J Family Med Prim Care: Knowledge of evidence-based medicine among medical students in Saudi Arabia

6 January, 2019

Dear HIFA colleagues,

The results of this open-access study are surprising: 95% of the respondents were not aware of the Cochrane Library, and more than two-thirds felt that evidence-based practice is 'not applicable to their culture'. Below are citation, abstract and a comment from me.

CITATION: Knowledge, attitude and perception toward evidence-based medicine among medical students in Saudi Arabia: Analytic cross-sectional study

Thamer Z. Aldugieman, Rawabi S. Alanezi, Wasmiah M. G. Alshammari, Yasmeen W. Z. Al-Shamary, Mishaal M. Alqahtani, and Fayez S. Alreshidi

J Family Med Prim Care. 2018 Sep-Oct; 7(5): 1026–1031.

doi: 10.4103/jfmpc.jfmpc_129_18



Objective: To study the knowledge, attitudes, and perceptions toward evidence-based medicine among medical students from different colleges across the Kingdom of Saudi Arabia.

Materials and Methods: An adapted evidence-based medicine (EBM) questionnaire was administered to second year to sixth year level of medical students and interns from different medical colleges across the Kingdom from November 2016 to May 2017. The questionnaire contains items that would describe the demographic characteristics of the respondents: 24 multiple-choice questions and one open-ended question. Questions were randomly arranged to refrain from respondents’ bias but are identified to determine the knowledge, attitudes, and perceptions of the respondents toward evidence-based medicine (EBP). Data were analyzed statistically using descriptive statistics.

Results: This study surveyed 344 medical students from different universities in Saudi Arabia. The students’ knowledge and attitude to EBM were low: 80.8% answered incorrectly on the components of EBM; 40.4% knew that the strongest evidence to EBP is systematic review, and 95% of the respondents were not aware of the Cochrane Library (CL). Nearly 70% did not attend EBP workshops, 18% read journals, and 85.8% use the Internet to support clinical decisions. Only 50% are interested of knowing and using CL, 69.5% would evaluate the veracity of evidence when it contradicts clinical judgment, 24.4% will follow the evidence, and 6.1% will discard the evidence favoring their clinical judgment. No journal subscription, having no time, and difficulty in comprehension were the greatest reported barriers with a relative weight of 29.1%, 25%, and 15.7%, respectively; 68.8% claimed that EBP is not applicable to their culture, and 87.1% believed that their patients are willing to participate in clinical decision-making but perceived a low participation in clinical trials.

Conclusion: The findings described the current status of the level of awareness and use of EBM among the medical students. This calls for a well-structured incorporation of the pedagogy into the undergraduate curriculum as a major competency standard considering culture and values that are well-preserved in the Kingdom. The outcomes of its integration will impact not only the medical and allied-medical professions but also the public health in general.

COMMENT (NPW): It would be interesting to compare levels of knowledge of EBM among medical students across different regions and countries. The authors do not appear to have searched the literature in this regard. Would anyone on HIFA like to volunteer to assess this? (Indeed, a comparative cross-country review among doctors would also be illuminating.)

Best wishes, Neil

Coordinator, HIFA Project on Evidence-Informed Policy and Practice


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HIFA profile: Neil Pakenham-Walsh is coordinator of the HIFA global health campaign (Healthcare Information For All - www.hifa.org ), a global community with more than 19,000 members in 177 countries, interacting on six global forums in four languages. Twitter: @hifa_org FB: facebook.com/HIFAdotORG neil@hifa.org