Abstract
BackgroundThe philosophy of evidence-based medicine (EBM) was introduced in the early 90s as a new approach to the practice of medicine, using the best available evidence to make decisions about health care. Despite ongoing controversy, EBM has developed enormously and physicians' attitude towards it is generally positive. Nevertheless, in Spain little is known about this topic. We will therefore undertake a study to explore perceptions, attitudes and knowledge about EBM among primary care physicians.Methods and designA mixed-method study combining qualitative and quantitative designs will target family practitioners in Spain with the objective of evaluating current attitudes and perceptions about evidence-based medicine. The project will consist of two phases: a first phase running focus groups to identify perceptions and attitudes of participants, and a second phase assessing their attitudes and knowledge about EBM by means of a survey. Both phases will explore these issues in three different subgroups: family practitioners, with or without previous formal education in EBM; members of working groups that formulate healthcare recommendations; and physicians in charge of training family practice residents. Additionally, we will undertake a systematic review to identify and synthesize the available evidence on this topic.DiscussionThe study will identify and gain insight into the perceived problems and barriers to the practice of evidence-based medicine among general practitioners in Spain. The project will also evaluate the main knowledge gaps and training needs, and explore how evidence-based medicine is being taught to family medicine residents, the medical practitioners of the future. Our results will aid researchers and health care planners in developing strategies to improve the practice of evidence-based medicine in our country.
Highlights
The philosophy of evidence-based medicine (EBM) was introduced in the early 90s as a new approach to the practice of medicine, using the best available evidence to make decisions about health care
EBM knowledge and skills among these working group members has never been explored. Taking all this into account, a study examining perceptions, attitudes and knowledge of EBM among general practitioners, working group members, and tutors of family practice, is relevant and necessary to bring some light to these issues, and to determine the main barriers preventing the use of EBM in Spain
This study will: a) shed light on the perceived difficulties and barriers to the comprehension and application of EBM; b) illustrate the needs for discussion, education and use of EBM to improve clinical practice of family doctors and; c) inform how EBM philosophy can be transmitted to future generations of family doctors as an approach to their education and clinical practice
Summary
During Phase I, with a qualitative design, we will run focus groups to gain insight into the perceptions and attitudes of family practitioners, working group members and tutors towards EBM. Taking into account how important it is to evaluate behavior and attitudes of our target populations (family practitioners, tutors and working group members), we consider the group interview will be the most adequate technique to gather for information. 2. Sample The questionnaire will be sent via e-mail to all potential participants in the three main subgroups of interest (family physicians, working group members and tutors) with a letter inviting them to collaborate and a link to an electronic version of the questionnaire. We estimated a sample size of 600 respondents needed to answer our main objective (percentage of favourable responses towards EBM) of the survey in the family physicians group, with a precision of 4%.
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