Applying evidence-based medicine in general practice: a video-stimulated interview study on workplace-based...

Area of Science:

• Medical Education
• General Practice
• Evidence-Based Medicine

Background:

• Evidence-based medicine (EBM) integrates evidence, patient preferences, and clinical expertise in general practice.
• General practitioners (GPs) and trainees learn EBM through observation and workplace learning.
• This study explores EBM learning by examining recognition of EBM behavior between supervisors and trainees.

Purpose of the Study:

• To investigate the extent of mutual recognition of EBM behavior between GP supervisors and trainees.
• To identify factors influencing the recognition of EBM behavior during observed consultations.
• To gain insights into workplace-based EBM learning.

Main Methods:

• A qualitative multicenter study using video-stimulated recall interviews (VSI) with 22 GP pairs (supervisors and trainees).
• Participants reviewed consultation videos, discussing their EBM considerations and perceived partner's actions.
• Interview transcripts were analyzed to develop a model of factors influencing EBM behavior recognition.

Main Results:

• Moderate similarity was found between observed EBM behavior and its recognition.
• Observer-related factors (judgment, unsolicited comments, relationship focus) negatively impacted recognition.
• Implicit reasoning (mindlines) and pair-related factors (prior discussion) influenced recognition.

Conclusions:

• GP trainees and supervisors exhibit incomplete recognition of each other's EBM behaviors.
• Improving recognition necessitates observer awareness of automatic judgments.
• Explicit learning moments discussing EBM decision-making can enhance shared knowledge and unveil tacit knowledge.