Evidence-based Medicine Knowledge Research Articles

Translation and cross-cultural adaptation of Persian version of Evidence Based Medicine Questionnaire (EBMQ) in postgraduate medical students in Iran.

Evidence Based Medicine Questionnaire (EBMQ) was developed to assess the knowledge, practice and barriers towards the implementation of Evidence-Based Medicine (EBM). This study aimed to translate, cross-culturally adapt and psychometrically validate the Persian version of EBMQ. This was an analytical cross sectional study. The EBMQ underwent translation and cross-cultural adaptation following best practices. Face validity was assessed by a panel of five experts. The content validity index (CVI) and content validity ratio (CVR) were evaluated by 15 experts who were familiar with EBM. The tool's internal consistency and test-retest reliability over a 2-week period were evaluated using Cronbach's α and intra-class correlation (ICC), respectively. To assess construct validity, the questionnaire was completed by 400 medical students. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used for construct validity assessment. All analyses were carried out using IBM SPSS v.24 and AMOS v.24. A significance level of 5% was considered. The CVR for 40 items was higher than 0.62, and their CVI score was 1.0, indicating good content validity. The scale demonstrated acceptable internal consistency and test-retest reliability (n = 30) with an ICC of 0.909 (95% CI: 0.866 to 0.941), and an overall alpha coefficient of 0.957. The structural validity was established through exploratory factor analysis (Bartlett's test p<0.001; the Kaiser-Meyer-Olkin index = 0.862), and it was further confirmed by confirmatory factor analysis. A three-factor solution with 40 items, explaining 51.610% of the variance, exhibited the best fit indices Chi-square statistics/df = 4.23; RMSEA = 0.08; CFI = 0.95; NFI = 0.93; TLI = 0.92). The Persian version of the EBMQ was a reliable and valid tool that could be utilized to assess the knowledge, practice and barriers of EBM for physicians in Persian language countries.

Case-based EBM instruction for Osteopathic Medical Students: A Case Report

Background: Evidence-based medicine (EBM) is an important part of graduate medical education and a learning outcome necessary for preparing students to become effective residents. However, many medical educators and librarians struggle to offer EBM instruction that is contextualized, relevant, and engaging. Case-based learning (CBL) can establish the relevance of EBM instruction sessions by using clinical scenarios that link theory to practice. Experience: This case report describes how a college of osteopathic medicine (COM) liaison librarian redesigned a large cohort, lecture-based learning approach to EBM instruction into interactive, relevant, and contextualized CBL labs. CBL labs with smaller student groups were designed to provide an active learning environment and encourage peer-to-peer learning. The CBL format has been previously applied to EBM instruction but not quantifiably evaluated. A modified rubric was created to provide a quantifiable measurement of student performance in future evaluations. Discussion: First-year osteopathic medical students participated in CBL sessions, integrating EBM into their curriculum. The small groups facilitated personalized guidance, peer-to-peer learning, and critical thinking. Clinical scenarios that were mapped to the students’ curriculum provided relevance to the learning experience. The CBL format allowed the librarian to support students individually and increased engagement compared to lecture-based learning. Challenges included assessing the students’ prior EBM knowledge and the time commitment for a solo librarian. However, group assignments and a grading rubric helped to minimize the challenge. Conclusion: The initial pilot testing of this instructional design format and rubric has shown promise in reaching the objectives of providing a relevant and active learning platform with quantifiable results. A future randomized controlled trial is planned to provide quantifiable evidence supporting CBL labs for EBM instruction when compared to lecture-based learning

Knowledge, Attitude, and Practice (KAP) Status toward Clinical Reasoning and Evidence-Based Medicine among the Medical Interns and Gynecology Residents of Iran University of Medical Sciences.

Clinical reasoning and evidence-based medicine (EBM) are important concepts in modern medicine. We performed this study to investigate the knowledge, attitude, and practice (KAP) status toward clinical reasoning and EBM among the medical interns and gynecology resident physicians of Iran University of Medical Sciences and related factors. A cross-sectional study (Tehran, Iran, first half of 2022) was conducted based on two researcher-made questionnaires consisting of three components for each including clinical reasoning attitude (CR-A), clinical reasoning knowledge (CR-K), clinical reasoning practice (CR-P), EBM attitude (EBM-A), EBM knowledge (EBM-K), and EBM practice (EBM-P). The related factors were age, gender, educational level, score of general practice education, having research experience, and general practice experience. A total of 60 individuals participated. The mean score was good for CR-A, moderate for CR-K, moderate for CR-P, good for EBM-A, moderate for EBM-K, and moderate for EBM-P. The total score was moderate in both clinical reasoning and EBM. Among the related factors, CR-P was associated with higher educational levels and having experience in general practice (P < 0.05). Research experience was associated with better CR-K and all KAP components for EBM (P < 0.05). The total score and many of the KAP components had moderate status for clinical reasoning and EBM. Planning on the associated factors should be regarded in the future. Such questionnaires are suggested to be validated for use in quasi-experimental studies.

Competency in evidence-based medicine and associated factors among medical radiology technologists in Addis Ababa, Ethiopia.

Evidence-based medicine integrates clinical expertise, patient values and best research evidence in clinical decision-making. This study aimed to assess evidence-based medicine knowledge, attitudes, practices and associated factors among medical radiology technologists in Addis Ababa, Ethiopia. A cross-sectional study was conducted among 392 medical radiology technologists from May to August 2022 using a self-administered questionnaire. Bivariate and multivariate logistic regression identified factors associated with evidence-based medicine practice. Most medical radiology technologists (57.7%) had moderate evidence-based medicine knowledge and 94.9% had favourable attitudes. However, 64.8% demonstrated poor evidence-based medicine practice. Factors significantly associated with better evidence-based medicine practice were moderate knowledge (AOR 1.949, 95% CI 1.155-3.291), good statistical understanding (AOR 1.824, 95% CI 1.135-2.930), sufficient time for evidence-based medicine (AOR 1.892, 95% CI 1.140-3.141), institutional support (AOR 2.093, 95% CI 1.271-3.440) and evidence-based medicine resource access (AOR 1.653, 95% CI 1.028-2.656). Despite moderate knowledge and positive attitudes towards evidence-based medicine, most medical radiology technologists had suboptimal utilisation. Strategies to improve knowledge, ensure dedicated time, provide institutional support and resources could enhance evidence-based radiology practice.

Online Evidence-Based Medicine Learning During the COVID-19 Era: Personal Experience in Two Online Autumn Schools

Background: The COVID-19 pandemic has disrupted the traditional educational system of schools and universities. Digital education has become the core method of learning during the pandemic. The objective of this study was to report our experience of a pilot online evidence-based medicine (EBM) school and review the opportunities and challenges coming along with online learning. Methods: The Iranian Student Center for EBM organized this online EBM course in two phases. The purpose of phase one was to familiarize participants with EBM basics, and phase two aimed to overview systematic review studies. The classes were accompanied by supplementary educational videos and practical group assignments. Participants were asked to complete a test evaluating their general knowledge of EBM and systematic reviews. Results: Overall, 29 students (10 men and 19 women) in the first phase and 51 students (24 males and 27 females) in the second phase from different universities and study fields (mostly medical fields) participated in this course. In the first and second phases, mean scores of 28.10 and 64.27, as well as 46.97 and 81.89 from 100, were obtained in the pre-test and post-test, respectively. Based on the analysis, test scores improved significantly after the course (P&lt;0.001). Subgroup analysis regarding the gender of students showed no statistical difference between the two groups. Conclusion: Despite the challenges facing remote education during the COVID-19 outbreak, this online EBM school was effective for the participants. Technical problems and low student engagement levels were the main setbacks of online learning.

Implementation of an Evidence-Based Medicine Curriculum for Postgraduate Emergency Medicine Physician Assistant and Nurse Practitioner Fellows.

Within physician assistant (PA) education, the inclusion of evidence-based medicine (EBM) is mandatory. Despite existing literature on EBM training methodologies for PA students and emergency medicine (EM) physician residents, there exists a dearth of published data concerning EBM instruction within postgraduate PA EM programs. A pilot study is described providing an overview of implementation of an EBM curriculum in a single-institution postgraduate physician assistant and nurse practitioner emergency medicine fellowship. Quantitative data using pre-curriculum and post-curriculum surveys were collected. The curriculum included statistical concept screencasts, required attendance at a journal club with assigned topics for discussion, and used a critical appraisal tool designed to help fellows better analyze and understand the articles being reviewed. Upon graduation, fellows participated in structured interviews to collect qualitative data about the curriculum and application of learned concepts to the clinical setting. There was a statistically significant improvement in fellows' reported confidence in discussing the medical literature with practicing providers ( P = .02). However, there was no difference in prescores and postscores on EBM knowledge questions or on fellows' feelings of importance of EBM to clinical practice. Qualitative data revealed several themes, including helpfulness of tools provided in the curriculum, appreciation of curricular changes made secondary to fellow suggestions, and reports of improvement in reviewing medical literature and comfort in participation in local journal clubs upon graduation from the fellowship program. Limitations, including small sample size and validity concerns, are discussed. Positive changes were made to the curriculum based on qualitative data collected. The authors advocate for subsequent investigations into this subject within a multi-institutional and multispecialty context, thereby enhancing the breadth of the findings. Nevertheless, this study furnishes the initial accessible substantiation of the viability of introducing an EBM curriculum within this specific demographic.

A Survey of the Perceptions, Knowledge, Attitudes and Practice of Evidence-Based Medicine among Rehabilitation Medicine Trainees and Consultants in a University-Based Tertiary Hospital

Objectives. The study aimed to determine the perceptions, attitudes, knowledge and practice of Evidence-Based Medicine (EBM) among Rehabilitation Medicine trainees and faculty. It aimed to compare trainees and faculty in terms of perceptions, attitudes, knowledge and practice. The study also intended to identify the barriers in the practice of EBM.&#x0D; Methods. The study utilized a cross-sectional design. The study included residents or trainees and consultants at the Department of Rehabilitation Medicine-Philippine General Hospital. A questionnaire exploring the perceptions, knowledge, attitudes and practice of EBM and the barriers in its practice was developed based on review of previous studies. Focus group discussions were conducted with the residents and consultants separately to probe the responses in the questionnaire.&#x0D; Results. Thirty-four trainees and consultants participated in the study. Trainees considered themselves having received more training in literature search (p=0.005) and critical appraisal (p=0.01) than consultants. Majority had fairly accurate conceptions of EBM. Thirty-eight percent of participants considered themselves competent in developing a clinical question and in doing a literature search. About 18% considered themselves competent in appraising literature. There were no significant differences between trainees and consultants in terms of their perceived knowledge and skills in EBM techniques. Consultants and trainees expressed positive attitudes towards EBM. In a week, some 50% search the literature at least twice and appraised an article. Eighty percent of Rehabilitation Medicine physicians (physiatrists) spent at least 2 hours per week reading related literature. In terms of practice of EBM, the trainees rated themselves higher in searching and appraising literature than the consultants but the differences were not significant. More than 90% indicated interest in further training in EBM. Majority cited lack of time, lack of understanding of statistics and inadequate information sources as barriers to EBM.&#x0D; Conclusion. Physiatrists have fairly accurate perceptions; positive attitudes; some knowledge / skills; and a high level of interest in EBM. There were no significant differences between consultants and trainees except in the aspect of training in literature search and appraisal. The lack of personal time, lack of understanding of statistical analyses and inadequate information sources were the most common perceived barriers in the practice of EBM in Physiatry.

The Effectiveness of a Journal Club for Improving Evidence-Based Medicine Skills and Confidence in Pre-clerkship Medical Students.

Evidence-based medicine (EBM) refers to medical practice that uses current best evidence to inform decision-making. This requires several skills including (1) creating an answerable question, (2) searching literature, (3) critically appraising evidence, and (4) applying results. Journal clubs are known to be effective in improving searching and critical appraisal skills in graduate medical education. In pre-clerkship medical education, journal clubs are used less often, and students often do not have the opportunity to engage in all of the steps above. We developed a journal club for pre-clerkship students and measured its effectiveness using a pre-test, post-test design. Students attended 5 journal club sessions run by rotating student leaders and facilitated by faculty. Student groups developed searchable questions from clinical cases, searched the literature, located and critically appraised an article, and applied results to the case. We measured EBM skills and confidence using two validated questionnaires. Twenty-nine students (MS-1 and MS-2) completed the study. EBM confidence significantly improved at post-test with greatest improvements in the MS-1 student cohort. Confidence in developing a searchable question from a patient case significantly improved in both cohorts. There were no changes measured on the Test of EBM Knowledge and Skills. Participation in a faculty-mentored, student-led journal club improved confidence across all domains of EBM, primarily in MS-1 students. Journal clubs are positively received by pre-clerkship medical students and provide effective mechanisms to teach and promote all steps of EBM in pre-clerkship curricula. The online version contains supplementary material available at 10.1007/s40670-023-01779-y.

A cross-sectional study evaluating the knowledge, attitude, and practice of evidence-based medicine among resident doctors of a health-care Institution of National Importance in India.

Evidence-based medicine (EBM) promotes the integration of updated- best evidence with patient preferences and medical expertise for clinical decision-making. Despite the availability of high-quality evidence such as systematic review and meta-analysis, some clinicians manage their patients based on past experiences and expert opinion. Thus, this study was proposed to assess the knowledge, attitude, and practice of EBM among resident doctors at a tertiary care hospital in India. This cross-sectional questionnaire-based study was conducted among senior residents and final-year postgraduates (PGs) who were independently involved in clinical decision-making. By convenience sampling method, the participants were recruited, and the validated EBM Questionnaire (EBMQ) was distributed online for assessing the knowledge, attitude, and practice of EBM. Descriptive statistics were represented as frequency and proportions. A total of 102 resident doctors participated with male preponderance (74.5%). Nearly, 96 (94.1%) participants were already practicing EBM and 21.6% had undergone EBM training. Textbooks (50%) were the most often referred sources for EBM information. Specific EBM databases such as MEDLINE and Cochrane were also utilized by 37.3% of participants. More than 70% of participants understood the terms such as a randomized controlled trial, case-control study, and P value. A higher proportion (80.4%) of participants showed a positive attitude about patient care improved by EBM. The majority of the resident doctors exhibited good knowledge and a positive attitude toward applying EBM in clinical decision-making. Periodic training through workshops or courses and integration of EBM with the PG curriculum would potentially enhance the EBM practice.

Knowledge, Attitude, and Practice towards Evidence-Based Medicine among Northern Saudi Primary Care Physicians: A Cross-Sectional Study.

The evidence-based practice of primary care physicians is essential because they are the first line of contact with the local community, and they cater to most of their communities' health needs. In the current study, in which we used a cross-sectional survey in northern Saudi Arabia, we assessed primary care physicians' knowledge, attitude, practice, and barriers regarding evidence-based medicine (EBM). Of the 300 physicians who participated, less than half had high knowledge (43.7%) and attitude (47.7%) toward EBM. The chi-square test revealed that the knowledge categories were significantly associated with the age group (p = 0.002) and EBM training received in the past five years (p &lt; 0.001), and the attitude categories were significantly associated with nationality (p = 0.008). Of the respondents, 155 (51.7%) used EBM in their daily clinical practice. Through logistic regression analysis, we found that the identified predictors of including EBM in clinical practice were the 31-45-year-old age group (adjusted odds ratio (AOR) = 2.11, 95% confidence interval (CI) = 1.65-2.73) and EBM training received during last 5 years (AOR = 2.12, 95% CI = 1.35-2.94). We recommend enhancing primary care physicians' knowledge of EBM and its importance in clinical practice through appropriate training programs. A multi-centric mixed-method survey is warranted in other provinces of the KSA to recognize region-specific training demand.

Exploring the Recent Trends in Management of Dementia and Frailty: Focus on Diagnosis and Treatment.

Dementia and frailty increase health adversities in older adults, which are topics of growing research interest. Frailty is considered to correspond to a biological syndrome associated with age. Frail patients may ultimately develop multiple dysfunctions across several systems, including stroke, transient ischemic attack, vascular dementia, Parkinson's disease, Alzheimer's disease, frontotemporal dementia, dementia with Lewy bodies, cortico-basal degeneration, multiple system atrophy, amyotrophic lateral sclerosis, and Creutzfeldt-Jakob disease. Patients with dementia and frailty often develop malnutrition and weight loss. Rigorous nutritional, pharmacological, and non-pharmacological interventions generally are required for these patients, which is a challenging issue for healthcare providers. A healthy diet and lifestyle instigated at an early age can reduce the risk of frailty and dementia. For optimal treatment, accurate diagnosis involving clinical evaluation, cognitive screening, essential laboratory evaluation, structural imaging, functional neuroimaging, and neuropsychological testing is necessary. Diagnosis procedures best apply the clinical diagnosis, identifying the cause(s) and the condition(s) appropriate for treatment. The patient's history, caregiver's interview, physical examination, cognitive evaluation, laboratory tests, and structural imaging should best be involved in the diagnostic process. Varying types of physical exercise can aid the treatment of these disorders. Nutrition maintenance is a particularly significant factor, such as exceptionally high-calorie dietary supplements and a Mediterranean diet to support weight gain. The core purpose of this article is to investigate trends in the management of dementia and frailty, focusing on improving diagnosis and treatment. Substantial evidence builds the consensus that a combination of balanced nutrition and good physical activity is an integral part of treatment. Notably, more evidence-based medicine knowledge is required.

Multisite assessment of emergency medicine resident knowledge of evidence-based medicine as measured by the Fresno Test of Evidence-Based Medicine.

Evidence-based medicine (EBM) is the application of scientific evidence while treating a patient. To date, however, there is very little evidence describing how residents in emergency medicine understand and incorporate EBM into practice. The aim of this study was to determine EBM theoretical and quantitative knowledge in emergency medicine residents in community hospital-based training programs. A sample of emergency medicine residents from nine hospitals was enrolled to complete a cross-sectional assessment of EBM skills from April 2021 through June 2021. Performance on the Fresno Test of Evidence-Based Medicine (FTEBM) was assessed utilizing descriptive statistics, t tests, and one-way analysis of variance. A total of 50.8% (124/244) of current emergency medicine residents completed the FTEBM during the study period. No significant difference on FTEBM scores was noted between the different types of medical degrees (DO vs. MD) (p=0.511), holding an advanced research degree (p=0.117), or between each postgraduate year of training (p=0.356). The mean score of those residents who rated their knowledge of EBM as average or higher was 36.0% (32.8-39.1%). The mean score of those residents who rated their programs as having an "average" or higher institutional focus on EBM was 34.9% (32.2-37.6%). Participating emergency medicine residents show an incomplete understanding of EBM both in theory and applied computations despite rating themselves as having an average understanding. Emergency medicine residencies would be well suited to implement a standardized EBM curriculum that focuses on longitudinal reinforcement of key concepts needed for the practicing physician.

Effects of Multimedia E-Books and Augmented Reality on Knowledge and Skills of Health Sciences Students: A Systematic Review

Background: The limited ability of educational institutions to prepare learning materials due to being expensive makes it essential to use other methods such as digital methods or minimize the use of excessive learning materials. Accordingly, the present systematic review aims to find out the effects of multimedia e-books and Augmented Reality (AR) on the knowledge and skills of health sciences students. Methods: This systematic review was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Relevant articles were searched in ScienceDirect, ERIC, ProQuest, Pubmed, and Wiley Online Library, with the publication year of 2010-2021. Eligibility criteria were determined based on the PICOS guidelines. Joanna Briggs Institute (JBI) checklists were used for the quality assessment of the included articles. The risk of bias was assessed using the Cochrane Collaboration’s risk-of-bias assessment tool. The articles were analyzed thematically after collecting their main findings, design, and applied methods. Results: The initial search yielded 493 articles. After removing duplicates, articles met exclusion criteria, and those with low quality, 11 eligible articles were selected for the review. Studies showed that multimedia e-books increased the students’ knowledge of evidence-based medicine, anatomy, community health nursing, pediatric care, electrocardiogram, and sexual harassment prevention. The use of AR increased the skills of students in performing local anesthesia, dental care, and anatomy. Conclusion: The use of multimedia e-books and AR has significant effects on the learning process of health sciences students compared to conventional teaching methods.

Links between evidence-based medicine and shared decision-making in courses for doctors in training: a scoping review

ObjectivesThis scoping review aims to synthesise the current evidence on the inclusion and effectiveness of integrating evidence-based medicine (EBM) and shared decision-making (SDM) into training courses for doctors in training...

Motivators and barriers for seasonal influenza vaccination among healthcare workers in Gulf Cooperation Council countries: a systematic review

The Gulf Cooperation Council (GCC) has adopted the guidelines and recommendations established by global health organizations and provides vaccination programs, both epidemic and seasonal, to all healthcare workers (HCWs). This article aimed at systemically reviewing the motivators and barriers for seasonal influenza vaccination (SIV) among HCWs in GCC countries that would help in developing and finding an optimum strategy to increase the SIV uptake rate. Published literature about the SIV among HCWs in the GCC was recovered from PubMed, Web of Science, Google Scholar, EMBASE, Scopus, and Directory of Open Access Journals databases. Only published articles between January 2000 and May 2020 were selected. A total of 182 studies were screened for eligibility. It was found that the availability of the vaccine free of charge and going to HCW units to administer the vaccines, in addition to campaigns and authority recommendation, showed a higher SIV uptake rate. Furthermore, targeted education with emphasis on the evidence-based medicine knowledge to show the effectiveness and safety of SIV and its value in protecting others and decreasing the burden of flu would impose a positive attitude toward SIV.

Dermatofibrosarcoma Protuberans: A Systematic Review of the Literature

Background: Dermatofibrosarcoma Protuberans (DFSP) is a rare slow growing cutaneous soft tissue sarcoma, that is characterized to be locally invasive with high recurrence rate. However, it has poor metastatic capacity.&#x0D; Objective: We are conducting this literature review to gather evidence-based medicine knowledge regarding Dermatofibrosarcoma Protuberans. Moreover, this study highlights the gaps of knowledge in regard to this disease entity.&#x0D; Methods: The literature search was conducted by searching the keywords “Dermatofibrosarcoma Protuberans” and “soft tissue sarcomas” in PubMed and Web of Science databases.&#x0D; Results: 1,769 potentially relevant results showed matched titles, of which 13 articles met the requirements and were included in the literature review.&#x0D; Limitations: Vague nonspecific clinical manifestations, makes it challenging to establish an early diagnosis and seek an appropriate counseling. In addition, it is difficult to diagnose due to the slow growing behavior and the tumor’s benign appearance. As a result of all of that there is no enough cases reported in the literature.&#x0D; Conclusion: This review highlights the need of high index of suspicion to help reach an early and proper diagnosis and to raise awareness. Dermatofibrosarcoma Protuberans needs a specialized center in order to identify and recognize the disease. The knowledge and awareness of the disease is low since it is rare.

Simulated Randomized Controlled Trial to Learn Critical Appraisal (SiRCA): A Randomized Controlled Study of Effectiveness Among Undergraduate Medical Students.

Introduction: The ideal method to teach evidence-based medicine (EBM) to medical students is unclear. We determined the effectiveness of a simulated randomized controlled trial (RCT) in improving critical appraisal and EBM skills among medical students compared to traditional training.Methods: One hundred and eighteen medical students were randomized into two groups. Sixty-one students (immersion arm) were trained in critical appraisal using a simulated RCT aimed at determining efficacy of a “brainy pill” on ability to crack puzzles. Fifty-seven students (traditional group) were trained using a journal club with a checklist. Primary outcome of change in knowledge and skills of critical appraisal and EBM was determined by comparing scores on pre- and post-intervention Fresno tests.Results: Mean age of students was 21.76 (SD - 0.78) years. Seventy (59.3%) were females and 48 (40.7%) males. Mean pre-test scores of traditional and immersion groups were 8.0 (SD - 4.88) and 9.31 (SD - 5.49) respectively and post-test scores were 50.2 (SD - 16.2) and 68.12 (SD - 14.72) respectively (post-intervention mean difference - 17.92; 95% CI 12.26 - 23.57; p<0.0000001). Odds of achieving 65% or more in post-intervention Fresno test score was significantly higher in immersion group (29.8% vs 8.2%; OR 4.76; 95% CI 1.62-13.97; p = 0.001). Perceived competence regarding EBM skills improved significantly in immersion group.Conclusions: Simulated RCT is effective in imparting critical appraisal and EBM practice skills to medical students. Trainers should consider integrating and reinforcing this approach in EBM curriculum to make learning contextual and immersive.

Factors Associated with Practicing Evidence-Based Medicine Among Medical Interns in Amhara Regional State Teaching Hospitals, Northwest Ethiopia: A Cross-Sectional Study.

BackgroundEvidence-based medicine (EBM) is an important component of modern medicine and is essential for the provision of high-quality health services. Little is known about the level of EBM use among Ethiopian medical students. This study aimed to assess the factors associated with EBM practice among medical interns in teaching hospitals in northwestern Ethiopia.MethodsA cross-sectional study was conducted using a random sample of medical interns in teaching hospitals of northwest Ethiopia. Binary logistic regression analysis was used to identify factors associated with EBM practice. The strength of the interaction between variables was calculated using the adjusted odds ratio (AOR) with a 95% confidence interval (CI).ResultsCompleted questionnaire was obtained from 403 (95.3%) of 423 medical interns. About 48.4% of respondents had a good EBM practice. EBM knowledge (AOR = 1.86, 95% CI = 1.220–2.835), attitude to EBM (AOR = 2.05, 95% CI = 1.318–3.193), ability to appraise evidence (AOR = 2.35, 95% CI = 1.570–3.517), and having sufficient time to search for evidence (AOR = 1.67, 95% CI = 1.065–2.627) were factors significantly associated to EBM practice.ConclusionThis study demonstrates that the main factors affecting medical intern’s practice of EBM were lack of critical appraisal skill, lack of knowledge needed to practice EBM, negative attitudes toward EBM, and insufficient time to search for evidence. Providing EBM training to the needs of medical interns would overcome the barriers identified in this study, as well as assist medical interns and other clinical staffs to ensure the correct application of EBM in to clinical practice.

Knowledge, attitude and practice of evidence-based medicine among primary care practitioners in Malaysia: a cross-sectional study

ObjectivesTo determine the level of knowledge and practice of evidence-based medicine (EBM) and the attitudes towards it and to identify the factors associated with its practice among primary care practitioners...

Assessing Awareness, Attitude, Knowledge of Evidence-Based Medicine (EBM) Among the Ambulatory Care Physicians and Its Reflection on Their Prescriptions Pattern, 3 Centers at Al-Kharj Hospitals, Saudi Arabia

Background: Evidence-Based Medicine (EBM) can be defined as “the integration of best research evidence with clinical expertise and patients’ values”. It is the best evidence in making decisions about the care of individual patients. The growing awareness of the limitations of traditional information on clinical decisions led to a shift in medical practice from unsystematic observations from clinical experience, towards evidence-based medicine. The principles of evidence-based medicine have become core concepts of undergraduate, postgraduate, continuing medical education, courses, and workshops offered to health professionals. Irrational prescription being a global problem leading to ineffective or unsafe treatment and that sometimes resulting from the lack of using the EBM. Objective: To assess awareness, attitude, knowledge of EBM among the ambulatory care physicians and its effect in their prescriptions pattern. Methods: A cross-sectional questionnaire study was done to assess the knowledge, attitudes, and practices regarding evidence-based medicine among ambulatory care physicians in 3 hospitals in the Al-Kharj region. In addition, a random sample of ambulatory care prescriptions were collected, then the World Health Organization (WHO) prescription indicators were used to evaluate the physicians prescribing behavior. The prescriptions were collected from the pharmacy department after obtaining approval from the hospital director for each hospital. Result: There was a positive attitude among the ambulatory physicians toward EBM (84%), but there were limit to the basic EBM knowledge (&lt;50 %). Average number of medication encounter was out of the WHO standard value (&gt;1.8%). The Barriers that faced the physicians were included Lack of time (47.7%) and no ready access to EBM (43.1%). The percentage of medications prescribe by generic name was varied between the hospitals, AKFAH (100%), AKMICH (90%) and PSABH (74.05%). Conclusion: In general, there was a positive attitude among the ambulatory physicians toward EBM. The frequent barriers that face the physician to apply EBM included lack of time, no ready access to EBM, and lack of reliable evidence. The attitude and knowledge have a proportion relation to WHO prescribing indicators. It was observed the hospital implement an electronic system were more compliant with prescribing with the generic name.