Clinicians’ self-perceived competency in evidence-based practice at Zagazig University Hospitals, Egypt

Abstract

Evidence-based medical practice has gained worldwide attention and is an emerging must-know topic for today's physicians. Yet, it continues to puzzle physicians either in its understanding or in its practice, and gaps continue to exist between research-based evidence and clinical practice. This study aimed to evaluate the self perceived EBM competency of the clinicians and staff of Zagazig University Hospital. A cross-sectional study was carried out on a sample of 184 clinicians during the period of March-July 2012 at five randomly chosen special medicine departments (tropical medicine, rheumatology, neurology, dermatology, and hematology-oncology) using a self-administered, specifically tailored questionnaire. Sampled clinicians were dichotomized according to their self-reported frequency of evidence-based practice into evidence-based medicine (EBM) nonusers (62.5%) and EBM users (37.5%). There was no significant difference between users and nonusers in total mean scores (21.37±1.86 vs. 21.34±2.2, P=0.119). Users had significantly higher mean score for self-perceived EBM competency compared with nonusers (P=0.000), although both users and nonusers had unsatisfactory mean score for EBM competency (38.33±2.87 vs. 32.96±3.026, respectively) (median, 39 vs. 33, respectively). Users of EBM had a significantly higher score in competencies related to the use of a bibliographic database, understanding of methodological terminology, confidence in their skills in EBM steps, and consequently in cumulative EBM competency (P=0.000). Our findings support some important facts: first, there is discrepancy between clinicians' perceptions and their competency, as they considered themselves practicing EBM although they were not; second, strategies to promote a change in clinical practice are more likely to be successful if they are based on an analysis of problems. All findings in this study highlighted the importance of training in EBM.