Evidence-based medicine training in a resource-poor country, the importance of leveraging personal and institutional relationships
Article first published online: 30 JAN 2011
© 2011 Blackwell Publishing Ltd
Journal of Evaluation in Clinical Practice
Special Issue: Evidence Based Medicine
Volume 17, Issue 4, pages 644–650, August 2011
How to Cite
Tomatis, C., Taramona, C., Rizo-Patrón, E., Hernández, F., Rodríguez, P., Piscoya, A., Gonzales, E., Gotuzzo, E., Heudebert, G., Centor, R. M. and Estrada, C. A. (2011), Evidence-based medicine training in a resource-poor country, the importance of leveraging personal and institutional relationships. Journal of Evaluation in Clinical Practice, 17: 644–650. doi: 10.1111/j.1365-2753.2011.01635.x
- Issue published online: 27 JUL 2011
- Article first published online: 30 JAN 2011
- Accepted for publication: 14 December 2010
- developing countries;
- evidence-based medicine;
- evidence-based practice;
- international cooperation
Rationale, aims and objectives Efforts to implement evidence-based medicine (EBM) training in developing countries are limited. We describe the results of an international effort to improve research capacity in a developing country; we conducted a course aimed at improving basic EBM attitudes and identified challenges.
Method Between 2005 and 2009, we conducted an annual 3-day course in Perú consisting of interactive lectures and case-based workshops. We assessed self-reported competence and importance in EBM using a Likert scale (1 = low, 5 = high).
Results Totally 220 clinicians participated. For phase I (2005–2007), self-reported EBM competence increased from a median of 2 to 3 (P < 0.001) and the perceived importance of EBM did not change (median = 5). For phase II (2008–2009), before the course, 8–72% graded their competence very low (score of 1–2). After the course, 67–92% of subjects graded their increase in knowledge very high (score of 4–5). The challenges included limited availability of studies relevant to the local reality written in Spanish, participants' limited time and lack of long-term follow-up on practice change. Informal discussion and written evaluation from participants were universally in agreement that more training in EBM is needed.
Conclusions In an EBM course in a resource-poor country, the baseline self-reported competence and experience on EBM were low, and the course had measurable improvements of self-reported competence, perceived utility and readiness to incorporate EBM into their practices. Similar to developed countries, translational research and building the research capacity in developing countries is critical for translating best available evidence into practice.