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Teaching and learning evidence-based medicine:\ud cross-sectional survey investigating knowledge and attitudes of teachers and learners in primary and secondary care

By A. Niroshan Siriwardena, John Sandars, Islay Gemmell and Aly Rashid

Abstract

Evidence-based medicine (EBM) is an important component of quality healthcare and a key part of the curriculum for\ud doctors in training. There have been no previous studies comparing attitudes and knowledge of doctors in primary and secondary care towards EBM practice and teaching and this study sets out to investigate this area. We asked participants, a stratified sample of general practitioners, hospital consultants, GP registrars and junior hospital doctors in Leicester, Northamptonshire and Rutland, UK, to\ud complete a self-administered survey questionnaire\ud and written knowledge test which provided ‘positive to evidence based practice’ (PEP) attitude scores and Manchester Short EBM Questionnaire Education for Primary Care (2007) 18: 45–57 # 2007 Radcliffe Publishing Limited\ud WHAT IS ALREADY KNOWN IN THIS AREA. There is little evidence on the relationship between attitudes and knowledge in relation to evidence-based medicine (EBM) in family doctors, consultants and doctors intraining.\ud WHAT THIS WORK ADDS. This study showed that, although general practitioners and general practitioner\ud trainers were significantly less positive in attitude to EBM compared to GP registrars, junior hospital doctors and consultant respondents, they had significantly higher\ud knowledge scores. This study demonstrated that the attitude (PEP) score and knowledge questionnaire(MANSEBMQ) have high reliability but require further research to demonstrate validity.\ud SUGGESTIONS FOR FURTHER RESEARCH. There remain opportunities for refinement of the MANSEBMQ, validation against existing tools and further application in a larger study, including assessment of EBM knowledge and skills, before and after an educational process, involving students in clinically relevant and integrated EBM learning.\ud Keywords: attitudes, evidence-based practice, general practice registrars, general\ud practitioners, hospital doctors, primary care, secondary care(MANSEBMQ) knowledge scores of participants.\ud The response rate was low which may have led to volunteer bias but there were sufficient responses to explore attitude\ud scores and knowledge scores. Attitude(PEP) scores were highest in hospital consultants, intermediate in doctors in training and lowest in general practitioner (GP)respondents (mean score 71.7 vs 70.5 vs 67.2; P = 0.006). PEP scores were also highest in respondents with higher degrees\ud (MD, PhD, MSc), intermediate in those with higher professional qualifications (MRCP, FRCS, MRCGP or equivalent) and lowest in those with none of these\ud (mean score 72.9 vs 70.6 vs 67.2; P = 0.005). PEP scores were significantly higher(P = 0.002) in respondents who taught EBM (mean score 71.7, 95% CI 70.3 to\ud 73.2, n=109, missing=5) compared with those who did not (mean score 68.6, 95% CI 67.3 to 69.9, n = 105, missing = 12) and in respondents with research experience\ud (P < 0.001), research training (P < 0.001) and training in EBM (P = 0.001). There was a positive correlation between\ud PEP score and MANSEBMQ score (P = 0.013). In contrast, and paradoxically opposite to the pattern of attitudes, knowledge scores were highest in GPs, intermediate\ud in junior hospital doctors and lowest in consultant respondents (mean score 63.5 vs 61.9 vs 54.5, P=0.005).\ud Although GPs and GP trainers were significantly less positive in attitude to EBM compared to GP registrars, junior hospital doctors and consultant respondents, they\ud had significantly higher knowledge scores. This study demonstrated that the attitude(PEP) score and knowledge questionnaire (MANSEBMQ) have good reliability but\ud require further research to demonstrate validity

Topics: L431 Health Policy, L510 Health & Welfare
Year: 2007
OAI identifier: oai:eprints.lincoln.ac.uk:732

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  1. (1998). A First Class Service: quality in the new NHS. Department of Health: London.
  2. (2000). A systematic review of the effectiveness of critical appraisal skills training for clinicians. doi
  3. (2001). Access to the evidence base from general practice: a survey of general practice staff in Northern and Yorkshire Region. doi
  4. (2001). Assessments in evidencebased medicine workshops: loose connection between perception of knowledge and its objective assessment. doi
  5. (2004). Attitudes and knowledge of primary care professionals towards evidence-based practice: a postal survey. doi
  6. (2004). Attitudes of GP trainers to teaching evidence 54
  7. (2004). Attitudes of teachers to evidence based medicine.
  8. (2002). Do short courses in evidence based medicine improve knowledge and skills? Validation of Berlin questionnaire and before and after study of courses in evidence based medicine. doi
  9. Ebell MH et al (2002) Obstacles to answering doctors’ questions about patient care with evidence: qualitative study. doi
  10. (1998). Effectiveness of instruction in critical appraisal (evidence-based medicine) skills: a critical appraisal.
  11. (2005). Evidence-based medicine in primary care: qualitative study of family physicians.
  12. (2002). Evidencebased medicine knowledge, attitudes and skills of community faculty. doi
  13. (1999). Experiences of general practitioners and practice nurses of training courses in evidence-based health care: a qualitative study.
  14. (1998). General practitioners’ perceptions of the route to evidence based medicine: a questionnaire survey. doi
  15. (2002). General practitioners’ self ratings of skills in evidence based medicine: validation study. doi
  16. Glasziou P et al (2005) Sicily statement on evidence-based practice.
  17. (2004). GPs’ and physicians’ interpretation of risks, benefits and diagnostic test results. doi
  18. (1999). Graduate medical education training in clinical epidemiology, critical appraisal, and evidence-based medicine: a critical review of curricula. doi
  19. (2004). Hospital doctors’ self-rated skills in and use of evidence-based medicine – a questionnaire survey. doi
  20. (2001). Some Questions about Evidence-based Practice in Education. www.leeds.ac.uk/educol/documents/ 00001819.htm, pp.1–17. Paper presented at the symposium on ‘Evidence-based practice
  21. (2003). Successful teaching in evidence-based medicine. Medical Education 34:18–22. Correspondence to: Professor A Niroshan Siriwardena, School of Health and Social Care, University of Lincoln, Lincoln LN6 7BG,
  22. (2001). Teaching critical appraisal skills in health care settings. Cochrane Database Systems Review CD001270. doi
  23. (2003). Validation of the Fresno test of competence in evidence based medicine. doi
  24. (2004). What is the evidence that postgraduate teaching in evidence based medicine changes anything? A systematic review. doi
  25. (2001). Why general practitioners do not implement evidence: qualitative study. doi

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