Mortada Eman M
Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
J Egypt Public Health Assoc. 2013 Dec;88(3):121-9. doi: 10.1097/01.EPX.0000436478.40699.a5.
Evidence-based medical practice has gained worldwide attention and is an emerging must-know topic for today's physicians. Yet, it continues to puzzle physicians either in its understanding or in its practice, and gaps continue to exist between research-based evidence and clinical practice. This study aimed to evaluate the self perceived EBM competency of the clinicians and staff of Zagazig University Hospital.
A cross-sectional study was carried out on a sample of 184 clinicians during the period of March-July 2012 at five randomly chosen special medicine departments (tropical medicine, rheumatology, neurology, dermatology, and hematology-oncology) using a self-administered, specifically tailored questionnaire.
Sampled clinicians were dichotomized according to their self-reported frequency of evidence-based practice into evidence-based medicine (EBM) nonusers (62.5%) and EBM users (37.5%). There was no significant difference between users and nonusers in total mean scores (21.37±1.86 vs. 21.34±2.2, P=0.119). Users had significantly higher mean score for self-perceived EBM competency compared with nonusers (P=0.000), although both users and nonusers had unsatisfactory mean score for EBM competency (38.33±2.87 vs. 32.96±3.026, respectively) (median, 39 vs. 33, respectively). Users of EBM had a significantly higher score in competencies related to the use of a bibliographic database, understanding of methodological terminology, confidence in their skills in EBM steps, and consequently in cumulative EBM competency (P=0.000).
Our findings support some important facts: first, there is discrepancy between clinicians' perceptions and their competency, as they considered themselves practicing EBM although they were not; second, strategies to promote a change in clinical practice are more likely to be successful if they are based on an analysis of problems. All findings in this study highlighted the importance of training in EBM.
循证医学实践已引起全球关注，是当今医生必须了解的新兴话题。然而，无论是在理解还是实践方面，它仍困扰着医生，基于研究的证据与临床实践之间的差距依然存在。本研究旨在评估扎加齐格大学医院临床医生和工作人员对循证医学能力的自我认知。
2012年3月至7月期间，在五个随机选取的特殊医学科室（热带医学、风湿病学、神经病学、皮肤病学和血液肿瘤学），对184名临床医生进行了横断面研究，采用自行填写的、专门定制的问卷。
根据自我报告的循证实践频率，将抽样的临床医生分为循证医学非使用者（62.5%）和循证医学使用者（37.5%）。使用者和非使用者的总平均分无显著差异（21.37±1.86对21.34±2.2，P=0.119）。尽管使用者和非使用者的循证医学能力平均分均不令人满意（分别为38.33±2.87和32.96±3.026）（中位数分别为39和33），但与非使用者相比，使用者对自我循证医学能力的平均分显著更高（P=0.000）。循证医学使用者在与使用书目数据库、理解方法学术语、对循证医学步骤技能的信心以及累积循证医学能力相关的能力方面得分显著更高（P=0.000）。
我们的研究结果支持了一些重要事实：第一，临床医生的认知与能力之间存在差异，因为他们认为自己在实践循证医学，而实际上并非如此；第二，如果基于问题分析，促进临床实践改变的策略更有可能成功。本研究的所有结果都凸显了循证医学培训的重要性。
