The review of the barriers to implementation and institutionalization of Evidence-Based Medicine in clinical wards from residents and clinical attending viewpoints

In recent years, many efforts were performed in education and the development of evidence-based medicine at the universities of medical sciences. Most research shows that education and empowerment clinical assistants, medical students and doctors in different ways in Iran and other countries are running, but despite positive effects on increasing the knowledge, skills, and attitudes of the learners, in some cases there was not notable sustainability effects on establishment the evidence based medicine. The present study aims to investigate the barriers to implementation and institutionalization of evidence-based medicine in clinical wards. This study was a qualitative approach using content analysis of clinical assistants and medical education experts’ point of view that participating in EBM courses. The current status of implementation of EBM was determined by using a questionnaire with 6 questions and then they were asked about the barriers of the applying the EBM in real environments. Group of experts included the 10 clinical faculty members that participant in focus group study. The view points of clinical assistant and experts were classified by quantitative and qualitative content analysis. After analyzing the views of residents and faculty, barriers to implementation of evidence-based medicine in clinical settings from the perspective of residents was classified in the 31 items and 7 components included facilities, quality of training, follow-up and accountability, the clinical environment, factors related to faculty and clinical assistants. Summary view of 10 faculty members was classified in19 items and 5 factors. The development and institutionalization of evidence-based medicine more than any other factor related to the environmental and individuals attitudes in clinical wards. However, developing this approach requires the strengthening of hardware facilities, law, management support, education and empowerment and sense of responsibility and accountability that all of these factors also affect each other.