Design of a questionnaire to identify the realities of Evidence-Based Medicine practice in residents: Use of modified semantic networks

Abstract

Introduction: Evidence-Based Medicine (EBM) is a necessary competence in medical training. Several universities have included EBM in their curriculum, including UNAM (Universidad Nacional Autónoma de México). Different questionnaires have been designed to identify the cultural, personal and technological limitations for the implementation of this strategy in professional practice.
Objective: To design a questionnaire to identify the realities Mexican medical residents experience during EBM practice.
Method: The Modified Semantic Networks technique was used to identify meaningful elements of EBM during medical resident professional practice. A questionnaire to identify EBM practice barriers of was designed and applied to medical residents after attending a structured course on this subject.
Results: Ten defining concepts were obtained from 25 UNAM Faculty of Medicine residents, to develop a 25-item questionnaire using a Likert scale. The questionnaire was applied to 20 medical residents eight months after an EBM course. Technological, cultural and personal barriers and those inherent to the institution were identified. Fifty-five percent acknowledged having free access to electronic journals and having limited computing equipment. Sixty-five percent reported that work overload hinders dedicating time to read and use scientific papers. Ninety-five percent consider that English language fluency is determinant to be current in medical knowledge.

Conclusions: The proposed questionnaire may offer relevant information for the implementation of EBM in educational and academic health centers. The most frequent barriers are lack of computer equipment, work overload, lack of  English language competency, chronic fatigue and difficulties to attend continuing medical education activities.