Knowledge, practice, and facilitating factors of evidence-based medicine among Malaysian doctors: a cross-sectional...

Evidence-based medicine (EBM) plays a critical role in improving clinical decision-making and patient outcomes. We aimed to determine the knowledge, practice, and facilitating factors of EBM and the associated factors of EBM knowledge and practice among Malaysian doctors.

A cross-sectional study with a nationwide online survey was conducted from June to November 2022 among Malaysian doctors. The survey assessed doctors' knowledge (K), practice (P), and facilitating factors (F) for EBM (collectively referred to as KPF) using the preexisting validated Evidence-Based Medicine Questionnaire (EBMQ). Higher scores indicated better knowledge, practice, and facilitating factors for EBM implementation. The KPF percentage scores were categorised into high (> 80%), moderate (60-79%), and low (< 59%). The Pearson correlation coefficient was used to assess the correlation between knowledge, practice, and facilitating factors. The differences in knowledge and practice scores by gender, designation, workplace, work sector, EBM workshop participation, research experience, publication, and level of facilitating factors after adjusting for years of service were analysed using multi-factorial multivariate analysis of covariance (MANCOVA).

Among 409 doctors, 53.8% of doctors had a moderate level of knowledge, while about two-thirds demonstrated a higher level of practice (67.2%) and a moderate level of facilitating factors (67.0%). About 18% and 12% of doctors had low levels of knowledge and facilitating factors, respectively. Only 0.5% had low EBM practice. A positive and significant correlation among knowledge, practice, and facilitator scores was noted (P < 0.001). Doctors with prior research experience, high facilitating factors, and EBM workshops attendance had higher EBM knowledge scores (all P < 0.001). Specialists (P = 0.029) and doctors with high facilitating factors (P < 0.001) had higher EBM practice scores.

Malaysian doctors reported a high level of EBM practice despite moderate knowledge and facilitating factors. This suggests a strong willingness to integrate EBM into clinical practice. EBM workshops may help doctors gain further knowledge. Stakeholders should address the barriers that exist at the individual, institutional, and health system levels to strengthen the implementation of EBM.