Subscales and items per subscale for the EBMEEM-67 tool (CFA data, n=274)
| Item | Mean | SD | |
|---|---|---|---|
| Subscale 1: Knowledge and learning materials | 1.88 | 0.81 | |
| 14 | I know how to calculate Number Needed to Treat when reviewing an article | 1.58 | 1.10 |
| 23 | Sufficient learning material is available on how to review the literature | 2.19 | 1.11 |
| 26 | I know how to calculate Relative Risk Reduction when reviewing an article | 1.72 | 1.13 |
| 31 | Sufficient learning material is available on how to critique articles | 2.06 | 1.04 |
| 38 | I know how to calculate Absolute Risk Reduction when reviewing an article | 1.60 | 1.08 |
| 40 | Sufficient learning material is available on how to ask a clinical question | 2.22 | 1.03 |
| 53 | I know how to calculate Relative Risk when reviewing an article | 1.91 | 1.12 |
| 65 | I know how to calculate Odds Ratio when reviewing an article | 1.75 | 1.22 |
| Subscale 2: Learner support | 2.37 | 0.76 | |
| 10 | Faculty/the consultants set clear expectations about how my review of evidence should support my clinical decisions | 2.24 | 1.06 |
| 15 | I am given time to participate in educational activities related to EBM | 2.05 | 1.15 |
| 28 | Residents/registrars are adequately supervised for their application of EBM in their clinical care | 1.99 | 1.10 |
| 30 | I have the opportunity to apply evidence-based principles in my clinical care | 3.01 | 0.86 |
| 33 | Faculty/the consultants are enthusiastic about teaching me EBM | 2.57 | 1.10 |
| 42 | Faculty/my mentor(s) provided me with internet EBM resources | 2.38 | 1.18 |
| 48 | Faculty/the consultants serve as role models for using EBM in clinical practice | 2.27 | 1.04 |
| 50 | There are good channels of communication in the hospital(s) and clinic(s) in which I work | 2.36 | 1.05 |
| 55 | I have online access to the most important EBM sources | 2.46 | 1.15 |
| 58 | Faculty/the consultants help me to increase my competence in EBM | 2.34 | 0.97 |
| Subscale 3: General relationships and support | 2.75 | 0.62 | |
| 2 | Consultants are easily available for assistance in any of the steps required for critical appraisal | 2.57 | 0.92 |
| 9 | Faculty/the consultants are approachable and friendly | 3.12 | 0.85 |
| 17 | There are good channels of communication in my department | 2.50 | 1.01 |
| 21 | I am able to ask ‘why? ’ with regard to clinical practice issues to faculty/consultants | 2.75 | 0.95 |
| 43 | I have good rapport with faculty/the consultants | 3.02 | 0.82 |
| 45 | I feel comfortable in my programme | 2.64 | 0.85 |
| 54 | Working here, I feel part of a team | 2.90 | 0.89 |
| 60 | My views are respected by faculty/consultants | 2.54 | 0.83 |
| Subscale 4: Institutional focus on EBM | 2.51 | 0.71 | |
| 1 | Feedback from review of practice or from morbidity and mortality conferences is used to change practice in my department | 2.59 | 0.92 |
| 18 | EBM gets sufficient attention in my department | 2.39 | 1.06 |
| 20 | Faculty/the head of department/head of the firm conducts ‘evidence-based’ ward rounds with residents/registrars | 2.21 | 1.12 |
| 24 | Faculty/The consultants are willing to challenge, question and explore | 2.69 | 0.90 |
| 27 | Faculty/the consultants address clinical questions through a formal review of the evidence | 2.31 | 0.92 |
| 29 | Case discussions in my hospital/unit/department emphasise critical appraisal of articles | 2.66 | 0.98 |
| 34 | Using EBM is a routine practice in my institution | 2.19 | 1.10 |
| 36 | I have access to evidence-based clinical advice from the consultants | 2.57 | 0.91 |
| 41 | Best practices that are communicated in my institution are normally implemented | 2.70 | 0.83 |
| 47 | Faculty/the consultants routinely review evidence in morbidity and mortality conferences and in case discussions | 2.57 | 1.08 |
| 49 | Senior faculty/consultants in my department listen when someone brings evidence that should lead to change of practice | 2.75 | 0.94 |
| 51 | Reviews of practice are carried out routinely in my department to improve the quality of care | 2.45 | 1.03 |
| 63 | The evidence from Cochrane Systematic Reviews is used in my department to develop new clinical practice guidelines | 2.41 | 1.07 |
| 67 | Faculty/the consultants usually use EBM principles when considering treatment for patients | 2.57 | 0.99 |
| Subscale 5: Education, training and supervision | 2.04 | 0.72 | |
| 3 | My workload does not allow me sufficient time to review evidence for my case presentations* | 1.48 | 1.13 |
| 5 | There is systematic, structured training in EBM at my institution | 1.91 | 1.17 |
| 7 | I receive regular feedback from faculty/seniors on my application of EBM | 1.82 | 1.03 |
| 16 | Residents/registrars address clinical questions through a formal review of the evidence | 2.23 | 1.06 |
| 35 | Faculty/the consultants taught me how to read and critique the scientific literature | 1.92 | 1.08 |
| 39 | The EBM materials on the computer at work are up-to-date | 2.14 | 1.03 |
| 62 | Residents/registrars get a good foundation in EBM | 1.85 | 1.05 |
| 64 | I have attended seminars or discussions on searching the literature and the critical appraisal of articles during my residency/since starting to work as a resident/registrar | 2.32 | 1.15 |
| 66 | Faculty/consultants give me regular feedback on my EBM knowledge and skills | 2.05 | 0.99 |
| Subscale 6: EBM application opportunities | 2.46 | 0.60 | |
| 4 | For the patients that I am taking care of, I am able to assess the validity of the evidence that I have found | 2.36 | 0.92 |
| 11 | I have the opportunity to identify my knowledge gaps in EBM | 2.39 | 1.01 |
| 13 | For the patients that I am taking care of, I am able to figure out what I need to know | 2.86 | 0.73 |
| 19 | For the patients that I am taking care of, I am able to apply the valid evidence that I have found to the patient | 2.78 | 0.69 |
| 25 | I am allocated sufficient time for applying EBM principles in my clinical cases | 1.89 | 1.07 |
| 32 | I was taught how to interpret a meta-analysis of studies | 1.84 | 1.11 |
| 37 | When I take care of patients, I have the opportunity to review relevant literature | 2.31 | 1.00 |
| 44 | I feel comfortable in generating clinical questions | 2.36 | 0.96 |
| 46 | There are ample opportunities for me to apply my knowledge of EBM in patient care | 2.46 | 0.95 |
| 56 | For the patients that I am taking care of, I am able to find the evidence needed to apply to the patient | 2.62 | 0.83 |
| 59 | When I take care of patients, I have the opportunity to ask a focused clinical question | 2.84 | 0.79 |
| 61 | My seniors expect me to review the evidence when taking care of a patient | 2.60 | 0.93 |
| Subscale 7: Affirmation of EBM environment | 2.44 | 0.75 | |
| 6 | It does not really help to review evidence when taking care of a patient* | 2.95 | 0.95 |
| 8 | Faculty/consultants do not promote EBM among residents/registrars* | 2.30 | 1.13 |
| 12 | The environment in which I work discourages initiative* | 2.50 | 1.08 |
| 22 | EBM in clinical practice is not valued in my department* | 2.61 | 1.09 |
| 52 | I seldom have the opportunity to use EBM when I am presenting cases* | 1.99 | 1.10 |
| 57 | My fellow residents/registrars are not keen on using EBM principles* | 2.30 | 0.95 |
*Reversed scores for items formulated in the negative.
CFA, confirmatory factor analysis; EBMEEM-67, Evidence-Based Medicine Educational Environment Measure 67.