Hospital doctors' self-rated skills in and use of evidence-based medicine - a questionnaire survey.

RATIONALE, AIMS AND OBJECTIVES: Problems in understanding basic aspects of evidence-based medicine (EBM) may form barriers to its implementation into clinical practice. We examined hospital doctors' skills in EBM terms and related these skills to their use of information sources, critical appraisal, and implementation of EBM into clinical practice.

METHODS: A self-administered questionnaire was sent to all hospital doctors (n = 376) at a university hospital in Denmark, including 12 questions on methodological terms frequently used in evidence-based literature plus one non-existing dummy term. Furthermore, participants were asked about their use of various information sources, self-rated skills of critical appraisal of standard scientific literature, and level of implementation of evidence-based principles in daily clinical settings. Based on the answers to the 12 evidence-based methodological terms, we calculated a familiarity score.

RESULTS: Proportion of responding was 60% (n = 225), but representative for all hospital doctors regarding background data. Ten doctors (4.4%) could define and explain all 12 methodological terms. The majority of all doctors showed interest in knowing more about the terms. Fifty-six per cent knew the dummy term. Doctors mainly consulted traditional and possibly insufficient sources (textbooks, colleagues, scientific journals) when searching for clinical evidence. The Cochrane Library was the least consulted information source and had never been consulted by 49%. Only 18% always practised EBM. More reliance on PubMed and The Cochrane Library as information sources, more competence of critical appraisal, and more frequent practise of EBM were significantly (P < 0.001) associated with a higher familiarity score. Compared to seldom or never users of The Cochrane Library, frequent users had significantly higher academic degree (P = 0.01), familiarity score (P < 0.001), and use of PubMed (P = 0.0004).

DISCUSSION AND CONCLUSIONS: Most hospital doctors seem to lack knowledge of key methodological evidence-based medicine terms. This may form a barrier when consulting EBM sources and to the implementation of EBM into clinical practice.