Self-perceived competencies on evidence-based medicine in medical students and physicians registered in a virtual course: a cross-sectional study

Figures & data

Table 1. Characteristics of the physicians and medical students enrolled in the CIMBE (n = 1793)

Variable	Medical studentsn (%)	Physiciansn (%)
Age: median (IQR)*	23 [21–25]	30 [27–37]
Gender: Female	722 (63.9)	303 (45.7)
Country:
Peru	915 (81.0)	556 (83.9)
Mexico	44 (3.9)	15 (2.3)
Bolivia	67 (5.9)	40 (6.0)
Others	104 (9.2)	52 (7.8)
Number of publications:
0	973 (86.1)	464 (70.0)
1	94 (8.3)	104 (15.7)
2	36 (3.2)	43 (6.5)
3 or more	27 (2.4)	52 (7.8)
Has belonged or belongs to a student scientific society	668 (59.1)	177 (26.7)
Report having a master’s degree		66 (10.0)
Report having a doctor’s degree		15 (2.3)

IQR: interquartile range

Table 2. Percentage of participants who agree or strongly agree with feeling trained to carry out each of the activities described (in = 1793)

Competencies	All (medical students or physicians)(n = 1793)n (%)	Physicians (n = 663)n (%)
Dimension 1: Question
1.1) Differentiate which questions can be answered by research studies, and searches cannot.	945 (52.7)	360 (54.3)
1.2) Identify the different types of clinical questions (questions about treatment, diagnosis, prognosis, and etiology).	1036 (57.8)	411 (62.0)
1.3) Convert a clinical question into a question in PICO format or its variants when appropriate (PICOT, PECO, PO).	703 (39.2)	245 (37.0)
Dimension 2: Search
2.1) Explain the results are the main databases and other resources (guides, reviews, UpToDate, others) to search for health evidence.	960 (53.5)	334 (50.4)
2.2) Build and carry out a suitable search strategy for clinical questions (including Boolean operators, truncation, and/or filters).	703 (39.2)	260 (39.2)
2.3) Identify the differences between the main databases of scientific information.	775 (43.2)	281 (42.4)
2.4) Obtain the full text of the scientific articles and/or resources, as needed.	1005 (56.1)	351 (52.9)
Dimension 3: Analysis
3.1) Identify how reliable a study is based on its biases, confidence intervals, confounders, conflicts of interest, and subgroup analysis.	529 (29.5)	217 (32.7)
3.2) Interpret the different measures of association (PR, OR, RR, HR, MD).	526 (29.3)	229 (34.5)
3.2) Interpret the different impact measures (RA, NNT, and NNH).	377 (21.0)	170 (25.6)
3.2) Interpret the graphs most used in clinical studies (Kaplan-Meier, cumulative incidence).	357 (19.9)	162 (24.4)
3.3) Value and interpret critically a systematic review, meta-analysis, forest plot and summary of findings table (SoF).	369 (20.6)	165 (24.9)
3.4) Value and interpret critically a treatment study (randomized clinical trial), as well as an observational study with statistical adjustment.	433 (24.1)	186 (28.1)
3.5) Value and interpret critically a diagnostic precision study (a study that presents sensitivity and specificity).	481 (26.8)	210 (31.7)
3.6) Distinguish between evidence-based clinical practice guidelines (based on systematic reviews), and opinion-based guidelines.	574 (32.0)	245 (37.0)
3.7) Identify the key features of a prognostic study (clinical prediction study) and be able to interpret it.	413 (23.0)	185 (27.9)
3.8) Explain in which cases to explain harm from interventions I rely on clinical trials and in which cases I rely on observational studies	412 (23.0)	177 (26.7)
3.9) Explain the purpose and processes of a qualitative study and how it can be used to make decisions.	479 (26.7)	195 (29.4)
Dimension 4: Application
4.1) Carry out a shared decision-making process (shared decision making) with the patient, including explaining the evidence (decision aids) to the patient and integrating their preferences.	371 (20.7)	194 (29.3)
4.2) Recognize the components and professional, ethical, and legal dimensions of clinical decision-making and the role of clinical reasoning.	537 (29.9)	245 (37.0)
4.3) Calculate the individual expected benefit of a certain intervention based on my patient’s initial risk (in terms of AR or NNT).	352 (19.6)	172 (25.9)
4.4) Interpret the certainty in the evidence (GRADE methodology) and the strength of the recommendations in health care.	402 (22.4)	199 (30.0)

Table 3. Association between graduation year (in tertiles) and mean score in each dimension, in physicians enrolled in the CIMBE (n = 632)*

Graduation Date	Score ± standard deviation *	Crude β (IC 95%)	Adjusted β (IC 95%) **
Dimension 1: Question
1981 to 2014	3.22 ± 1.00	Ref	Ref
2015 to 2018	3.17 ± 1.01	−0.05 (−0.24 to 0.14)	0.01 (−0.22 to 0.25)
2019 to 2020	3.34 ± 0.94	0.11 (−0.07 to 0.30)	0.18 (0.04 to 0.33)
Dimension 2: Search
1981 to 2014	3.04 ± 0.96	Ref	Ref
2015 to 2018	3.17 ± 1.02	0.13 (−0.06 to 0.32)	0.18 (−0.08 to 0.44)
2019 to 2020	3.30 ± 0.97	0.26 (0.07 to 0.44)	0.32 (0.19 to 0.44)
Dimension 3: Analysis
1981 to 2014	2.73 ± 0.90	Ref	Ref
2015 to 2018	2.89 ± 0.90	0.16 (−0.02 to 0.33)	0.19 (−0.07 to 0.45)
2019 to 2020	2.93 ± 0.90	0.20 (0.03 to 0.37)	0.23 (0.06 to 0.40)
Dimension 4: Application
1981 to 2014	2.83 ± 0.91	Ref	Ref
2015 to 2018	2.84 ± 0.97	0.01 (−0.17 to 0.20)	0.04 (−0.09 to 0.17)
2019 to 2020	2.88 ± 0.95	0.05 (−0.13 to 0.23)	0.09 (−0.07 to 0.25)

*The scores are the averages for the items in each dimension, which had 5 categories (from totally disagree [1 point] to totally agree [5 points])**Mixed-model linear regression adjusted for sex, master degree, doctor degree, having belonged to a students scientific society, and having published papers; with the country as a random effect