EVIDENCE BASED PRACTICE – A CHALLENGE
FOR CONTINUING MEDICAL EDUCATION
Oberklaid F
Centre
for Community Child Health
Royal
Children’s Hospital, Melbourne, Australia
Objective: To
investigate reasons for the apparent gap between research evidence and
practice, and determine barriers that prevent practitioners to utilise
evidence based practice.
Methods: Review of literature regarding effectiveness of the various
methods to change clinical practice including continuing education,
practice incentives, clinical guidelines, financial incentives, peer
review, and face-to-face meetings.
Results: Significant
barriers exist in our attempts to disseminate research findings and
clinical evidence of effectiveness so that they are taken up by
practitioners. There is a
difficulty in communicating research findings in practical ways so that it
is perceived as relevant to clinical practice. Significant barriers exist to changing clinical practice
including the organisation of service delivery at a macro and micro level,
the lack of incentives for practitioners to change, practitioner suspicion
of research findings and natural resistance to change. There is little evidence of
effectiveness of most traditional teaching methods (eg. lectures, written
materials) to effect any change in practice. Despite the popularity in recent years of clinical
guidelines, there is little evidence that they have done much to
systematically change practice.
Conclusions: Despite
the inherent attractiveness of providing continual medical education to
practitioners, there remain formidable challenges that need to be addressed
and overcome if we are to meet the goal of ensuring evidence based clinical
practice.