Table 4

Subscales and items per subscale for the EBMEEM-67 tool (CFA data, n=274)

Subscale 1: Knowledge and learning materials1.880.81
14I know how to calculate Number Needed to Treat when reviewing an article1.581.10
23Sufficient learning material is available on how to review the literature2.191.11
26I know how to calculate Relative Risk Reduction when reviewing an article1.721.13
31Sufficient learning material is available on how to critique articles2.061.04
38I know how to calculate Absolute Risk Reduction when reviewing an article1.601.08
40Sufficient learning material is available on how to ask a clinical question2.221.03
53I know how to calculate Relative Risk when reviewing an article1.911.12
65I know how to calculate Odds Ratio when reviewing an article1.751.22
Subscale 2: Learner support2.370.76
10Faculty/the consultants set clear expectations about how my review of evidence should support my clinical decisions2.241.06
15I am given time to participate in educational activities related to EBM2.051.15
28Residents/registrars are adequately supervised for their application of EBM in their clinical care1.991.10
30I have the opportunity to apply evidence-based principles in my clinical care3.010.86
33Faculty/the consultants are enthusiastic about teaching me EBM2.571.10
42Faculty/my mentor(s) provided me with internet EBM resources2.381.18
48Faculty/the consultants serve as role models for using EBM in clinical practice2.271.04
50There are good channels of communication in the hospital(s) and clinic(s) in which I work2.361.05
55I have online access to the most important EBM sources2.461.15
58Faculty/the consultants help me to increase my competence in EBM2.340.97
Subscale 3: General relationships and support2.750.62
2Consultants are easily available for assistance in any of the steps required for critical appraisal2.570.92
9Faculty/the consultants are approachable and friendly3.120.85
17There are good channels of communication in my department2.501.01
21I am able to ask ‘why? ’ with regard to clinical practice issues to faculty/consultants2.750.95
43I have good rapport with faculty/the consultants3.020.82
45I feel comfortable in my programme2.640.85
54Working here, I feel part of a team2.900.89
60My views are respected by faculty/consultants2.540.83
Subscale 4: Institutional focus on EBM2.510.71
1Feedback from review of practice or from morbidity and mortality conferences is used to change practice in my department2.590.92
18EBM gets sufficient attention in my department2.391.06
20Faculty/the head of department/head of the firm conducts ‘evidence-based’ ward rounds with residents/registrars2.211.12
24Faculty/The consultants are willing to challenge, question and explore2.690.90
27Faculty/the consultants address clinical questions through a formal review of the evidence2.310.92
29Case discussions in my hospital/unit/department emphasise critical appraisal of articles2.660.98
34Using EBM is a routine practice in my institution2.191.10
36I have access to evidence-based clinical advice from the consultants2.570.91
41Best practices that are communicated in my institution are normally implemented2.700.83
47Faculty/the consultants routinely review evidence in morbidity and mortality conferences and in case discussions2.571.08
49Senior faculty/consultants in my department listen when someone brings evidence that should lead to change of practice2.750.94
51Reviews of practice are carried out routinely in my department to improve the quality of care2.451.03
63The evidence from Cochrane Systematic Reviews is used in my department to develop new clinical practice guidelines2.411.07
67Faculty/the consultants usually use EBM principles when considering treatment for patients2.570.99
Subscale 5: Education, training and supervision2.040.72
3My workload does not allow me sufficient time to review evidence for my case presentations*1.481.13
5There is systematic, structured training in EBM at my institution1.911.17
7I receive regular feedback from faculty/seniors on my application of EBM1.821.03
16Residents/registrars address clinical questions through a formal review of the evidence2.231.06
35Faculty/the consultants taught me how to read and critique the scientific literature1.921.08
39The EBM materials on the computer at work are up-to-date2.141.03
62Residents/registrars get a good foundation in EBM1.851.05
64I 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/registrar2.321.15
66Faculty/consultants give me regular feedback on my EBM knowledge and skills2.050.99
Subscale 6: EBM application opportunities2.460.60
4For the patients that I am taking care of, I am able to assess the validity of the evidence that I have found2.360.92
11I have the opportunity to identify my knowledge gaps in EBM2.391.01
13For the patients that I am taking care of, I am able to figure out what I need to know2.860.73
19For the patients that I am taking care of, I am able to apply the valid evidence that I have found to the patient2.780.69
25I am allocated sufficient time for applying EBM principles in my clinical cases1.891.07
32I was taught how to interpret a meta-analysis of studies1.841.11
37When I take care of patients, I have the opportunity to review relevant literature2.311.00
44I feel comfortable in generating clinical questions2.360.96
46There are ample opportunities for me to apply my knowledge of EBM in patient care2.460.95
56For the patients that I am taking care of, I am able to find the evidence needed to apply to the patient2.620.83
59When I take care of patients, I have the opportunity to ask a focused clinical question2.840.79
61My seniors expect me to review the evidence when taking care of a patient2.600.93
Subscale 7: Affirmation of EBM environment2.440.75
6It does not really help to review evidence when taking care of a patient*2.950.95
8Faculty/consultants do not promote EBM among residents/registrars*2.301.13
12The environment in which I work discourages initiative*2.501.08
22EBM in clinical practice is not valued in my department*2.611.09
52I seldom have the opportunity to use EBM when I am presenting cases*1.991.10
57My fellow residents/registrars are not keen on using EBM principles*2.300.95
  • *Reversed scores for items formulated in the negative.

  • CFA, confirmatory factor analysis; EBMEEM-67, Evidence-Based Medicine Educational Environment Measure 67.