Impact of deliberate practice on evidence-based medicine attitudes and behaviours of health care professionals.

Eelco Draaisma,Paul L P Brand,A Debbie C Jaarsma,Jolita Bekhof,Lauren A Maggio

doi:10.1007/s40037-020-00634-9

Abstract

IntroductionAlthough evidence-based medicine (EBM) teaching activities may improve short-term EBM knowledge and skills, they have little long-term impact on learners’ EBM attitudes and behaviour. This study examined the effects of learning EBM through stand-alone workshops or various forms of deliberate EBM practice.MethodsWe assessed EBM attitudes and behaviour with the evidence based practice inventory questionnaire, in paediatric health care professionals who had only participated in a stand-alone EBM workshop (controls), participants with a completed PhD in clinical research (PhDs), those who had completed part of their paediatric residency at a department (Isala Hospital) which systematically implemented EBM in its clinical and teaching activities (former Isala residents), and a reference group of paediatric professionals currently employed at Isala’s paediatric department (current Isala participants).ResultsCompared to controls (n = 16), current Isala participants (n = 13) reported more positive EBM attitudes (p < 0.01), gave more priority to using EBM in decision making (p = 0.001) and reported more EBM behaviour (p = 0.007). PhDs (n = 20) gave more priority to using EBM in medical decision making (p < 0.001) and reported more EBM behaviour than controls (p = 0.016).DiscussionHealth care professionals exposed to deliberate practice of EBM, either in the daily routines of their department or by completing a PhD in clinical research, view EBM as more useful and are more likely to use it in decision making than their peers who only followed a standard EBM workshop. These findings support the use of deliberate practice as the basis for postgraduate EBM educational activities.

Highlights

Evidence-based medicine (EBM) teaching activities may improve short-term EBM knowledge and skills, they have little long-term impact on learners’ EBM attitudes and behaviour
Health care professionals exposed to deliberate practice of EBM, either in the daily routines of their department or by completing a PhD in clinical research, view EBM as more useful and are more likely to use it in decision making than their peers who only followed a standard EBM workshop
The results of this study show that, compared to a standard stand-alone 2-day EBM workshop, exposure to deliberate EBM practice is associated with participants giving significantly more priority to using EBM principles in medical decision making, and showing more EBM behaviour in daily practice

Summary

Introduction

Evidence-based medicine (EBM) teaching activities may improve short-term EBM knowledge and skills, they have little long-term impact on learners’ EBM attitudes and behaviour. Evidence-based medicine (EBM) is regarded as one of the most prominent milestones in modern medicine [1,2,3,4] It has made well-recognised contributions to high-quality, individualised, cost-conscious care for patients [2, 3, 5, 6]. Most efforts of the EBM movement have been aimed at standardising and studying the first three steps of the EBM process [1, 3] The application of these EBM steps requires sufficient knowledge about and skills in framing a clinical question, searching and appraising relevant evidence, and applying the retrieved results to the patient’s scenario [9]

Objectives

Methods

Results

Conclusion