Knowledge and attitudes of students of College of Medicine towards evidence-based medicine and barriers to its use in clinical practice in Erbil city, Iraq

* Department of community medicine, college of medicine, Hawler Medical University, Erbil, Iraq. Introduction Evidence-based medicine (EBM) is defined as the “conscientious, explicit, and judicious use of current best evidence”. Later David Sackett et al, refined the definition of EBM as “Integrating the best research evidence with clinical expertise and patient values and circumstances to achieve the best possible patient management”. By best research evidence we mean valid and relevant research, often from the basic sciences of medicine, however the patient-centered clinical research into the accuracy of diagnostic tests, the power of prognostic markers, the efficacy and safety of therapeutic, rehabilitative and preventive regimens should be taken in consideration. By clinical expertise we mean the ability to use our clinical skills and past experience to rapidly identify each patient’s unique health state and diagnosis, their individual risks and benefits of potential interventions, their personal circumstances and expectations. Background and objective: Evidence-based medicine, by guiding medical care towards meaningful outcomes to patients, has a significant worldwide impact on medical care and education. It is important that medical students, whom are the future physicians, keep themselves updated with recent advancement in medical knowledge and health care. The aim of this cross-sectional study was to determine the attitude, knowledge and barriers among students towards evidence-based medicine and making them familiar with the concept and advantage of evidence based medicine. Methods: A cross-sectional study was conducted on 163 sixth year students of the College of Medicine at Hawler Medical University during the period from October 2012 to May 2013. The response rate was 86.5%. Knowledge towards evidence-based medicine, accessing and interpreting evidence and perceived barriers to practice evidence-based medicine among participants were the main outcome measures. Results: Of 141 of participants that filled the questionnaire, only 69.5% had heard about evidence-based medicine. Around 82% stated that they had knew evidence-based medicine and only 23.5% had knew steps of evidence-based medicine. Around 65% of respondents welcomed the promotion of evidence-based medicine and 74.4% agreed with that finding from the current study in which it would be helpful in daily management of patients. Furthermore, 31.6% of students reported that standard textbook as a frequent source used for medical knowledge. Around 91% of students did not know the strongest evidence in the hierarchy of evidence and only small proportion of students reported that they understand the common epidemiological concepts that are used in evidence-based medicine. Conclusion: Evidence-based medicine is relatively a new concept among students at the College of Medicine in Erbil. Although the students appeared interested in learning and implementing evidence-based medicine in clinical practice, they need more guidance and training to ensure the correct use of evidence-based medicine ideals.