The use of best evidence is vital to improving patient outcomes yet the extent to which trainee clinicians are motivated to engage with evidence-based practice is unclear.
The Cochrane United Kingdom and Ireland Trainees Advisory Group (CUKI TAG) undertook a national survey of trainees from across the UK and Republic of Ireland (RoI) to determine the extent to which doctors and dentists in training utilise the evidence base in everyday clinical practice, and to identify barriers to, and motivators for, further engagement.
A nationwide survey of medicine and dentistry trainees using a pre-piloted SurveyMonkey cloud-based online survey programme. The questionnaire was distributed to trainees across the UK and RoI via social media and through mailing lists held by specialty and deanery-specific organisations between September 2017 and November 2017.
This survey yielded 243 responses from 30 medical/surgical specialties and seven dental specialties. Approximately half (52.0%) of the respondents reported that they referred to the literature at least weekly to determine the evidence base for a clinical decision. The foremost two barriers to evidence-based practice were insufficient time (54.6%) and tendency to follow the generally accepted clinical practice in their department (41.7%). In addition, 22.3% reported that they would feel comfortable querying a colleague's management based on their understanding of relevant evidence only if that colleague was more junior than them. The motivators for evidence-based practice included the desire to better understand how clinical decisions are made (61.6%) and senior encouragement (38.9%). When asked how they could be encouraged to draw more on the evidence base by Cochrane UK, the respondents expressed most interest in receiving email updates on evidence-based practice (53.7%) or participating in online journal clubs (47.3%).
A lack of time, a reluctance to challenge colleague’s management and the influence of established departmental practice are key inhibitors to the wider adoption of evidence-based practice by medical and dental trainees.
Further work undertaken by the CUKI TAG to challenge these barriers and improve trainee engagement with the evidence base will have to be evaluated involving patients receiving care from the trainees.