Self-reported attitudes, knowledge and skills of using evidence-based medicine in daily health care practice: A national survey among students of medicine and health sciences in Hungary.

Mónika Csertő,Tamás Decsi,Károly Berényi,Szimonetta Lohner,Cesario Bianchi

doi:10.1371/journal.pone.0225641

Mónika Csertő, Tamás Decsi + Show 3 more

Open Access

https://doi.org/10.1371/journal.pone.0225641

Copy DOI

Journal: PloS one	Publication Date: Dec 27, 2019
Citations: 9	License type: CC BY 4.0

Affiliation: University of Pecs

Abstract

In order to map attitudes, knowledge and skills related to evidence-based medicine (EBM) in students of medical and health sciences faculties, we performed an online survey during the spring semester 2019 in all medical and health sciences faculties in Hungary. In total, 1080 students of medicine and 911 students of health sciences completed the online questionnaire. The attitude towards EBM was generally positive; however, only a small minority of students rated their EBM-related skills as advanced. There were large differences in the understanding of different EBM-related terms, with 'sample size' as the term with the highest (65%) and 'intention-to-treat analysis' with the lowest (7%) proportion of medical students being able to properly explain the meaning of the expression. Medical students who already participated in some EBM training rated their skills in searching and evaluating medical literature and their knowledge of EBM-related terms significantly better and had a more positive attitude towards using EBM in the practice than students without previous EBM training. EBM trained medical students were more likely to choose online journals (17.5% compared to 23.9%, p<0.05) and professional guidelines (15.4% compared to 6.1%, p<0.001) instead of printed books (33.6% compared to 52.6, p<0.001) as the main source of healthcare information retrieval and used Pubmed/Medline, Medscape and the Cochrane Library to a significant higher rate than students without any previous EBM training. Healthcare work experience (OR = 1.59; 95% CI = 1.01-2.52), conducting student research (OR = 2.02; 95% CI = 1.45-2.82) and upper year university students (OR = 1.65; 95% CI = 1.37-1.98) were other factors significantly influencing EBM-related knowledge. We conclude that the majority of students of medical and health sciences faculties are keen to acquire EBM-related knowledge and skills during their university studies. Significantly higher EBM-related knowledge and skills among EBM trained students underline the importance of targeted EBM education, while parallel increase of knowledge and skills with increasing number of education years highlight the importance of integrating EBM terminology and concepts also into the thematic of other courses.

Highlights

Using evidence-based medicine (EBM) in daily medical and health care practice represents an essential element of developed health care systems
For successful implementation of evidence-based practice (EBP), ideas of EBM should become an integral part of the thinking of health care providers at all levels; besides their adequate knowledge of EBM it is important that health care professionals possess the willingness and ability to use the acquired knowledge in the daily practice, when making actual decisions about the therapy of patients
EBM is an accepted part of clinical practice, there are still opposing standpoints: while supporters emphasize facilitated and improved healthcare decisions, which result in a smaller variability in quality of health care provided by different practitioners, the critics take the position that EBM is “cookbook medicine”, that it is unable to account for individual patient factors and neglects personal professional experiences [2]

Summary

Introduction

Using evidence-based medicine (EBM) in daily medical and health care practice represents an essential element of developed health care systems. EBM is an accepted part of clinical practice, there are still opposing standpoints: while supporters emphasize facilitated and improved healthcare decisions, which result in a smaller variability in quality of health care provided by different practitioners, the critics take the position that EBM is “cookbook medicine”, that it is unable to account for individual patient factors and neglects personal professional experiences [2]. Another potential problem is that health care providers are often not properly trained to implement the evidence [3, 4]. Cochrane Hungary was founded in 2014 with the aim to provide postgraduate training to healthcare practitioners and to support the understanding of the aims of Cochrane and relevance of EBM among various professionals working at all levels of healthcare

Results

Discussion

Conclusion