Evidence-Based Medicine Within Surgical Practice and Training: A Scoping Review.

Abstract

Background: Evidence-based medicine (EBM) is a fundamental element of modern surgical practice. However, its integration into surgical training remains challenging. Through a scoping review, this study mapped existing evidence on the practice of EBM in surgery, focusing on knowledge, attitudes, barriers, and curricula.

Methods: The literature was systematically searched through 3 databases and 2 registers. Fifty articles published over a 22-year period (2001-2023) were identified based on predefined eligibility criteria. These were reviewed using Arksey and O'Malley's methodological framework. The review was checked against the PRISMA 2018 checklist for scoping reviews.

Results: There is evidence of awareness and appreciation of EBM principles among surgeons and surgical trainees. However, the understanding of EBM terminology is varied. Attitudes toward EBM were predominantly positive yet reliance on clinical experience over evidence-based guidelines was noted. Key barriers to EBM practice included time constraints, lack of structured training, and methodological challenges in surgical research. The review highlighted the lack of validated competency assessment tools and the need for structured EBM curricula. Various educational strategies, such as journal clubs and courses, were found to improve EBM knowledge, albeit with limited evidence on long-term practice change.

Conclusion: This scoping review underscores the need for a more detailed understanding of stakeholder views of EBM in surgical practice, the development, implementation, and assessment of educational interventions in this field, and tailored strategies to assess EBM competency in surgery.