Article type
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Abstract
Background: The Royal Australasian College of Physicians (RACP) promotes continuing professional development and standards of practice in adult medicine in Australia and New Zealand. Our survey was designed to assess the views of physicians about evidence-based medicine (EBM) and related issues, including the recent promotion in Australia by governments of clinical quality improvement (CQI) as a vehicle to promote EBM.
Method: We first randomly selected a representative sample of Australian physicians; each was telephoned in advance to alert them of the survey which then arrived by mail. Our 17-page self-administered questionnaire included questions about EBM, clinical quality improvement, skills in EBM and information technology (IT).
Results: Of 311 eligible physicians, 244 (78.5%) returned questionnaires. While only 13.4% of respondents themselves were extremely positive about EBM, significantly fewer perceived their colleagues shared this view (3.4%). While 16.8% strongly agreed they had sufficient skills to search for evidence and, for 11.9%, to appraise evidence, less than 1% strongly agreed they had the time to do so. Similarly, 13.9% were extremely positive about CQI although only 2.5% indicated that their colleagues were extremely positive. Less than two-thirds (61.0%) had access to the Cochrane Library, either at their private practices, hospitals or homes. Among other views, 66.0% indicated web-based access to Cochrane and Medline would be very useful in supporting EBM in practice; 55.3% indicated government subsidies to encourage physicians to purchase, train in and use IT to access evidence would be very useful and 45.4% that small group workshops held in hospitals around specific guidelines would be very useful. Half (50.0%) also endorsed more commissioned research in response to gaps in clinical knowledge.
Conclusions: Having ascertained the views of Australian physicians with regard to EBM, a mix of local and national initiatives is recommended to enhance the incorporation of evidence in practice.
Method: We first randomly selected a representative sample of Australian physicians; each was telephoned in advance to alert them of the survey which then arrived by mail. Our 17-page self-administered questionnaire included questions about EBM, clinical quality improvement, skills in EBM and information technology (IT).
Results: Of 311 eligible physicians, 244 (78.5%) returned questionnaires. While only 13.4% of respondents themselves were extremely positive about EBM, significantly fewer perceived their colleagues shared this view (3.4%). While 16.8% strongly agreed they had sufficient skills to search for evidence and, for 11.9%, to appraise evidence, less than 1% strongly agreed they had the time to do so. Similarly, 13.9% were extremely positive about CQI although only 2.5% indicated that their colleagues were extremely positive. Less than two-thirds (61.0%) had access to the Cochrane Library, either at their private practices, hospitals or homes. Among other views, 66.0% indicated web-based access to Cochrane and Medline would be very useful in supporting EBM in practice; 55.3% indicated government subsidies to encourage physicians to purchase, train in and use IT to access evidence would be very useful and 45.4% that small group workshops held in hospitals around specific guidelines would be very useful. Half (50.0%) also endorsed more commissioned research in response to gaps in clinical knowledge.
Conclusions: Having ascertained the views of Australian physicians with regard to EBM, a mix of local and national initiatives is recommended to enhance the incorporation of evidence in practice.