Identifying the effective factors in using medical evidence in clinical medicine: A qualitative study in the emergency department

Abstract

Introduction: Evidence-based medicine can increase the clinical performance of physicians. This qualitative study was conducted with the aim of examining the effective factors for using new evidence by emergency medicine residents in Rasoul Akram and Haftam Tir Hospitals in Tehran, Iran. Methods: The present descriptive-analytical study was conducted in the year 2016 in two hospitals In Tehran. In order to conduct this qualitative study, residents were selected by purposive sampling. The data was collected during 18 in-depth individual interviews and the categories and themes of the effective factors in the use of new evidence were extracted using conventional content analysis. Results: Participants were introduced to medical evidence through text books, attending workshops, faculty classes, attending conferences, or through friends. Evidence-based medicine consists of factors such as: physician incentive factors, patient incentive factors, factors in favor of scientific facts, environmental-cultural incentives and moral incentives, and among the inhibitory factors discouraging the use of evidence based medicine are factors that influence physician and patient, environmental-cultural inhibitors and social inhibitors. Conclusion: There seems to be a positive attitude among residents towards the use of evidence-based medicine, but there are still several obstacles to its implementation in society. Structural and individual factors and policy-making are the most important determining factors in its implementation in Iran.