of the total curriculum. Public health, epidemiology, research methodology and biostatistics courses are offered with greater frequency (55% or less) and curricular value (0.6% or less). In some cases, they are taught as combined courses. Clinical research, health informatics and clinical epidemiology are taught less than EBM, while scientific dissemination is nil. CONCLUSION In Mexico, EBM teaching is limited to only one of five curriculums with minimal curricular value. A comprehensive curricular review is necessary across programmes to incorporate EBM as a first step to improve medical education and, consequently, public health. We call to action through an online, collaborative platform with several applications to optimise teaching of EBM. REVIEW PROTOCOL REGISTRATION The systematic review protocol is excluded from the International Prospective Register of Systematic Reviews since this platform only accepts systematic reviews with health-related outcomes. Review protocol registration: https://osf.io/3xm2q/.
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Affiliation(s)
- David Rodriguez
- Teaching Evidence-Based Medicine Mexico (TEBMx), Cuernavaca, Mexico
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Alabdullah MN, Alabdullah H, Kamel S. Knowledge, attitude, and practice of evidence-based medicine among resident physicians in hospitals of Syria: a cross-sectional study. BMC MEDICAL EDUCATION 2022; 22:785. [PMID: 36376824 PMCID: PMC9661745 DOI: 10.1186/s12909-022-03840-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 10/27/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Evidence-based medicine (EBM) is to integrate the best research evidence with our clinical expertise, circumstances, and unique values of our patient. However, there are no studies about using EBM in clinical practice among resident doctors in Syria. In this study, we aimed to evaluate the self-reported knowledge, attitude and practice (KAP) of EBM by resident doctors throughout different teaching hospitals in Syria. METHODS The study is a cross-sectional. A self-reported online questionnaire was used to collect data about KAP of EBM from 214 resident physicians working in secondary and tertiary teaching hospitals. The study was conducted between September 2021 and February 2022. All data were analyzed using SPSS, and non-parametric statistical tests were used to identify the correlation between different variables and make the necessary comparisons. RESULTS Two hundred and fourteen physicians responded to the questionnaire with a response rate of 85.6%. The overall mean scores of KAP of EBM were 59.2, 74.3 and 53.9%, respectively. The participants displayed a low level of awareness of resources and statistical terms used in EBM. The most well-known resources for residents were Up To Date and PubMed. Among the participants, pediatric residents achieved the highest score in practicing EBM, while family medicine residents scored the lowest score. CONCLUSION The overall impression about the KAP of EBM among Syrian residents was as following: weak awareness, neutral attitude and poor practice of EBM. Training workshops should be set up to teach residents the skills needed to move from opinion-based practice to evidence-based practice.
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Affiliation(s)
- Muhammad Nour Alabdullah
- Otorhinolaryngology Department, Al-Mowassat University Hospital, Damascus University, Damascus, Syrian Arab Republic
| | - Hadi Alabdullah
- Faculty of Medicine, Hama University, Hama, Syrian Arab Republic
| | - Sondos Kamel
- Faculty of Civil Engineering, Hama University, Hama, Syrian Arab Republic
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Knowledge, Attitude, and Practice towards Evidence-Based Medicine among Northern Saudi Primary Care Physicians: A Cross-Sectional Study. Healthcare (Basel) 2022; 10:healthcare10112285. [PMID: 36421609 PMCID: PMC9690608 DOI: 10.3390/healthcare10112285] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/03/2022] [Accepted: 11/08/2022] [Indexed: 11/16/2022] Open
Abstract
The evidence-based practice of primary care physicians is essential because they are the first line of contact with the local community, and they cater to most of their communities’ health needs. In the current study, in which we used a cross-sectional survey in northern Saudi Arabia, we assessed primary care physicians’ knowledge, attitude, practice, and barriers regarding evidence-based medicine (EBM). Of the 300 physicians who participated, less than half had high knowledge (43.7%) and attitude (47.7%) toward EBM. The chi-square test revealed that the knowledge categories were significantly associated with the age group (p = 0.002) and EBM training received in the past five years (p < 0.001), and the attitude categories were significantly associated with nationality (p = 0.008). Of the respondents, 155 (51.7%) used EBM in their daily clinical practice. Through logistic regression analysis, we found that the identified predictors of including EBM in clinical practice were the 31−45-year-old age group (adjusted odds ratio (AOR) = 2.11, 95% confidence interval (CI) = 1.65−2.73) and EBM training received during last 5 years (AOR = 2.12, 95% CI = 1.35−2.94). We recommend enhancing primary care physicians’ knowledge of EBM and its importance in clinical practice through appropriate training programs. A multi-centric mixed-method survey is warranted in other provinces of the KSA to recognize region-specific training demand.
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Gorgui J, Atallah A, Boucoiran I, Gomez YH, Bérard A. SARS-CoV-2 vaccine uptake and reasons for hesitancy among Canadian pregnant people: a prospective cohort study. CMAJ Open 2022; 10:E1034-E1043. [PMID: 36735245 PMCID: PMC9744265 DOI: 10.9778/cmajo.20210273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Several vaccines against SARS-CoV-2 have been developed and approved at an unparalleled speed. Given that SARS-CoV-2 vaccines are recommended to pregnant people, our aim was to quantify vaccination uptake, and describe vaccination hesitancy and behavioural attitudes surrounding SARS-CoV-2 vaccination in pregnancy in Canada. METHODS The CONCEPTION study is an ongoing international study started in June 2020, evaluating the impact of the COVID-19 pandemic on the health of pregnant people and their children. For this study, pregnant people recruited from Apr. 20, 2021, to Feb. 8, 2022, and residing in Canada were invited to complete a Web-based survey. In addition to all CONCEPTION variables, data on vaccine uptake as well as personal knowledge of COVID-19 severity in pregnancy and of SARS-CoV-2 vaccine safety and efficacy were collected. Marginal risk differences and adjusted odds ratios (ORs) were calculated to assess determinants of SARS-CoV-2 vaccination during pregnancy. RESULTS From Apr. 20, 2021, to Feb. 8, 2022, 603 pregnant people were recruited and gave consent, of which 83.7% (n = 505) were vaccinated and 16.3% (n = 98) were not vaccinated against SARS-CoV-2. Uptake of the influenza vaccine in 2020/21 was a significant predictor of being vaccinated against SARS-CoV-2 or intention to be vaccinated (marginal risk difference 3.2%, 95% confidence interval [CI] 3.0% to 3.3%, adjusted OR 4.43, 95% CI 2.32 to 9.25), and being employed (marginal risk difference 11.2%, 95% CI 10.6% to 11.9%, adjusted OR 2.17, 95% CI 1.03 to 4.35) increased the likelihood of being vaccinated against SARS-CoV-2. Self-assessed knowledge of COVID-19 severity and vaccine efficacy was not associated with vaccine uptake. INTERPRETATION Among the Canadian pregnant people who responded to this study, vaccine uptake against SARS-CoV-2 was high. However, our results underscore the importance of improving knowledge transfer about the efficacy of SARS-CoV-2 vaccines in pregnancy to guide vaccination efforts.
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Affiliation(s)
- Jessica Gorgui
- Centre hospitalier universitaire Sainte-Justine Research Centre (Gorgui, Bérard, Gomez); Faculty of Pharmacy (Gorgui, Bérard), Université de Montréal; Mother and Children's Infectious Diseases Centre (Atallah, Boucoiran), CHU Sainte-Justine, Université de Montréal, Montréal, Que.; Hospices Civils de Lyon (Atallah), Hôpital Femme Mère Enfant, Department of Prenatal Diagnosis, Université Claude Bernard Lyon 1, Lyon, France; Department of Obstetrics and Gynecology (Atallah), and School of Public Health (Boucoiran), Université de Montréal, Montréal, Que.; Faculty of Medicine (Boucoiran, Bérard), Université Claude Bernard Lyon 1, Lyon, France
| | - Anthony Atallah
- Centre hospitalier universitaire Sainte-Justine Research Centre (Gorgui, Bérard, Gomez); Faculty of Pharmacy (Gorgui, Bérard), Université de Montréal; Mother and Children's Infectious Diseases Centre (Atallah, Boucoiran), CHU Sainte-Justine, Université de Montréal, Montréal, Que.; Hospices Civils de Lyon (Atallah), Hôpital Femme Mère Enfant, Department of Prenatal Diagnosis, Université Claude Bernard Lyon 1, Lyon, France; Department of Obstetrics and Gynecology (Atallah), and School of Public Health (Boucoiran), Université de Montréal, Montréal, Que.; Faculty of Medicine (Boucoiran, Bérard), Université Claude Bernard Lyon 1, Lyon, France
| | - Isabelle Boucoiran
- Centre hospitalier universitaire Sainte-Justine Research Centre (Gorgui, Bérard, Gomez); Faculty of Pharmacy (Gorgui, Bérard), Université de Montréal; Mother and Children's Infectious Diseases Centre (Atallah, Boucoiran), CHU Sainte-Justine, Université de Montréal, Montréal, Que.; Hospices Civils de Lyon (Atallah), Hôpital Femme Mère Enfant, Department of Prenatal Diagnosis, Université Claude Bernard Lyon 1, Lyon, France; Department of Obstetrics and Gynecology (Atallah), and School of Public Health (Boucoiran), Université de Montréal, Montréal, Que.; Faculty of Medicine (Boucoiran, Bérard), Université Claude Bernard Lyon 1, Lyon, France
| | - Yessica-Haydee Gomez
- Centre hospitalier universitaire Sainte-Justine Research Centre (Gorgui, Bérard, Gomez); Faculty of Pharmacy (Gorgui, Bérard), Université de Montréal; Mother and Children's Infectious Diseases Centre (Atallah, Boucoiran), CHU Sainte-Justine, Université de Montréal, Montréal, Que.; Hospices Civils de Lyon (Atallah), Hôpital Femme Mère Enfant, Department of Prenatal Diagnosis, Université Claude Bernard Lyon 1, Lyon, France; Department of Obstetrics and Gynecology (Atallah), and School of Public Health (Boucoiran), Université de Montréal, Montréal, Que.; Faculty of Medicine (Boucoiran, Bérard), Université Claude Bernard Lyon 1, Lyon, France
| | - Anick Bérard
- Centre hospitalier universitaire Sainte-Justine Research Centre (Gorgui, Bérard, Gomez); Faculty of Pharmacy (Gorgui, Bérard), Université de Montréal; Mother and Children's Infectious Diseases Centre (Atallah, Boucoiran), CHU Sainte-Justine, Université de Montréal, Montréal, Que.; Hospices Civils de Lyon (Atallah), Hôpital Femme Mère Enfant, Department of Prenatal Diagnosis, Université Claude Bernard Lyon 1, Lyon, France; Department of Obstetrics and Gynecology (Atallah), and School of Public Health (Boucoiran), Université de Montréal, Montréal, Que.; Faculty of Medicine (Boucoiran, Bérard), Université Claude Bernard Lyon 1, Lyon, France
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