Albart Stephenie Ann, Looi Irene
Clinical Research Centre, Hospital Seberang Jaya, Ministry of Health Malaysia, Seberang Jaya, Penang, Malaysia.
Department of Medicine, Hospital Seberang Jaya, Ministry of Health Malaysia, Seberang Jaya, Penang, Malaysia.
BMC Med Educ. 2025 Feb 19;25(1):270. doi: 10.1186/s12909-025-06865-w.
Evidence-based medicine (EBM) plays a critical role in improving clinical decision-making and patient outcomes. We aimed to determine the knowledge, practice, and facilitating factors of EBM and the associated factors of EBM knowledge and practice among Malaysian doctors.
A cross-sectional study with a nationwide online survey was conducted from June to November 2022 among Malaysian doctors. The survey assessed doctors' knowledge (K), practice (P), and facilitating factors (F) for EBM (collectively referred to as KPF) using the preexisting validated Evidence-Based Medicine Questionnaire (EBMQ). Higher scores indicated better knowledge, practice, and facilitating factors for EBM implementation. The KPF percentage scores were categorised into high (> 80%), moderate (60-79%), and low (< 59%). The Pearson correlation coefficient was used to assess the correlation between knowledge, practice, and facilitating factors. The differences in knowledge and practice scores by gender, designation, workplace, work sector, EBM workshop participation, research experience, publication, and level of facilitating factors after adjusting for years of service were analysed using multi-factorial multivariate analysis of covariance (MANCOVA).
Among 409 doctors, 53.8% of doctors had a moderate level of knowledge, while about two-thirds demonstrated a higher level of practice (67.2%) and a moderate level of facilitating factors (67.0%). About 18% and 12% of doctors had low levels of knowledge and facilitating factors, respectively. Only 0.5% had low EBM practice. A positive and significant correlation among knowledge, practice, and facilitator scores was noted (P < 0.001). Doctors with prior research experience, high facilitating factors, and EBM workshops attendance had higher EBM knowledge scores (all P < 0.001). Specialists (P = 0.029) and doctors with high facilitating factors (P < 0.001) had higher EBM practice scores.
Malaysian doctors reported a high level of EBM practice despite moderate knowledge and facilitating factors. This suggests a strong willingness to integrate EBM into clinical practice. EBM workshops may help doctors gain further knowledge. Stakeholders should address the barriers that exist at the individual, institutional, and health system levels to strengthen the implementation of EBM.
循证医学（EBM）在改善临床决策和患者预后方面发挥着关键作用。我们旨在确定马来西亚医生的循证医学知识、实践情况及促进因素，以及循证医学知识与实践的相关因素。
2022年6月至11月对马来西亚医生开展了一项全国性在线横断面研究。该调查使用预先验证的循证医学问卷（EBMQ）评估医生的循证医学知识（K）、实践（P）和促进因素（F）（统称为KPF）。得分越高表明循证医学实施的知识、实践和促进因素越好。KPF百分比得分分为高（>80%）、中（60 - 79%）和低（<59%）。采用Pearson相关系数评估知识、实践和促进因素之间的相关性。在校正服务年限后，使用多因素多变量协方差分析（MANCOVA）分析性别、职称、工作场所、工作部门、循证医学研讨会参与情况、研究经验、发表情况和促进因素水平对知识和实践得分的差异。
在409名医生中，53.8%的医生知识水平中等，约三分之二的医生实践水平较高（67.2%），促进因素水平中等（67.0%）。分别约有18%和12%的医生知识水平和促进因素水平较低。只有0.5%的医生循证医学实践水平较低。知识、实践和促进因素得分之间存在显著正相关（P < 0.001）。有既往研究经验、促进因素水平高且参加过循证医学研讨会的医生循证医学知识得分更高（均P < 0.001）。专科医生（P = 0.029）和促进因素水平高的医生（P < 0.001）循证医学实践得分更高。
尽管知识和促进因素水平中等，但马来西亚医生的循证医学实践水平较高。这表明他们有将循证医学融入临床实践的强烈意愿。循证医学研讨会可能有助于医生获得更多知识。利益相关者应消除个人、机构和卫生系统层面存在的障碍，以加强循证医学的实施。
