Open Access Highly Accessed Study protocol

Perceptions, attitudes and knowledge of evidence-based medicine in primary care in Spain: a study protocol

Pablo Alonso-Coello12*, Ivan Solà1, Rafael Rotaeche3, Ana Isabel González4, Mercè Marzo-Castillejo5, Arturo Louro-González6, Ricard Carrillo7, Paola Velázquez8, Guillermo García-Velasco9 and Carlos Calderón3

Author Affiliations

1 Iberoamerican Cochrane Center, Hospital Sant Pau, Sant Antoni Maria Claret 171, Barcelona, Spain

2 CIBER de Epidemiología y Salud Pública (CIBERESP), Spain

3 Centro de Salud de Alza, Donostia-San Sebastián, Spain

4 Centro de Salud Vicente Muzas, Área 4, Madrid, Spain

5 Àmbit d'Atenció Primària Costa de Ponent, Barcelona, Spain

6 Servicio de Atención Primaria de Cambre, Cambre, Coruña, Spain

7 EAP La Florida Sud, L'Hospitalet de Llobregat, Barcelona, Spain

8 Consultas Médicas y Psicológicas, Barcelona, Spain

9 Centro de Salud La Calzada II, Gijón, Asturias, Spain

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BMC Health Services Research 2009, 9:80  doi:10.1186/1472-6963-9-80

Published: 15 May 2009



The philosophy of evidence-based medicine (EBM) was introduced in the early 90s as a new approach to the practice of medicine, using the best available evidence to make decisions about health care. Despite ongoing controversy, EBM has developed enormously and physicians' attitude towards it is generally positive. Nevertheless, in Spain little is known about this topic. We will therefore undertake a study to explore perceptions, attitudes and knowledge about EBM among primary care physicians.

Methods and design

A mixed-method study combining qualitative and quantitative designs will target family practitioners in Spain with the objective of evaluating current attitudes and perceptions about evidence-based medicine. The project will consist of two phases: a first phase running focus groups to identify perceptions and attitudes of participants, and a second phase assessing their attitudes and knowledge about EBM by means of a survey. Both phases will explore these issues in three different subgroups: family practitioners, with or without previous formal education in EBM; members of working groups that formulate healthcare recommendations; and physicians in charge of training family practice residents. Additionally, we will undertake a systematic review to identify and synthesize the available evidence on this topic.


The study will identify and gain insight into the perceived problems and barriers to the practice of evidence-based medicine among general practitioners in Spain. The project will also evaluate the main knowledge gaps and training needs, and explore how evidence-based medicine is being taught to family medicine residents, the medical practitioners of the future. Our results will aid researchers and health care planners in developing strategies to improve the practice of evidence-based medicine in our country.