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      Knowledge and Attitudes of Physicians Towards Evidence Based Medicine in Ilam, Iran

      research-article
      1 , 2 , 3 , *
      Iranian Red Crescent Medical Journal
      Kowsar
      Attitude, Knowledge, Evidence Based Medicine, Physician

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          Abstract

          Background

          Evidence based medicine (EBM) is very important in the process of decision making, diagnosis and treatment of patients. For years, medical schools have developed instructions for EBM to determine the attitude and knowledge of physicians towards EBM and their related educational needs.

          Materials and Methods

          This study was a questionnaire study among physicians. One hundred twenty physicians were selected using stratified random sampling in Ilam. A main outcome measure was attitudes and knowledge of physicians toward EBM, ability to access and interpret evidence, and best method of moving from opinion based to EBM.

          Results

          Of the 120 questionnaires we have sent, 94 (78.3%) were answered. 56.6% were using the internet to answer their patients questions and 23.8% used the internet to obtain clinical evidence. Mean and standard deviation (SD) of knowledge and attitude scores were 24% ± 23% and 72% ± 10%, respectively. Pearson correlation shows a significant relation between knowledge of physicians and years of graduation (r = -0.37, P = 0.00). There was a significant difference between mean of knowledge score of general practitioners, specialist and subspecialist (P = 0.026).

          Conclusions

          Knowledge and attitude of young physicians were more based on EBM compare to old physicians. A significant difference in knowledge mean score of physician shows that the EBM is still new in Iran, the future physician’s critical need to learn EBM and necessity of entering EMB at all medical levels.

          Related collections

          Most cited references15

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          Instruments for evaluating education in evidence-based practice: a systematic review.

          Evidence-based practice (EBP) is the integration of the best research evidence with patients' values and clinical circumstances in clinical decision making. Teaching of EBP should be evaluated and guided by evidence of its own effectiveness. To appraise, summarize, and describe currently available EBP teaching evaluation instruments. We searched the MEDLINE, EMBASE, CINAHL, HAPI, and ERIC databases; reference lists of retrieved articles; EBP Internet sites; and 8 education journals from 1980 through April 2006. For inclusion, studies had to report an instrument evaluating EBP, contain sufficient description to permit analysis, and present quantitative results of administering the instrument. Two raters independently abstracted information on the development, format, learner levels, evaluation domains, feasibility, reliability, and validity of the EBP evaluation instruments from each article. We defined 3 levels of instruments based on the type, extent, methods, and results of psychometric testing and suitability for different evaluation purposes. Of 347 articles identified, 115 were included, representing 104 unique instruments. The instruments were most commonly administered to medical students and postgraduate trainees and evaluated EBP skills. Among EBP skills, acquiring evidence and appraising evidence were most commonly evaluated, but newer instruments evaluated asking answerable questions and applying evidence to individual patients. Most behavior instruments measured the performance of EBP steps in practice but newer instruments documented the performance of evidence-based clinical maneuvers or patient-level outcomes. At least 1 type of validity evidence was demonstrated for 53% of instruments, but 3 or more types of validity evidence were established for only 10%. High-quality instruments were identified for evaluating the EBP competence of individual trainees, determining the effectiveness of EBP curricula, and assessing EBP behaviors with objective outcome measures. Instruments with reasonable validity are available for evaluating some domains of EBP and may be targeted to different evaluation needs. Further development and testing is required to evaluate EBP attitudes, behaviors, and more recently articulated EBP skills.
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            General practice postal surveys: a questionnaire too far?

            A primary care led NHS, driven by evidence based practice, needs to build on a firm foundation of research in primary care. As researchers are making increasing use of questionnaire surveys to assess general practitioners' views and attitudes, so response rates to questionnaire surveys among general practitioners are dropping. The reasons include lack of perceived relevance of the research and lack of information and feedback about it, and researchers need to be more aware of the realities of everyday practice. Approaches that might reverse this trend include monitoring all research activities going on in an area to ensure that practices are not overused, giving general practitioners incentives to participate, and improving the relevance of research and the quality of questionnaires.
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              • Article: not found

              Evidence based general practice: a retrospective study of interventions in one training practice.

              To estimate the proportion of interventions in general practice that are based on evidence from clinical trials and to assess the appropriateness of such an evaluation. Retrospective review of case notes. One suburban training general practice. 122 consecutive doctor-patient consultations over two days. Proportions of interventions based on randomised controlled trials (from literature search with Medline, pharmaceutical databases, and standard textbooks), on convincing non-experimental evidence, and without substantial evidence. 21 of the 122 consultations recorded were excluded due to insufficient data; 31 of the interventions were based on randomised controlled trial evidence and 51 based on convincing non-experimental evidence. Hence 82/101 (81%) of interventions were based on evidence meeting our criteria. Most interventions within general practice are based on evidence from clinical trials, but the methods used in such trials may not be the most appropriate to apply to this setting.
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                Author and article information

                Journal
                Iran Red Crescent Med J
                Iran Red Crescent Med J
                10.5812/ircmj
                Kowsar
                Iranian Red Crescent Medical Journal
                Kowsar
                2074-1804
                2074-1812
                05 September 2013
                September 2013
                : 15
                : 9
                : 798-803
                Affiliations
                [1 ]Medical Student, Student Research Committee, Ilam University of Medical Sciences, Ilam, IR Iran
                [2 ]Psychosocial Injuries Research Center, Ilam University of Medical Sciences, Ilam, IR Iran
                [3 ]Social Medicine Department, Medicine faculty, Ilam University of Medical Sciences, Ilam, IR Iran
                Author notes
                [* ]Corresponding author: Kourosh Sayehmiri, Psychosocial Injuries Research Center, Ilam University of Medical Sciences, Ilam, IR Iran. Tel: +98-9183410782, E-mail: Sayehmiri@ 123456razi.tums.ac.ir .
                Article
                10.5812/ircmj.7204
                3929814
                24616789
                16351eaa-9eb4-49ef-9bd0-c0957ed2091a
                Copyright © 2013, Iranian Red Crescent Medical Journal

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 10 July 2012
                : 10 January 2013
                : 11 June 2013
                Categories
                Research Article

                Medicine
                attitude,knowledge,evidence based medicine,physician
                Medicine
                attitude, knowledge, evidence based medicine, physician

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