Do knowledge infrastructure facilities support Evidence-Based Practice in occupational health? An exploratory study across countries among occupational physicians enrolled on Evidence-Based Medicine courses

Abstract

Background: Evidence-Based Medicine (EBM) is an important method used by occupational physicians (OPs) to deliver high quality health care. The presence and quality of a knowledge infrastructure is thought to influence the practice of EBM in occupational health care. This study explores the facilities in the knowledge infrastructure being used by OPs in different countries, and their perceived importance for EBM practice.

The Obstacles of Teaching Evidence Based Medicine in Iran, from the View Point of Clinical Academics and Medical Students; a Qualitative Study

“…A study from Denmark showed that the majority of clinical doctors at a University Hospital lacked knowledge about key methodological evidence-based medicine terms [16]. A study in occupational medicine practitioners showed that one of the main barriers were little acquaintance with EBM skills [8]. In our study most of the students confessed they only passed and did not learn enough epidemiology, statistics and research methods and cannot write a research proposal independently.…”

“…Studies have reported that especially older physicians find it hard to acquire EBM skills [8]. In our study the students openly discussed the fact that their older academics use out of date information for teaching and decision making.…”

“…This fact along with unfamiliarity with library services, lack of time, work overload and exhaustion seems responsible for physicians and health personnel not using the library resources properly [15]. A study in occupational medicine practitioners showed that some of the main barriers for EBM were lack of free access to full-text articles, language barriers (most texts in foreign language), and unreliable internet connectivity [8]. A study in Iran showed that less than 30% of medical residents were familiar with the available EBM databases and among those who were familiar many did not use these databases for decision making [7].…”

“…One of the main obstacles mentioned in studies is time constrains [2,8,10,14]. Time constraints include both the competing study demands and the long time spent for searching the evidence.…”

“…EBM was introduced into the medical curriculum in the last decade in many countries [8]. Now many universities have specific curricula designed and revised for teaching EBM with the objective of assisting medical residents to become competent, self directed, life-long learners and with sufficient skills to keep up to date with the medical literature and properly solve problems they face in everyday practice [9].…”