Introduction/Objective: To draw attention to a possibly naive issue: evidence-based medicine (EBM) and clinical practice guidelines (GL) may imply an important cultural dimension which goes beyond the sometimes prevailing operational or even regulatory perspectives. To open a discussion about the role of academic institutions in supporting this cultural dimension not only in the continuing medical training of professionals, but also in the educational process of medical students. Rationale: Guidelines are often interpreted as a mostly operational tool for professionals, able to translate scientific evidence (EBM) into models of 'efficacious' clinical practice or to formally express a consensus on models of 'reasonable' clinical practice (where evidence does not exist). A narrower interpretation circumscribes guidelines into the limits of a regulatory perspective, strictly relating them to better efficiency and lower costs. In our opinion both these perspectives can be misleading or even dangerous, possibly hiding the true cultural strength of this approach. When adopting a 'guidelines philosophy', a medical community explicitly recognizes not only the professional value of scientific evidence but also the responsibility in managing the complexity of the medical practice as well as in taking charge of certainties and uncertainties in the medical knowledge. Briefly, a different way of medical reasoning and decision making, to the construction of which academic institutions are committed by mandate.

Methods: We planned to conduct an E-mail poll in among the Cochrane Collaboration Centers and the respective Medical Schools asking them about (i) current or previous experiences, if any, of some formal use of LBM and GL in the educational programs for undergraduates and postgraduates; (ii) their opinion about the opportunity of promoting this approach in the near future; (iii) the existence of some strategies aimed at extending the 'EBM and GL Philosophy' from the 'continuing' to the 'basic' medical education.