Article type
Year
Abstract
Background: The aim of practice evidence-based medicine is to provide evidence-based care and improve outcomes for patients. Improvement of knowledge, attitude and behavior of clinicians is a precondition of evidence-based care and a key of teaching evidence-based medicine.
Objective: To assess the effect of evidence-based medicine (EBM) courses on change of knowledge, attitude and behavior related to evidence-based medicine in medical postgraduates.
Methods: One hundred and eleven second year medical postgraduates who selected the EBM course were included. The course lasted four weeks (3 hours twice a week, total 21 hours). The lectures were delivered in combination with cases. A 49-item self-completion questionnaire was developed to assess the knowledge, attitude and behavior related to evidence-based medicine before and after the course. The test-retest reliability of the questionnaire was good (ICC: 0.44-0.92).
Results: 93 people responded before the course and 111 responded after the course. 1. Knowledge and skills: There was a significant increase in the understanding of specific terms in evidence-based medicine after compared with before (75% showed a statistical difference, p<0.01); there was also an improvement in familiarity with medical search tools after the course compared with before (p<0.05). 2. Attitude: The mean scores of 55% items were high both before and after the course. The two items 'Strong evidence is lacking to support most of the interventions I use with my patients' and 'EBP takes into account patient preferences' had a significant increase after course comparing with before course (p<0.01). 3. Behavior: About 60% of postgraduates in before and after the course did not read literature related to their specialty at all. Using professional literature and research findings in their clinical decisions making was not significantly different between before and after the course (>6 times /month, 29% before and 35.1% after). There were not significant differences in using clinical practice guidelines after compared with before the course. 4. Barriers: The medical postgraduates considered 'poor ability to critically appraise the literature' as the top barrier both before and after the course. The second barrier 'lack of search skills' was rated more highly than 'lack of information resources' before the course, but after the course, 'lack of information resources' rated more highly as a barrier than did 'lack of search skills'.
Conclusion: The knowledge of medical postgraduates significantly increased after a course of EBM, and attitude and behavior showed some improvement. The top three barriers to evidence- based practice were 'poor ability to critically appraise the literature', 'lack of information resources' and 'lack of search skills'.
Objective: To assess the effect of evidence-based medicine (EBM) courses on change of knowledge, attitude and behavior related to evidence-based medicine in medical postgraduates.
Methods: One hundred and eleven second year medical postgraduates who selected the EBM course were included. The course lasted four weeks (3 hours twice a week, total 21 hours). The lectures were delivered in combination with cases. A 49-item self-completion questionnaire was developed to assess the knowledge, attitude and behavior related to evidence-based medicine before and after the course. The test-retest reliability of the questionnaire was good (ICC: 0.44-0.92).
Results: 93 people responded before the course and 111 responded after the course. 1. Knowledge and skills: There was a significant increase in the understanding of specific terms in evidence-based medicine after compared with before (75% showed a statistical difference, p<0.01); there was also an improvement in familiarity with medical search tools after the course compared with before (p<0.05). 2. Attitude: The mean scores of 55% items were high both before and after the course. The two items 'Strong evidence is lacking to support most of the interventions I use with my patients' and 'EBP takes into account patient preferences' had a significant increase after course comparing with before course (p<0.01). 3. Behavior: About 60% of postgraduates in before and after the course did not read literature related to their specialty at all. Using professional literature and research findings in their clinical decisions making was not significantly different between before and after the course (>6 times /month, 29% before and 35.1% after). There were not significant differences in using clinical practice guidelines after compared with before the course. 4. Barriers: The medical postgraduates considered 'poor ability to critically appraise the literature' as the top barrier both before and after the course. The second barrier 'lack of search skills' was rated more highly than 'lack of information resources' before the course, but after the course, 'lack of information resources' rated more highly as a barrier than did 'lack of search skills'.
Conclusion: The knowledge of medical postgraduates significantly increased after a course of EBM, and attitude and behavior showed some improvement. The top three barriers to evidence- based practice were 'poor ability to critically appraise the literature', 'lack of information resources' and 'lack of search skills'.