Evidence-based practice has become a crucial component of general practice and primary healthcare delivery, especially with the public’s expanding access to health-related information and demand for accountability. EBM encompasses all aspects of the clinical decision-making in medicine, from diagnosis to treatment. The knowledge and skills for EBM is becoming a core competence to be acquired by all physicians (14).
In comparison to similar studies, our findings indicate an increased engagement in Evidence-Based Medicine (EBM) training, with 51.3% of students having attended sessions, either online or offline. This contrasts with a study in Iran where 71.5% reported no education on EBM or online search methods.2 The observed rise in EBM training participation suggests a positive trend in enhancing students' familiarity with these crucial practices in medical education(15).
The findings from this questionnaire reveal that a majority of medical students exhibited lack of knowledge of EBM and its fundamental concepts. The assessment of knowledge across six key areas related to EBM, including locating professional literature, searching online databases, critical appraisal of scientific publications, identifying knowledge gaps in practice, appraising available scientific literature critically, and identifying patient-relevant clinical questions, yielded consistently low scores(16). A study conducted in Iran similarly indicates limited knowledge. Additionally, other studies have highlighted a low level of awareness of evidence-based medicine among general practitioners in countries such as Norway, Sudan, and England 3 4 5. On the contrary, a study conducted with occupational therapy students in Ireland reported substantial knowledge and awareness.6 Similarly, another study focusing on medical students in Peshawar, Pakistan, also revealed a comparable level of understanding and awareness(17).
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Moreover, our analysis indicates that there is no significant difference in skill levels between students who attended EBM training and those who did not. This suggests a consistent trend in the assessed competencies, emphasizing the need for targeted interventions to enhance understanding and proficiency in EBM among medical students(18)."
The understanding of certain terms related to EBM terms varied among participants. Notably, "sample size" emerged as the most comprehensible statistical term, with 49.6% capable of explaining it. Other statistical terms like "mode" and "median" followed closely, with 48.5% and 46.1%, respectively. In terms of study design, "case report" stood out as the most recognized term, with a substantial majority of 46.8% of students comprehending and explaining it(19). Conversely, "meta-analysis" was less well-understood, with only 19.9% of students having a full understanding. In the field of epidemiology, "prevalence" and "incidence" were the most understood terms, with 43.2% and 43.6% of students, respectively, demonstrating a comprehensive understanding(20).
In a study in Iran Most students reported they do not understand but would like to understand some of the technical terms used in EBM. "Incidence rate" was the term best understood, while "Prevalence" was understood the least.2 In a Sudanese study, doctors exhibited varying knowledge levels about several EBM terms. The meaning of risk factors was known by 67 (83%) respondents, and the definitions of relative risk, absolute risk, and sensitivity were known by 56 (70%)(21).
The participants overwhelmingly exhibited a positive attitude towards Evidence-Based Medicine (EBM) and recognized its significance in patient management. Notably, no notable differences surfaced in the attitudes of students who received EBM training compared to their counterparts(22). The majority of students expressed strong agreement or agreement on various aspects, reflecting an overall positive stance towards EBM. This trend aligns with findings in medical literature from Iran, Pakistan, and Sudan, suggesting a promising foundation for the incorporation of EBM into the medical curriculum (23). Conversely, a study among physical therapy students in the Netherlands reported a less optimistic attitude toward EBM(24).
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The consensus among the majority of our respondents is Evidence-based medicine (EBM) is important for the practical work of physicians, and guaranteeing optimal treatment for patients. The survey highlights a shared ambition among medical professionals to enhance their EBM application skills in practical settings. This aligns with findings from studies conducted among both students and general physicians, emphasizing the widespread recognition of EBM's pivotal role in elevating healthcare practices and outcomes(25).
in India, a survey study was carried out among physicians working in top government and private hospitals in Hyderabad (India) revealed that physicians have positive attitudes toward EBMP. They also agree that EBMP is obligatory on the part of physicians—professionally, ethically, and legally. They indicated a high usage rate of print and electronic sources, which suggests that health science libraries should be equipped to support physicians in EBM(15).
Despite the availability of easy and free access to evidence-based resources, the predominant source of health information for medical students in Sudan remains medical books, with 92.4% relying on them, followed by scientific journals. Like a study in Hungary suggested that students depend on textbooks and expert opinions when seeking clinical information(26).Interestingly, only a minority of respondents were aware of Evidence-Based Medicine (EBM) resources, a trend observed in other studies as well.
Notably, students who underwent Evidence-Based Medicine (EBM) training demonstrated notably higher usage rates for specific sources, including Medline, Medscape, Cochrane Library, Scopus, Web of Science, and Embase. This underscores the significance of Evidence-Based Medicine (EBM), emphasizing its importance in guiding students towards additional resources that offer substantial benefits in their academic and professional pursuits(27).
The Cochrane Library, recognized as a primary source for systematic reviews and meta-analyses, is underutilized among students, reflecting a lack of awareness. Similar observations were made in studies conducted in Norway, where over half of respondents were aware of the Cochrane Library but did not use it 13. In a Canadian study, only 5% of practicing clinicians used the Cochrane Library regularly(14).
The majority of students assessed their skills in applying Evidence-Based Medicine (EBM) to patient management as average. A study among resident doctors in Sudan, shows only 10% incorporated EBM into 50% to 100% of their clinical practice(4).
Sudan lacks of studies exploring undergraduates' opinions on EBM, prompting our investigation into their knowledge and attitudes. While our findings reveal a generally positive disposition and reasonable awareness of research among students, the actual completion of projects, presentations, and publications remains limited. This underscores the importance of cultivating a EBM culture among medical students. Addressing this requires further research, especially in developing and validating tools to assess Evidence-Based Practice (EBP) competencies in undergraduate curricula. Additionally, we need to broaden our research focus to evaluate how these competencies translate into real-world workforce settings. Enhancing evidence-based medicine skills in students not only enriches their academic experience but also contributes to a more research-informed and competent healthcare workforce, ultimately benefiting patient care and medical practice(1).