| Summary: | 碩士 === 東海大學 === 工業工程與經營資訊學系 === 97 === Objective:
Evidence-based medicine (EBM) provides a route of scientific thinking for the doctor, so that the diagnosis and treatment of the disease could be more efficient, accurate and safe. The use of EBM indicates an important life long self-learning. In order to retrieve, appraise and clinically apply the current best evidence, the practitioner needs to possess special knowledge and skill. The objective of this study was to survey the attitudes, knowledge, skills and educational needs of the physicians regarding EBM. The research findings may be used as a guidance by the educator for EBM curriculum planning and EBM promotion.
Method:
The physicians of a medical center at the central Taiwan was surveyed, self-structured questionnaire was used. A total of 323 questionnaires were distributed, with 235 questionnaires being returned, the response rate was 72.75%.
Results:
1.Most physicians had a positive attitude towards EBM. Among the statements, “I think that doctor should receive EBM education” got the highest score, while “I think that EBM is more important that personal clinical experience” got the lowest score.
2.Knowledge and skills of EBM:
(1)The average score in physicians’ understanding of EBM terminology was 3.55 ± 0.80 (5 for fully understand, 1 for not understand at all).
(2)The average score in physicians’ skills of EBM practice was 3.53 ± 0.63 (5 for very good skill, 1 for not familiar at all). Among that, appraisal of research article and clinical application of EBM got the lowest score.
3.The educational needs of EBM among physicians were high, the three most popular courses range in sequence were “statistics”, “efficacy evaluation” and “study design”. Workshop was the favorite way of teaching preferred by most physicians.
4.53.6% of the physicians in our study always find medical evidences. PubMed was the most frequent used resource while the usage of Cochrane, an EBM database, was low.
5.Compare to other department, the doctors in medical and surgical department had significant higher score in the attitudes, terminology and skills of EBM. Those who had publication as first or correspondent author also had significantly more positive attitudes towards EBM. Physicians with doctor degree had significant higher score than those with bachelor degree in the skills of EBM.
6.There were positive correlation between attitudes of EBM and terminology understanding, skills and educational needs of EBM. The correlation between EBM terminology and skills, educational needs of EBM were positive too.
Conclusion and Suggestion:
1.The knowledge and skills of EBM among physicians are generally inadequate, there is still much to learn.
2.We should have more courses on “statistics”, “efficacy evaluation”, and “study design” since they are most needed by physicians.
3.In general, physicians still lack confidence in applying the EBM to their clinical practice. We suggested that EBM learning should be incorporated into daily ward round.
4.The attitudes, knowledge and skills of EBM among physicians other than medical and surgical department was poor, we should accent and promote the education of EBM more aggressively to the physicians in this field.
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