Critical thinking and attitude of physicians toward evidence-based medicine in Egypt

A third of physicians in Egyptian university hospitals reported ‘feeling knowledge gap every day’ and this was associated with positive attitude towards evidence-based medicine and was also positively associated with the ability to answer questions related to critical reading of literature. (Beware the physician who thinks s/he knows it all.)

Below is the citation and abstract. Unfortunately the full text is restricted-access.

CITATION: J Egypt Public Health Assoc. 2015 Sep;90(3):115-120.

Critical thinking and attitude of physicians toward evidence-based medicine in Alexandria, Egypt.

Shehata GM1, Zaki A, Dowidar NL, El Sayed I.

ABSTRACT

BACKGROUND: Evidence-based practice is important for developing countries and is expected to thrive in a questioning culture. Experienced physicians differ in the making of clinical judgements, which are often not based on evidence. Although this topic is of paramount importance to the quality of care provided in the university hospitals in Alexandria, little research has been done about attitudes towards evidence-based medicine (EBM), and the extent of physicians’ skills to access and interpret evidence.

OBJECTIVE: This study aimed to investigate the relation between the attitude towards EBM and the indicators for questioning mind and critical appraisal skills among physicians in Alexandria, Egypt.

PARTICIPANTS AND METHODS: In a cross-sectional study, physicians (N=549) were randomly selected from different clinical departments in three of the university hospitals in Alexandria, Egypt using the stratified proportionate random sampling technique. A self-administrated questionnaire modified from the questionnaire used by McColl and colleagues was used.

RESULTS: A high percentage of physicians (83%) had positive attitude towards EBM. Feeling knowledge gap every day was reported by 34.2% of the physicians while 55.6% felt knowledge gap less frequently. The percentage of physicians who understood the meaning of different measures used to assess the importance of results and quality of evidence in meta-analysis studies ranged from 10.8 to 24.2%. Higher frequency of feeling knowledge gap in clinical practice and the ability to correctly answer different questions reflecting critical reading skills were all significantly associated with positive attitude towards EBM (P<0.05). A significant association (P<0.05) was also found between the frequency of feeling knowledge gap and the ability to answer questions related to critical reading of literature.

CONCLUSION AND RECOMMENDATIONS: This study has identified a significant relation between critical thinking skills and having a positive attitude towards EBM among physicians in the university hospitals in Alexandria. The study supported the hypothesis that strategies that encouraging critical thinking in medical education could improve the attitude of physicians towards EBM. Adopting teaching methods that encourage critical thinking in medical education as well as including the concepts and principals of critical appraisal of scientific research in the syllabus of both undergraduate and postgraduate medical students are recommended.

Let’s build a future where people are no longer dying for lack of healthcare knowledge – Join HIFA: www.hifa2015.org

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