Evidence-based medicine knowledge, attitudes, and skills of community faculty

CONTEXT. As medical schools turn to community physicians for ambulatory care teaching, assessing the preparation of these faculty in principles of evidence-based medicine (EBM) becomes Important. OBJECTIVE: To determine the knowledge and attitudes of community faculty concerning EBM and their use of EBM In patient care and teaching. DESIGN. Cross-sectional survey conducted from January to March of 2000. SETTING: A clinical campus of a state medical school; a midwestern city of a half-million people with demographics close to national means. MAIN OUTCOME MEASURES: Comparisons of community faculty with full-time faculty in perceived importance and understanding of EBM (5-point scale), knowledge of EBM, and use of EBM in patient care and teaching. MAIN RESULTS: Responses were obtained from 63% (177) of eligible community faculty and 71% (22) of full-time faculty. Community faculty considered EBM skills to be less Important for daily practice than did full-time faculty (3.1 vs 4.0; P <.01). Primary care community faculty were less confident of their EBM knowledge than were subspecialty community or full-time faculty (2.9 vs 3.3 vs 3.6; P <.01). Objective measures of EBM knowledge showed primary care and subspecialty community faculty about equal and significantly below full-time faculty (P <.01). Thirty-three percent of community faculty versus 5% of full-time faculty do not Incorporate EBM principles Into their teaching (P <.01). CONCLUSIONS: Community faculty are not as equipped or motivated to Incorporate EBM into their clinical teaching as are full-time faculty. Faculty development programs for community faculty should feature how to use and teach basic EBM concepts.