Clinical Physicians' Attitudes towards Evidence-Based Medicine (EBM) and Their Evidence-Based Practice (EBP) in Wuhan, China.

Jianan Hong,Jing Chen

doi:10.3390/ijerph16193758

Abstract

Objective: Numerous studies have proved the importance of Evidence-Based Medicine (EBM) in daily clinical practice, however, clinicians’ attitudes play an important role in determining its implementation. The objective of this study was to investigate Chinese clinical physicians’ perception of and attitude towards EBM and their Evidence-Based Practice (EBP) as well as the barriers towards EBP. Methods: Using a cross-sectional design, self-response questionnaires were distributed to clinical physicians (internal medicine and surgery departments) across three tertiary hospitals in Wuhan, China. Results: In total, 131 out of 195 (67.2%) physicians completed and returned the questionnaire. A total of 64.9% of the physicians either knew moderately or a lot about EBM. The mean score of physicians’ attitude toward EBM was 2.35 ± 0.35, and that of their EBP skill/ competency was 1.51 ± 0.56 (on 0–3 Likert scale). In total, 76.0% of physicians often or sometimes applied EBM in routine daily practice. The largest barrier preventing implementation was the varying individual differences in diseases (61.0%), followed by a lack of investment from the hospital/department (39.8%), and a lack of patient cooperation (37.4%). Chinese physicians in tertiary hospitals possessed expressed positive attitudes towards EBM; however, they only retained a moderate level of clinical evidence competency. Both an individual factor (personal interest) and organizational factors (workload, hospital requirement) had an effect on physicians’ attitudes and their EBP skills. Management and organizational efforts, in addition to time dedicated for EBP projects could help reduce barriers that prevent EBP.

Highlights

Evidence-based medicine (EBM) is considered to be the careful and meticulous use of up-to-date evidence in the decision-making process regarding individual patient care, whereas evidence-based practice (EBP) integrates individual clinical expertise with the best available clinical evidence obtained from systematic research [1]
Chinese physicians in tertiary hospitals possessed expressed positive attitudes towards EBM; they only retained a moderate level of clinical evidence competency
Management and organizational efforts, in addition to time dedicated for EBP projects could help reduce barriers that prevent EBP

Summary

Introduction

Evidence-based medicine (EBM) is considered to be the careful and meticulous use of up-to-date evidence in the decision-making process regarding individual patient care, whereas evidence-based practice (EBP) integrates individual clinical expertise with the best available clinical evidence obtained from systematic research [1]. The importance of EBM has been widely accepted by physicians such as physical therapists, pediatricians, dentists, and orthodontists. British and German surgeons rated EBM, on a scale from 1 to 10, as very important for daily clinical decision making (7.3), patients (7.8), and for the national health system (7.8) [12]. Canadian family physicians embraced the facilitation of EBM in family practices and some physicians alluded to its significance in their daily implementation. Public Health 2019, 16, 3758; doi:10.3390/ijerph16193758 www.mdpi.com/journal/ijerph

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