Knowledge, attitudes and practice of physicians toward evidence‐based medicine: A systematic review

Barzkar, Farzaneh; Baradaran, Hamid Reza; Koohpayehzadeh, Jalil

doi:10.1111/jebm.12325

Cited by 48 publications

(65 citation statements)

References 49 publications

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“…Moreover, more than half of the members were completely unaware of the Cochrane Library (28). According to multiple studies, the low level of knowledge among dental students opposes strong attitudes and limits the clinical use of the EBD approach (27,28,(31)(32)(33)(34)(35)(36).…”

Section: Discussionmentioning

confidence: 99%

Evidence-Based Dentistry Among Iranian General Dentists and Specialists: A Knowledge, Attitude, and Practice Study

Vahabi

Namdari

Vatankhah

et al. 2020

ircmj

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Background: The use of evidence-based dentistry (EBD) as the integration of investigations and clinical decisions has been a focus of attention in recent years. Objectives: The present study aimed to evaluate the knowledge, attitude, and practice of EBD among Iranian dentists in 2019. Methods: A total of 140 self-administered questionnaires with 57 items were distributed among dentists in the 2019 exhibition of Iranian dentists. Moreover, 60 self- administered questionnaires were sent to five different dentistry schools in Iran. The analyses were carried out using the Chi-square test, independent samples t-test, and Pearson correlation. Results: A total of 119 fully-responded self-administered questionnaires were analyzed in this study. The dentists attending EBD workshops obtained significantly higher scores of knowledge. The Cochrane Library, manufacturer’s brochures, and evidence-based guidelines were used the least for clinical decisions. Consultation with colleagues, use of textbooks, and personal judgment were mostly utilized for clinical decisions. In addition, 93.3% of the participants stated sensible uncertainties in their clinical decisions. The most important barriers to EBD were the need for long discussions with patients, lack of skills in the critical appraisal of articles, and lack of motivation in dentists with the incidence rates of 62.2%, 62.2%, and 39.5%, respectively. Conclusions: Due to the low levels of EBD knowledge among Iranian dentists, it is recommended to give further close attention to increasing the knowledge in this regard. However, their high enthusiasm for participation in EBD workshops and enhancement of EBD skills is promising.

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Section: Discussionmentioning

confidence: 99%

Evidence-Based Dentistry Among Iranian General Dentists and Specialists: A Knowledge, Attitude, and Practice Study

Vahabi

Namdari

Vatankhah

et al. 2020

ircmj

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“…When looking at attitudes and practice toward evidence‐based medicine (EBM), Barzkar et al performed a systematic review demonstrating an overall positive attitude from physicians toward the idea of practicing EBM; however, they reported awareness and knowledge was poor due to similar barriers as those stated above . How, then, can providers overcome these barriers to realize their desire to practice EBM consistent with published CPGs?…”

Section: Discussionmentioning

confidence: 99%

Clinician adherence to the clinical practice guideline: Acute otitis externa

et al. 2019

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Objectives/Hypothesis: Over 10 years have passed since the Clinical Practice Guideline: Acute Otitis Externa (CPG-AOE) was first published, and it has been several years since its update. We sought to assess clinicians' adherence as well as referral patterns.Study Design: Survey. Methods: A 23-question survey was distributed to regional primary care clinicians evaluating demographic data, perception of the clinical practice guideline (CPG), adherence, and details of specialist referral. Statistical analysis was performed to compare adherence and referral patterns using the Fisher exact test or the χ 2 test.Results: One hundred seventeen clinicians completed the survey. Fifteen respondents (12.8%) had reviewed the CPG. The recommendations with the least reported adherence were pain management (39.1%) and accounting for prior radiotherapy as a modifying factor (43.0%). The recommendations of prescribing ototopical therapy and avoiding systemic antimicrobials in uncomplicated acute otitis externa had adherence of 94.0% and 83.8%, respectively. When analyzed by provider type (e.g., resident, nurse practitioner/physician assistant), there were no significant differences in adherence. No significant differences in adherence were observed based on previous review of the CPG. When reporting frequency of specialist referral, the majority of respondents selected rarely (53.9%). The most favored reason for referral was symptoms >4 weeks (86.3%).Conclusions: Of the providers who responded, very few had reviewed the CPG-AOE. Despite the added emphasis on pain management in the CPG update, this recommendation had the lowest adherence. Rates of adherence were similar across provider types and did not differ significantly if the CPG was reviewed. Efforts at improved provider education should be considered to increase adherence to the CPG.

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“…7,8,[18][19][20] Barzkar et al summarized the knowledge, attitudes and practice (KAP) of physicians in a systematic review including 57 articles and reported that physicians generally have positive attitude toward EBM and most believe that its implementation improves patient care but found that their self-reported awareness and knowledge regarding EBM concepts to be generally poor. 10 Based on a literature review, no study in Nigeria has assessed the KAP of EBM among resident doctors who are responsible for the majority of clinical decision making in tertiary hospitals. This study therefore, assessed the self-rated EBM KAP and barriers among resident doctors in a selected teaching hospital in southern Nigeria.…”

Section: Udod Andmentioning

confidence: 99%

“…First, clinician's understanding of this care delivery strategy may be poor; for example, findings from studies suggested that a low proportion of clinicians understood the components of EBM in some settings 6,7 . Apart from knowledge, clinicians do also face other barriers in adopting the EBM concepts, the most consistently documented of which is the lack of time to search for, retrieve and study evidence each time a clinical question is raised 7‐12 . The time barrier and similar challenges are probably of higher relevance in resource‐constraint settings like Nigeria with a low doctor‐population ratio of 4 in 10 000, 13 and an average consultation time of 10 minutes or less 14 …”

Section: Introductionmentioning

confidence: 99%

“…6,7 Apart from knowledge, clinicians do also face other barriers in adopting the EBM concepts, the most consistently documented of which is the lack of time to search for, retrieve and study evidence each time a clinical question is raised. [7][8][9][10][11][12] The time barrier and similar challenges are probably of higher relevance in resource-constraint settings like Nigeria with a low doctor-population ratio of 4 in 10 000, 13 and an average consultation time of 10 minutes or less. 14…”

Section: Introductionmentioning

confidence: 99%

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Is evidence‐based medicine a mirage in resource‐constrained settings? A survey among resident doctors in selected teaching hospitals in Nigeria

Bello

Ajayi

Bamgboye

et al. 2020

J Evidence Based Medicine

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Aim The study aimed to assess the self‐rated knowledge, attitude toward, and practice (KAP) of evidence‐based medicine (EBM) among resident doctors in Nigeria. Methods This was a cross‐sectional web‐based survey among 238 resident doctors in four selected teaching hospitals in southern Nigeria. Survey questionnaire contained items assessing the KAP of EBM, familiarity with and understanding of key EBM terms, the use of EBM in decision making, barriers militating against EBM and ways to improve EBM adoption. Proportions and summary statistics were reported for the distribution of survey items. Results Mean number of years in clinical practice was 9.3 ± 4.5 years. Respondents were uniformly distributed in major clinical specialties. The majority (70.5%) were senior registrars. Respondents’ understanding of EBM components included; current best clinical evidence (98.3%), clinical expertise (65.5%), and patients’ choices (36.6%). Self‐rated familiarity with EBM terms was high while perceived understanding of the terms was lower. The least understood concept was heterogeneity (20.6%). The attitude toward EBM was generally positive. Only about half (53.6%) had used medical bibliographic databases within the last 6 months prior to the survey. Barriers against EBM included lack of time (47.1%) and lack of requisite skills (32.4%). Suggestions to improve EBM adoption included training (58.1%), provision of free Wi‐Fi, and free access to bibliographic databases (25.2%) and increased political will (23.1%). Conclusion A further understanding of the EBM concept, provision of enabling infrastructure, regular clinical audit and advocacy to hospital management and clinical consultants, may improve the level of adoption of EBM.

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Knowledge, attitudes and practice of physicians toward evidence‐based medicine: A systematic review

Cited by 48 publications

References 49 publications

Evidence-Based Dentistry Among Iranian General Dentists and Specialists: A Knowledge, Attitude, and Practice Study

Evidence-Based Dentistry Among Iranian General Dentists and Specialists: A Knowledge, Attitude, and Practice Study

Clinician adherence to the clinical practice guideline: Acute otitis externa

Is evidence‐based medicine a mirage in resource‐constrained settings? A survey among resident doctors in selected teaching hospitals in Nigeria

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