Examining aptitude and barriers to evidence-based medicine among trainees at an ACGME-I accredited program

Abstract Background The aims of Evidence-Based medicine (EBM) are to promote critical thinking and produces better patients’ outcome (Profetto-McGrath J, J Prof Nurs Off J Am Assoc Coll Nurs 21:364-371, 2005). Accreditation Council for Graduate Medical Education (ACGME) competencies require trainees...

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Main Authors: Mai A. Mahmoud, Sa’ad Laws, Antoun Kamal, Dabia Al Mohanadi, Ahmed Al Mohammed, Ziyad R. Mahfoud
Format: Article
Language:English
Published: BMC 2020-11-01
Series:BMC Medical Education
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12909-020-02341-9
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author Mai A. Mahmoud
Sa’ad Laws
Antoun Kamal
Dabia Al Mohanadi
Ahmed Al Mohammed
Ziyad R. Mahfoud
author_facet Mai A. Mahmoud
Sa’ad Laws
Antoun Kamal
Dabia Al Mohanadi
Ahmed Al Mohammed
Ziyad R. Mahfoud
author_sort Mai A. Mahmoud
collection DOAJ
description Abstract Background The aims of Evidence-Based medicine (EBM) are to promote critical thinking and produces better patients’ outcome (Profetto-McGrath J, J Prof Nurs Off J Am Assoc Coll Nurs 21:364-371, 2005). Accreditation Council for Graduate Medical Education (ACGME) competencies require trainees to locate, appraise and apply clinical evidence to patients’ care. Despite the emphasis that ACGME place on EBM, few organizations provide adequate training in EBM. This is even more critical in regions where medical trainees matriculate from diverse backgrounds of undergraduate medical education, where EBM may not be emphasized nor taught at all. EBM practice has a history of research in the West, however, EBM has not been widely studied in the Middle East. Methods Clinicians and trainees at Hamad Medical Corporation (HMC) matriculate from many countries in the Middle East and North Africa (MENA) and Asia. Because trainees in Graduate Medical Education (GME) come to HMC from a variety of geographic backgrounds, it is assumed that they also have a variety of experiences and aptitudes in EBM. To assess trainees EBM attitudes and knowledge in the internal medicine department at HMC in Doha, Qatar, the authors surveyed residents and fellows using a two-part survey. The first part was adapted from the evidence-based practice inventory by Kaper to assess trainees’ attitudes and perceptions of EBM. Trainees were also asked to complete the Assessing Competency in Evidence Based Medicine (ACE) tool to evaluate their aptitude in different elements of EBM. The results from the two parts were analyzed. Results The average score on the ACE tool among the participants was 8.9 (±1.6). Most participants rated themselves as beginners or intermediate in their EBM capabilities. Higher ACE scores were observed from participants with educational background from South Asia, and among those with more favorable attitudes towards EBM. There was no clear pattern that early incorporation of EBM into practice will result in better ACE score. Participants also reported reasonable abilities in EBM tasks and a favorable work atmosphere for EBM implementation. Lack of knowledge, resources, and time were the most reported barriers to utilizing EBM. Conclusions While it is clear that participants are enthusiastic about EBM and see it as a useful method for clinical decision making, their aptitude in EBM is not optimal and there are gaps and barriers for them to practice.
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spelling doaj.art-55b81b234a834b818e54c9d71d68ef732022-12-21T19:18:08ZengBMCBMC Medical Education1472-69202020-11-012011910.1186/s12909-020-02341-9Examining aptitude and barriers to evidence-based medicine among trainees at an ACGME-I accredited programMai A. Mahmoud0Sa’ad Laws1Antoun Kamal2Dabia Al Mohanadi3Ahmed Al Mohammed4Ziyad R. Mahfoud5Weill Cornell Medicine in Qatar, Education CityWeill Cornell Medicine in Qatar, Education CityHamad Medical CorporationHamad Medical CorporationHamad Medical CorporationWeill Cornell Medicine in Qatar, Education CityAbstract Background The aims of Evidence-Based medicine (EBM) are to promote critical thinking and produces better patients’ outcome (Profetto-McGrath J, J Prof Nurs Off J Am Assoc Coll Nurs 21:364-371, 2005). Accreditation Council for Graduate Medical Education (ACGME) competencies require trainees to locate, appraise and apply clinical evidence to patients’ care. Despite the emphasis that ACGME place on EBM, few organizations provide adequate training in EBM. This is even more critical in regions where medical trainees matriculate from diverse backgrounds of undergraduate medical education, where EBM may not be emphasized nor taught at all. EBM practice has a history of research in the West, however, EBM has not been widely studied in the Middle East. Methods Clinicians and trainees at Hamad Medical Corporation (HMC) matriculate from many countries in the Middle East and North Africa (MENA) and Asia. Because trainees in Graduate Medical Education (GME) come to HMC from a variety of geographic backgrounds, it is assumed that they also have a variety of experiences and aptitudes in EBM. To assess trainees EBM attitudes and knowledge in the internal medicine department at HMC in Doha, Qatar, the authors surveyed residents and fellows using a two-part survey. The first part was adapted from the evidence-based practice inventory by Kaper to assess trainees’ attitudes and perceptions of EBM. Trainees were also asked to complete the Assessing Competency in Evidence Based Medicine (ACE) tool to evaluate their aptitude in different elements of EBM. The results from the two parts were analyzed. Results The average score on the ACE tool among the participants was 8.9 (±1.6). Most participants rated themselves as beginners or intermediate in their EBM capabilities. Higher ACE scores were observed from participants with educational background from South Asia, and among those with more favorable attitudes towards EBM. There was no clear pattern that early incorporation of EBM into practice will result in better ACE score. Participants also reported reasonable abilities in EBM tasks and a favorable work atmosphere for EBM implementation. Lack of knowledge, resources, and time were the most reported barriers to utilizing EBM. Conclusions While it is clear that participants are enthusiastic about EBM and see it as a useful method for clinical decision making, their aptitude in EBM is not optimal and there are gaps and barriers for them to practice.http://link.springer.com/article/10.1186/s12909-020-02341-9EBM practiceTrainees’ knowledge and attitude about EBM
spellingShingle Mai A. Mahmoud
Sa’ad Laws
Antoun Kamal
Dabia Al Mohanadi
Ahmed Al Mohammed
Ziyad R. Mahfoud
Examining aptitude and barriers to evidence-based medicine among trainees at an ACGME-I accredited program
BMC Medical Education
EBM practice
Trainees’ knowledge and attitude about EBM
title Examining aptitude and barriers to evidence-based medicine among trainees at an ACGME-I accredited program
title_full Examining aptitude and barriers to evidence-based medicine among trainees at an ACGME-I accredited program
title_fullStr Examining aptitude and barriers to evidence-based medicine among trainees at an ACGME-I accredited program
title_full_unstemmed Examining aptitude and barriers to evidence-based medicine among trainees at an ACGME-I accredited program
title_short Examining aptitude and barriers to evidence-based medicine among trainees at an ACGME-I accredited program
title_sort examining aptitude and barriers to evidence based medicine among trainees at an acgme i accredited program
topic EBM practice
Trainees’ knowledge and attitude about EBM
url http://link.springer.com/article/10.1186/s12909-020-02341-9
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