Barriers to and Facilitators of Evidence-Based Practice in Psychiatry Core Trainees in Northwest England

Barriers and facilitators of evidence-based practice (EBP) in psychiatrists in training have only been researched with reference to prescribing decisions. We sought to quantitatively describe general EBP barriers and facilitators perceived by psychiatry core trainees (CTs) in England.

A cross-sectional survey of CTs from a single English region in their 1st to 3rd year of specialist training (CT1-3) uses the EBP inventory, a 26-item questionnaire subdivided into the domains of attitudes, social norms, perceived behavioral control (PBC), decision-making preferences, and intention and behavior. This was analyzed using a multiple indicators multiple causes model.

The response rate was 42.9% (72/168 CTs). In all, domain's responses overall tended to be positive toward EBP. The most commonly reported barriers were rarely discussing research literature, feeling incapable of staying up to date, aversion to statistics, a preference for intuition or experience, and a perception that EBP disregards the individual differences between patients. Attitudes, norms, and behavior all loaded onto their intended factors. The decision-making factor was not present and PBC subdivided into 2 factors: clinical and knowledge self-efficacy. Regression coefficients for predicting behavior from the other factors were attitudes - 0.16 (p = 0.34), norms 0.34 (p = 0.24), clinical PBC - 0.28 (p = 0.10), and knowledge PBC 0.613 (p = 0.01). Additionally, question 5 (EBP respects individual patients) and question 13 (discusses research literature with colleagues) independently predicted behavior (β = 0.388; p = 0.05 and β = 0.433; p = 0.01).

EBP intention and behavior were associated with perceiving EBP as relevant to individual patients, discussion about research with colleagues, and knowledge self-efficacy.