Survey of the Perceptions, Knowledge, A!itudes and
Practice
Evidence-Based
Medicine
ORIGINAL
ARTICLE
CASE of
REPORT
ȱž›ŸŽ¢ȱ˜ȱ‘ŽȱŽ›ŒŽ™’˜—œǰȱ—˜ •ŽŽǰȱ’žŽœȱŠ—ȱ›ŠŒ’ŒŽȱ˜ȱȱ
Ÿ’Ž—ŒŽȬŠœŽȱŽ’Œ’—ŽȱŠ–˜—ȱŽ‘Š‹’•’Š’˜—ȱŽ’Œ’—Žȱȱ
›Š’—ŽŽœȱŠ—ȱ˜—œž•Š—œȱ’—ȱŠȱ—’ŸŽ›œ’¢ȬŠœŽȱŽ›’Š›¢ȱ
˜œ™’Š•ȱȱ
ȱ
Š›’ŠȱŽ—Ž•¢—ȱǯȱ•Ÿ’Š›ȱ
ȱ
Ž™Š›–Ž—ȱ˜ȱŽ‘Š‹’•’Š’˜—ȱŽ’Œ’—Žǰȱ
ȱ˜••ŽŽȱ˜ȱŽ’Œ’—ŽȱŠ—ȱ‘’•’™™’—ŽȱŽ—Ž›Š•ȱ
˜œ™’Š•ǰȱ—’ŸŽ›œ’¢ȱ˜ȱ‘Žȱ‘’•’™™’—ŽœȱŠ—’•Šȱ
ȱ
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ABSTRACT
Objectives. The study aimed to determine the perceptions,
attitudes, knowledge and practice of Evidence-Based Medicine
(EBM) among Rehabilitation Medicine trainees and faculty. It
aimed to compare trainees and faculty in terms of perceptions,
attitudes, knowledge and practice. The study also intended to
identify the barriers in the practice of EBM.
Methods. The study utilized a cross-sectional design. The study
included residents or trainees and consultants at the
Department of Rehabilitation Medicine-Philippine General
Hospital. A questionnaire exploring the perceptions, knowledge,
attitudes and practice of EBM and the barriers in its practice was
developed based on review of previous studies. Focus group
discussions were conducted with the residents and consultants
separately to probe the responses in the questionnaire.
Results. Thirty-four trainees and consultants participated in the
study. Trainees considered themselves having received more
training in literature search (p=0.005) and critical appraisal
(p=0.01) than consultants.
Majority had fairly accurate
conceptions of EBM. Thirty-eight percent of participants
considered themselves competent in developing a clinical
question and in doing a literature search. About 18% considered
themselves competent in appraising literature. There were no
significant differences between trainees and consultants in
terms of their perceived knowledge and skills in EBM techniques.
Consultants and trainees expressed positive attitudes towards
EBM. In a week, some 50% search the literature at least twice and
appraised an article. Eighty percent of Rehabilitation Medicine
physicians (physiatrists) spent at least 2 hours per week reading
related literature. In terms of practice of EBM, the trainees rated
themselves higher in searching and appraising literature than
the consultants but the differences were not significant. More
than 90% indicated interest in further training in EBM. Majority
cited lack of time, lack of understanding of statistics and
inadequate information sources as barriers to EBM.
ȏȏȏȏȏȏȏȏȏȏȏȏȏȏȏȱ
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˜››Žœ™˜—’—ȱŠž‘˜›DZȱŠ›’ŠȱŽ—Ž•¢—ȱǯȱ•Ÿ’Š›ǰȱǰȱŒȱ
Š¢ž–ŠȱŠȱ‹ŠȱŠȱ•’—’”ȱȱ
˜—ȱŠ—’Š˜ȱž’•’—ȱ
ŠȱŸŽ—žŽǰȱŠ—’•Šǰȱ‘’•’™™’—ŽœȱŗŖŖŖȱ
–Š’•DZȱ“Ž—ǯŠ•Ÿ’Š›ȓ–Š’•ǯŒ˜–ȱȱ
30 ACTA MEDICA PHILIPPINA
Conclusion. Physiatrists have fairly accurate perceptions; positive
attitudes; some knowledge / skills; and a high level of interest in
EBM. There were no significant differences between consultants
and trainees except in the aspect of training in literature search
and appraisal. The lack of personal time, lack of understanding of
statistical analyses and inadequate information sources were the
most common perceived barriers in the practice of EBM in
Physiatry.
Key Words: evidence-based medicine, physiatry, rehabilitation
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Ÿ’Ž—ŒŽȬŠœŽȱ Ž’Œ’—Žȱ ǻǼȱ ’œȱ ›ŽŠ›Žȱ Šœȱ Šȱ
™Š›Š’–ȱœ‘’ȱ’—ȱ–Ž’ŒŠ•ȱ™›ŠŒ’ŒŽǯȱȱ—›˜žŒŽȱ’—ȱ‘ŽȱŽŠ›•¢ȱ
ŗşşŖȂœǰȱ’œȱ™›ŠŒ’ŒŽȱ’œȱ‹Ž•’ŽŸŽȱ˜ȱ ‹Žȱ‘Žȱ“ž’Œ’˜žœȱ žœŽȱ˜ȱ‘Žȱ
‹Žœȱ Š—ȱ Œ•’—’ŒŠ••¢ȱ ›Ž•ŽŸŠ—ȱ ›ŽœŽŠ›Œ‘ȱ Œ˜–‹’—Žȱ ’‘ȱ Œ•’—’ŒŠ•ȱ
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–Š”’—ȱ Œ•’—’ŒŠ•ȱ ŽŒ’œ’˜—œǯŗȱ ȱ Žœ™’Žȱ ‘Žȱ œž›Žȱ ˜ȱ ‘Žȱ ȱ
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Š•–˜œȱ •ŠŒ”’—ȱ ’—ȱ ‘Žȱ œŠ–Žȱ ’—Œ•žœ’ŸŽȱ ¢ŽŠ›œǯŘȱ Ž’œŠȱ
Ž–™‘Šœ’£Žȱ ‘Žȱ ’—Œ•žœ’˜—ȱ ˜ȱ ȱ Œ˜—ŒŽ™œȱ ’—ȱ ǭȱ
˜—’—ž’—ȱŽ’ŒŠ•ȱžŒŠ’˜—ȱǻǼȱŠ—ȱ›ŠžŠŽȱ–Ž’ŒŠ•ȱ
™›˜›Š–œȱ˜ȱ‹ž’•ȱ‘ŽȱœŒ’Ž—’’Œȱ˜ž—Š’˜—ȱ˜ȱ‘Žȱœ™ŽŒ’Š•¢ǯřȱ
—ȱ ‘’œȱ Š¢ȱ Š—ȱ ŠŽȱ ˜ȱ ›Š™’ȱ ŽŸŽ•˜™–Ž—œȱ Š—ȱ
’œŒ˜ŸŽ›’Žœȱ ’—ȱ ‘ŽŠ•‘ȱ Š—ȱ –Ž’Œ’—Žǰȱ œ˜ȱ –žŒ‘ȱ ’—˜›–Š’˜—ȱ ’œȱ
ŠŸŠ’•Š‹•Žȱ‘ŠȱŒŠ—ȱ‹Žȱž’•’£Žȱ’—ȱ‘ŽȱŒ•’—’ŒŠ•ȱœŽ’—ȱŠ—ȱ’—ȱ‘Žȱ
’Ž•ȱ ˜ȱ ›ŽœŽŠ›Œ‘ǯȱ ȱ ‘Žȱ ǰȱ ŠŠ‹ŠœŽȱ ˜ȱ ‘Žȱ Š’˜—Š•ȱ
’‹›Š›¢ȱ˜ȱŽ’Œ’—Žǰȱœ˜›ŽœȱŗŜȱ–’••’˜—ȱ›ŽŽ›Ž—ŒŽœȱ›˜–ȱ–˜›Žȱ
‘Š—ȱ śǰŘŖŖȱ ‹’˜–Ž’ŒŠ•ȱ “˜ž›—Š•œȱ Š—ȱ ‘Žȱ Ÿ˜•ž–Žȱ ’œȱ ›Š™’•¢ȱ
›˜ ’—ǯŚȱ ȱ ’œȱ ‘Ž›Ž˜›Žȱ ’–™˜›Š—ȱ ˜ȱ Š’—ȱ œ”’••œȱ ‘Šȱ ’••ȱ
Š••˜ ȱ ™‘¢œ’Œ’Š—œȱ ˜ȱ —ŠŸ’ŠŽȱ ‘’œȱ ŸŠœȱ œŽŠȱ ˜ȱ ›Žœ˜ž›ŒŽœǯȱȱ
ŽŽ™’—ȱŠ‹›ŽŠœȱ ’‘ȱ‘ŽȱŽ¡™Š—œ’˜—ȱ˜ȱ–Ž’ŒŠ•ȱ•’Ž›Šž›ŽȱŠ—ȱ
’—Ž›Š’—ȱ ‘’œȱ ’—˜›–Š’˜—ȱ ˜ȱ ™Š’Ž—ȱ ŒŠ›Žȱ –Š”Žœȱ ˜Œ˜›œȱ
–˜›ŽȱŽ’Œ’Ž—ȱŠ—ȱ–˜›Žȱ›Ž•ŽŸŠ—ȱ˜ȱ‘Žȱ™›ŽœŽ—ȱ’–Žœǯȱȱȱ
ȱ ’œȱ ŽœœŽ—’Š•ȱ ˜ȱ ’—Œ˜›™˜›ŠŽȱ ȱ ’—ȱ ‘¢œ’Š›¢ȱ ˜›ȱ
œŽŸŽ›Š•ȱ›ŽŠœ˜—œDZȱŠǼȱ’ȱŒ˜—›’‹žŽœȱ˜ȱ‘Žȱ˜ž—Š’˜—ȱ˜ȱŒž››Ž—ȱ
ȱǭȱȱ”—˜ •ŽŽȱ řDzȱ‹Ǽȱ’ȱŠŒ’•’ŠŽœȱ‘Žȱ›˜ ‘ȱ˜ȱ›Ž•ŽŸŠ—ȱ
›ŽœŽŠ›Œ‘řDzȱ ŒǼȱ ’ȱ —Š››˜ œȱ ‘Žȱ Š™ȱ ‹Ž ŽŽ—ȱ ȱ ǭȱ ȱ ›ŽœŽŠ›Œ‘ȱ
Š—ȱŒ•’—’ŒŠ•ȱ™›ŠŒ’ŒŽDzȱǼȱ’ȱŠ’œȱ’—ȱŒ•’—’ŒŠ•ȱŽŒ’œ’˜—Ȭ–Š”’—ŗDzȱŽǼȱ
’ȱœ’–ž•ŠŽœȱŒ›’’ŒŠ•ȱ‘’—”’—DzȱŠ—ȱǼȱ’ȱž’Žœȱ‘Žȱ™‘¢œ’Š›’œȱ
˜ȱ‹ŽȱŠȱ˜˜ȱ›ŽœŽŠ›Œ‘Ž›ȱŠ—ȱŠȱ˜˜ȱŽ—ȬžœŽ›ȱ˜ȱ›ŽœŽŠ›Œ‘ǯȱȱȱ
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