Intended for healthcare professionals


All members of primary care team are aware of importance of evidence based medicine

BMJ 1998; 317 doi: (Published 25 July 1998) Cite this as: BMJ 1998;317:282
  1. Nicola Hagdrup, Clinical lecturer,
  2. Maggie Falshaw, Research coordinator,
  3. Richard W Gray, Research assistant,
  4. Yvonne Carter, Professor
  1. Department of General Practice and Primary Care, St Bartholomew's and the Royal London School of Medicine and Dentistry, London, E1 4NS

    EDITOR—McColl et al present findings about the attitudes towards evidence based medicine of general practitioners in Wessex, but they lack information from other members of the primary care team.1Comprehensive evidence based practice will require the involvement of all members of staff. As part of a baseline needs assessment before the implementation of a computer network project we carried out a postal survey of general practices that participated in undergraduate medical education in east London in June 1997. Questionnaires were completed by practice nurses, health visitors, practice managers, and reception staff as well as general practitioners. We received questionnaires completed by 40 (68%) of the 59 practices (129 general practitioners, 44 nurses and health visitors, and 24 practice managers and receptionists). This provided an initial view of evidence based medicine among other members of practice staff.

    All the primary care team was aware of the importance of evidence based medicine for the daily management of patients' problems (table). As in Wessex, there was little use and awareness of electronic sources of data. Other sources of information about evidence, however, were used frequently: all members of the team consulted colleagues and experts in the field. We found a considerable discrepancy between the importance given to understanding statistical concepts in medical literature and confidence in these concepts. Practice nurses and health visitors thought the use of research was important in patient care. Half, however, had never heard of Medline, half had never received any training in literature searches, and only a fifth expressed confidence in their understanding of statistical concepts when reading medical literature. This indicates that, at least in east London, more education in the basic principles of evidence based medicine is needed. We have since conducted training workshops, making efforts to include all members of the primary care team.

    Responses to questions on evidence based medicine by role in practice. Figures in parentheses are percentages

    View this table:

    Consultation with colleagues and experts is currently regarded as an important means of accessing information. We agree with McColl et al that access to local practitioners skilled in evidence based principles should be encouraged. Our workshops have targeted core practices involved in undergraduate teaching, where practice staff are well placed to promote evidence based practice.