Haluza Daniela, Jungwirth David, Gahbauer Susanne
Center for Public Health, Department of Environmental Health, Medical University Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria.
Center for Public Health, Department of Social and Preventive Medicine, Medical University Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria.
J Clin Med. 2021 Sep 27;10(19):4438. doi: 10.3390/jcm10194438.
Developed in the pre-internet era in the early 1980s, empirical medical practice, i.e., evidence-based practice (EBP) has become crucial in critical thinking and statistical reasoning at the point-of-care. As little evidence is available so far on how EBP is perceived in the Austrian academic context, we conducted a cross-sectional online survey among a nonrandom purposive sample of employees and students at the Medical University Vienna, Austria (total = 1247, 59.8% females). The German questionnaire assessed both EBP capability beliefs and EBP use, with the respective indices both yielding good internal consistency. We conducted subgroup comparisons between employees ( = 638) and students ( = 609). In line with Bandura's self-efficacy theory, we found a correlation between EBP capability beliefs and EBP use, with higher scores reported in the employee group. The results indicated that the participants did not strictly follow the sequential EBP steps as grounded in the item-response theory. Since its emergence, EBP has struggled to overcome the dominating traditional way of conducting medicine, which is also known as eminence-based medicine, where ad hoc decisions are based upon expert opinions, and nowadays frequently supplemented by quick online searches. Medical staff and supervisors of medical students should be aware of the existing overlaps and synergies of these potentially equivalent factors in clinical care. There is a need for intensifying the public and scientific debate on how to deal with the divergence between EBP theory and EBP practice.
循证医学实践，即基于证据的实践（EBP），是在20世纪80年代初互联网时代之前发展起来的，如今在医疗现场的批判性思维和统计推理中已变得至关重要。由于目前在奥地利学术背景下关于人们如何看待循证医学的证据很少，我们对奥地利维也纳医科大学的员工和学生进行了一项非随机目的性抽样的横断面在线调查（共1247人，女性占59.8%）。德文问卷评估了循证医学能力信念和循证医学应用情况，各自的指标都具有良好的内部一致性。我们对员工（n = 638）和学生（n = 609）进行了亚组比较。与班杜拉的自我效能理论一致，我们发现循证医学能力信念与循证医学应用之间存在相关性，员工组的得分更高。结果表明，参与者并未严格遵循基于项目反应理论的循证医学的顺序步骤。自循证医学出现以来，它一直在努力克服主导医学实践的传统方式，即基于权威的医学，在这种方式中，临时决策基于专家意见，如今还经常辅以快速的在线搜索。医务人员和医学生的导师应意识到这些在临床护理中可能等效因素之间存在的重叠和协同作用。有必要加强关于如何处理循证医学理论与循证医学实践之间差异的公众和科学辩论。
