Engaging Australian physicians in evidence-based medicine: a representative national survey

Aim: To assess Australian adult physicians’ views about evidence‐based medicine (EBM) and quality improvement (QI). Background: Cross‐sectional postal survey of two hundred and forty‐four randomly selected Australian physicians (78.5% response rate). Method: Physicians’ views about the promotion of EBM and QI and their impact on patient care, strategies to support better clinical practice and self‐reported understanding of EBM terms. Results: Sixty‐eight per cent (95% confidence interval (CI): 62–74%) of physicians had a positive view of the current promotion of EBM in Australia. Significantly fewer (45%; 95% CI: 38–51%) were so positive about QI (P < 0.001). Although 74% (95% CI: 68–79%) indicated that EBM improves patient care, significantly fewer (46%; 95% CI: 40–53%) held this view with respect to QI (P < 0.001). Although 70% (95% CI: 64–76%) of physicians agreed they had adequate skills to search for evidence, significantly fewer (21%; 95% CI: 17–27%) agreed they had sufficient time to do so (P < 0.001). EBM skills were positively associated with involvement in teaching. Physicians were significantly more positive about approaches exclusive to themselves compared with those involving other disciplines. Conclusions: Although Australian physicians have positive views of EBM, QI appears less well regarded. Initiatives to improve quality and safety that incorporate principles and language of EBM will likely be received better by physicians than isolated QI. Further enhancement of EBM requires concomitant attention to physician training, workplace infrastructure and supportive professional development. (Intern Med J 2005; 35: 9–17)