Background: Since the introduction of evidence-based medicine (EBM) into China by forerunners from the West China Medical University in the 1990s, continuous efforts have been made to disseminate EBM and evidence-based practice (EBP) in the Chinese medical system. Before EBP becomes part of routine clinical encounters, doctors need to be conscious first of concepts, and then grasp skills. Knowing how this process has been achieved helps inform policy-makers and educator of the ways ahead.
Objectives: To examine the status quo (current situation) of the Chinese doctors’ awareness of EBM, their acquisition of EBP skills, and use of EBP in daily work.
Methods: We searched two Chinese-language electronic databases for studies surveying the Chinese doctors’ knowledge and skills of EBM or the extent to which they practice EBM in daily work.
Results: Twelve cross-sectional surveys undertaken between 1999 and 2014 involving 5239 doctors were included. Qualitative synthesis of statistics showed that:
1. the Chinese doctors' general awareness of EBM has increased from 20% to around 60% over the past 15 years;
2. self-perceived acquisition of basic EBP skills such as formulating a clinical question, searching the literature and understanding risk ratios improved from none to 50%;
3. the development of EBM education was not balanced nationwide - for most doctors in provinces such as Liaoning and Hainan the term EBM is still fresh;
4. EBP is far from being part of daily work for Chinese doctors, as experience-based medical decision-making dominates;
5. it is indicated the gap between evidence and medical practice based on experience might lead to divergent health outcomes and have significant implications.
Conclusions: The development of EBM education in China is rapid, but imbalanced. Policy and education support is needed to implement EBP in the medical system. Moreover, tests for evaluating EBM knowledge and EBP skills should be developed to allow objective assessment of these abilities.