Barriers to Implementation and Application of Evidence-Based Medicine from the Viewpoints of Clinical Residents

Abstract

Background: Nowadays, evidence-based medicine (EBM) is considered a rational framework for decision-making in medicine and its skill training. Thus, the present study aimed to determine the barriers to the execution and application of EBM. Methods: In this cross-sectional survey study, 99 clinical assistants of Hamadan University of Medical Sciences in Iran were randomly assigned to the study. Data were collected using a questionnaire, including background information and information related to barriers in 5 areas, and then analyzed by SPSS-22. Results: Overall, 66.7% of the clinical assistants identified spending a long time to justify the patient to implement EBM, and 61.6% identified the lack of trained people for evidence-based care, the absence of monitoring mechanisms, and the follow-up of EBM in education and treatment. In addition, 60.6% identified new evidence-based medical devices and the lack of knowledge of many doctors in this category as the most serious obstacles. The highest and lowest average barriers were obtained concerning the health system managers (76.30) and librarians and medical informants (64.27), respectively. Conclusion: Notwithstanding that the assistants consider EBM effective in treating patients; the lack of training in the skills associated with this category and the lack of attention of health system managers have prevented the utilization of EBM in practice. Accordingly, eliminating the barriers associated with managers can be the most important step in the development of EBM.