Effectiveness Of Evidence-based Medicine Training For Primary Health Care Physicians And Nurses In Gongshu District Of Hangzhou City

Objective:To evaluate the effectiveness of evidence-based medicine training by measuring primary health care physicians and nurses EBP knowledge,attitudes,personal application,and anticipated future use with custom scale.Methods:Primary health care physicians and nurses recruited from the two community health service centers in Gongshu district of Hangzhou city were randomly assigned to participate in a weekly EBP course,combining lectures with small group discussion and EBP-structured case conferences(Group A,n = 69),or to receive a weekly EBP course through online self-learning(Group B,n = 82).The teaching effects of these 2 interventions were evaluated by a validated instrument for assessment of EBP related knowledge(EBP-K),attitude(EBP-A),personal application(EBP-P),and anticipated future use(EBP-F)with custom scale,and the data were analyzed using paired t-tests to show the significance of the difference between these two groups,and the before-and-after comparison of each group with SPSS17.0.Results:1.the comparison of the basic condition between the groups:the ratio of men/women,physician/nurse,junior/senior,TCM/western medicine were similar,the difference was not statistically significant(P>0.05).2.Baseline scores comparison of EBP four aspects:there were no significant differences between the two groups in the scores of EBP-K,EBP-A,EBP-P and EBP-F(P>0.05).3.Before and after comparison:EBP-K,EBP-P and EBP-F score items were higher than pre-intervention,the differences were statistically significant(P<0.05),EBP-A score reduced after intervention,the difference was statistically significant(P<0.05),the total scores of four items of the control group are consistent,the difference was not statistically significant(P>0.05).4.Comparison between groups after intervention:EBP-K,EBP-P and EBP-F were higher than the control group,the differences were statistically significant(P<0.05),EBP-A score were lower,the difference was statistically significant(P<0.05);and after the training,the percentage change of EBP-K,EBP-A,EBP-P and EBP-F were higher than the control group,the difference was statistically significant(P<0.05).5.Stratified comparison of each group after intervention:EBP-K,EBP-A,EBP-P and EBP-F of different gender,titles,identity,category of medicine are similar,the difference was not statistically significant(P>0.05).6.After the training,the comparison between the custom scale of the group was higher than that of the control group,the difference was significant(P<0.05),there was no significant difference between the two groups on objective part comparison(P>0.05).Conclusions:1.Integrated EBP training with multiple teaching methods improved primary health care physicians and nurses EBP knowledge,attitudes,personal application,and anticipated future use.2.Integrated EBP training with multiple teaching methods improved primary health care physicians confidence in clinical practice.3.Due to the constraints of the professional ability,time and other factors of the community health care professionals,it is difficult to achieve the ideal EBP training effect.4.According to the training object of the scientific development of EBP training courses,so that the training courses more applicable,thereby improving the effectiveness of EBP training.5.According to the purpose of EBP training to choose the appropriate evaluation tools help to objectively reflect the training effect.6.The promotion of evidence-based medical training programs for community health care workers need to be further verified.