Hong Bosun, O'Sullivan Eoin Daniel, Henein Christin, Jones Christopher Mark
Birmingham Dental Hospital, Birmingham, UK.
Cochrane UK & Ireland Trainees Advisory Group, Oxford, United Kingdom.
BMJ Open. 2019 Oct 17;9(10):e031809. doi: 10.1136/bmjopen-2019-031809.
To explore the extent to which doctors and dentists in training within the UK and Republic of Ireland (RoI) engage in and with evidence-based practice (EBP), and to identify motivators and barriers to them doing so.
An observational, prepiloted web-based survey developed by a trainee-led focus group.
The survey instrument was disseminated to doctors and dentists in training within the UK and RoI during June 2017 via social media and through deaneries, Royal Colleges and specialty-specific mailing lists.
Data from 243 trainees were analysed; 188 doctors from 31 specialties and 55 dentists from 9 specialties. Responses were received from trainees at all stages of postgraduate training though the overall response rate was low.
The motivators and barriers to, and the extent of, trainee engagement with EBP.
Cronbach's α was 0.83. Most trainees (87.6% (n=148) of doctors and 75.1% (n=39) of dentists) consulted the evidence base at least monthly, while 23.1% [n=39 doctors, 12 dentists] of both specialties did so daily. The two most commonly cited barriers to engagement with EBP for both doctors and dentists, respectively, were insufficient time (57.6% (n=95) and 45.1% (n=23)) and a tendency to follow departmental practice (40.6% (n=67) and 45.1% (n=23)). Key motivators for EBP included curiosity, following the example set by senior colleagues and a desire to avoid harm. Most trainees reported high levels of confidence interpreting evidence yet for 26.8% (n=45) of doctors and 36.5% (n=19) of dentists, medical hierarchy would impede them querying a colleague's management plan based on their own reading of the evidence.
Time, accepted departmental practice and the behaviour of senior clinicians all highly impact on trainee engagement with EBP. Given the low response rate, the extent to which these data represent the overall population is unclear.
探讨英国和爱尔兰共和国（RoI）接受培训的医生和牙医参与循证实践（EBP）的程度，以及确定他们这样做的动机和障碍。
由实习医生主导的焦点小组开发的一项观察性、预试点的基于网络的调查。
2017年6月，通过社交媒体以及通过各医学院、皇家学院和特定专业的邮件列表，将调查问卷分发给英国和RoI接受培训的医生和牙医。
分析了243名实习医生的数据；其中包括来自31个专业的188名医生和来自9个专业的55名牙医。尽管总体回复率较低，但收到了研究生培训各阶段实习医生的回复。
实习医生参与循证实践的动机、障碍以及参与程度。
克朗巴哈系数α为0.83。大多数实习医生（87.6%（n = 148）的医生和75.1%（n = 39）的牙医）至少每月查阅一次证据库，而两个专业中分别有23.1%[n = 39名医生，12名牙医]每天都这样做。医生和牙医参与循证实践最常被提及的两个障碍分别是时间不足（57.6%（n = 95）和45.1%（n = 23））以及倾向于遵循科室的做法（40.6%（n = 67）和45.1%（n = 23））。循证实践的关键动机包括好奇心、效仿资深同事树立的榜样以及避免伤害的愿望。大多数实习医生报告称在解释证据方面有很高的信心，但对于26.8%（n = 45）的医生和36.5%（n = 19）的牙医来说，医疗等级制度会阻碍他们根据自己对证据的解读质疑同事的管理计划。
时间、公认的科室做法以及资深临床医生的行为都对实习医生参与循证实践有很大影响。鉴于回复率较低，这些数据在多大程度上代表总体人群尚不清楚。
