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Most like it but some don't – attitudes of vocational trainees in general practice towards evidence-based medicine


Dr Wolfgang A. Blank, Institute of General Practice, Technische Universität München, Wolfgangstrasse 8, 81667 Munich, Germany. E-mail:


Rationale and objectives  Vocational trainees in general practice are often confronted with new and unusual situations. The application of the principles and techniques of evidence-based medicine (EBM) could often be appropriate in these situations. We aimed to investigate attitudes towards EBM among doctors undergoing postgraduate training in general practice in Germany. In particular, we were interested in which aspects the answers of doctors with an overall negative attitude towards EBM differed from those with a positive attitude.

Methods  A total of 153 doctors participating in courses for postgraduate medical training in general practice were asked to fill in a questionnaire on attitudes towards EBM and relevance of clinical research. Answers of doctors with a negative attitude towards EBM (negative sum in the questions asking personal judgment on EBM) were compared with those of the remaining doctors.

Results  A total of 142 (93%) doctors returned the questionnaire and 121 responded to the questions on EBM (21 responded that they had not heard about EBM). On average, attitudes towards EBM were positive; however, nine doctors gave negative ratings. EBM-sceptics were similar regarding age, years working as doctors and working hours per week, but were more often male (P = 0.03). EBM-sceptics considered keeping up to date as important as non-sceptics but were significantly (P < 0.001) more negative regarding whether EBM is an important decision aid in one's personal work, whether it helps to identify the best clinical options and whether it constrains therapeutic freedom.

Conclusion  Overall, doctors specializing in general practice in Germany have a quite positive attitude towards EBM. A small minority, however, seems to consider EBM a threat to their professional autonomy.