Evaluation of evidence-based medicine adoption among Nigerian surgeons: competence, knowledge, attitudes, practices, and barriers.

Abstract

Aim: To determine the competence, knowledge, attitude, and barriers to evidence-based medicine (EBM) among surgeons in southwest Nigeria.

Methods: Between April 1 and June 30, 2019, a composite questionnaire consisting of the McAllister knowledge and attitude questionnaire, the Zwolsman barrier questionnaire, and 5 questions from the Berlin Questionnaire (BQ) on competence in EBM was administered to 185 surgeons and trainees in five hospitals in southwest Nigeria.

Results: The study involved 169 respondents (57 surgeons and 112 trainees). A total of 122 (72.1%) participants reported to always/often use EBM in their practice and 47 (27.9%) to rarely/never use EBM. The majority of both groups still relied on traditional sources of information in their clinical practice. Even though self-identified EBM-users (28% points) scored significantly higher on the BQ than non-users (23.8% points), there was no difference in their performance on the McAllister and Zwolsman questionnaires. Paradoxically, those with prior training in EBM were not more likely to use EBM than those without training, and there were no significant differences in their BQ scores.

Conclusions: Surgeons in Nigeria have a high level of awareness and use of EBM, as indicated by the 72% awareness rate found in our study, but their knowledge and confidence in its application are low. Our findings indicate that the quality of EBM training in the region needs to be reevaluated.