How can we teach EBM in clinical practice? An analysis of barriers to implementation of on-the-job EBM teaching and learning

Abstract

Incorporation of teaching EBM in practice faces several barriers to implementation. Teaching EBM in clinical settings is most successful where EBM principles are culturally embedded and form part and parcel of everyday clinical decisions and medical practice.

Access of primary and secondary literature by health personnel in an academic health center: implications for open access

“…Despite the frequently mentioned barriers to accessing evidence in clinical settings-lack of time [4] and poor information retrieval skills [41]-SUH health personnel took frequent advantage of the published literature. Although UpToDate was used more frequently than PubMed, which is consistent with previous studies [25,42,43], health personnel did access primary Uterature using both PubMed and UpToDate, indicating that UpToDate alone is not sufficient to support information seeking for patient care.…”

“…The prospect that new technologies and policies will allow health personnel to increase the use of research evidence in clinical practice creates the potential for improving the health care of individuals and populations [1,2] and facilitating lifelong learning for health personnel [3,4]. In the last decade, an international movement to increase free orúine access to journals across all disciplines, including medicine, has made a greater proportion of the scholarly literature freely available outside of tiniversities and research institutions.…”

Challenges to Learning Evidence-Based Medicine and Educational Approaches to Meet These Challenges

“…These challenges expand on previously identified challenges which have been focused on the barriers to practicing and teaching EBM 4,8,[12][13][14] instead of on what makes EBM difficult for students to learn. Our learner-centric approach uncovered new challenges that may provide medical educators with additional insights into how students experience EBM training and may help guide the design of EBM curricula.…”

“…4,7,8 Additionally, EBM instructors have described barriers to teaching EBM in clinical care. These barriers include a lack of time for teaching EBM, an absence of EBM requirements for trainees, and their own, as well as trainees', lack of EBM knowledge and skills.…”

“…These barriers include a lack of time for teaching EBM, an absence of EBM requirements for trainees, and their own, as well as trainees', lack of EBM knowledge and skills. 8 On the basis of these studies, researchers have suggested that the challenges reported by physicians and EBM instructors be considered when designing EBM curricula, as they may have implications for student learning. For example, if physicians are challenged by time constraints and fail to practice EBM, then students may have limited exposure to optimal EBM role models, which could impact their learning experiences.…”