• Farzaneh Barzkar, Hamid Reza Baradaran, and Jalil Koohpayehzadeh.
• Center for Educational Research in Medical Sciences (CERMS), Iran University of Medical Sciences, Tehran, Iran.
• J Evid Based Med. 2018 Nov 1; 11 (4): 246-251.

AimTo assess knowledge, attitude, and practice of graduate physicians toward evidence-based medicine (EBM) and the barriers to the implementation of EBM worldwide.MethodsRelevant databases were searched systematically with appropriate search terms up to September 2017. References of the articles detected by the search were screened for any new articles. Risk of bias was assessed by two independent reviewers. Data were extracted from the full-text articles based on the study summary measures and were collected in a data table.ResultsFifty-seven articles were finally included in this systematic review. The studies were of variable and moderate quality. Based on our results, physicians have a generally positive attitude toward EBM and most of them believe that its implementation improves patient care. However, their self-reported awareness and knowledge regarding EBM concepts and the main databases are generally poor. The major barriers to the practice of EBM were related to patient overload and lack of personal time, knowledge, and skills rather than a lack of facilities and resources. However, this pattern varied among the studies. Most of the physicians in the included studies referred to their colleagues and textbooks to answer most of their clinical questions.ConclusionAlthough many physicians have poor EBM knowledge and skills, the majority of them have a positive attitude toward the implication of EBM. To overcome the barriers against the evidence-based practice, it is recommended that appropriate policies be adopted to decrease physicians' workload and to provide them with preappraised evidence.© 2018 Chinese Cochrane Center, West China Hospital of Sichuan University and John Wiley & Sons Australia, Ltd.

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