Document Detail


What are the barriers to residents' practicing evidence-based medicine? A systematic review.
MedLine Citation:
PMID:  20186032     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Insufficient time and lack of skills are important barriers to the practice of evidence-based medicine (EBM). Residents could have additional barriers because their practice can be strongly influenced by the educational system and clinical supervisors. The purpose of this study, therefore, was to systematically appraise and summarize the literature on the barriers that residents experience in the application of EBM in daily practice. METHOD: The authors searched MEDLINE, EMBASE, the Cochrane Library, CINAHL, and ERIC for publications preceding January 2008. Additionally, they manually screened the abstracts of relevant conferences (Association for Medical Education in Europe, Society of General Internal Medicine, Society of Medical Decision Making, Ottawa, and Evidence-Based Health Care Teachers & Developers) from January 2001 until January 2008. The search was extended by contacting experts in the field. Original studies on barriers to applying EBM in daily practice were included. Methodological quality was assessed and results were extracted by two reviewers using prespecified forms. RESULTS: The search resulted in 511 titles, 84 abstracts, and 3 studies suggested by experts, of which 9 were included in this review. The quality of the included studies was high. The most frequently mentioned barriers for residents were limited available time (28%-85%), attitude, and knowledge and skills. In four studies, specific barriers related to the position of residents, such as influences from staff members, lack of experience in EBM, and low possibilities to change conditions, were described. CONCLUSIONS: Residents experience specific barriers to practice EBM. These barriers should be recognized and integrated into EBM training programs for residents.
Authors:
Nynke van Dijk; Lotty Hooft; Margreet Wieringa-de Waard
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Academic medicine : journal of the Association of American Medical Colleges     Volume:  85     ISSN:  1938-808X     ISO Abbreviation:  Acad Med     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-01     Completed Date:  2010-08-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8904605     Medline TA:  Acad Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1163-70     Citation Subset:  AIM; IM    
Affiliation:
Department of General Practice/Family Medicine, Academic Medical Center-University of Amsterdam, The Netherlands. n.vandijk@amc.uva.nl <n.vandijk@amc.uva.nl>
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MeSH Terms
Descriptor/Qualifier:
Attitude of Health Personnel
Clinical Competence*
Evidence-Based Medicine*
Guideline Adherence
Humans
Internship and Residency*
Interprofessional Relations
Medical Informatics
Motivation
Netherlands
Patient Care Team
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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