title: Rural surgeons' attitudes towards and usage of evidence-based medicine in rural surgical practice.
abstract: BACKGROUND
  Rural and remote surgical practice presents unique barriers to the uptake of the evidence-based medicine (EBM) paradigm. As medical and education institutions around Australia develop practices and support for EBM, there are growing questions about how EBM is situated in the rural and remote context. The Monash University Department of Surgery at Monash Medical Centre implemented a study to explore the current understandings, attitudes and practices of rural surgeons towards the EBM paradigm.
  
  
  METHODS
  Descriptive survey of rural surgeons based in a tertiary care environment.
  
  
  RESULTS
  The overall results of the survey demonstrate that: (1) rural surgeons have a good understanding of EBM; (2) EBM evidence is somewhat useful but not very important to clinical decision making; and (3) while rural surgeons are relatively confident in most sources listed, they are most confident in their own judgment and clinical practice guidelines, and least confident in telephone contact with colleagues. Rural surgeons' understanding, usage and confidence in EBM purports that rural surgeons have contradictory, ambivalent and complex views of the EBM paradigm and its place in rural surgical practice.
  
  
  CONCLUSIONS
  Professional isolation and context specificity are important to consider when extending the EBM paradigm to rural surgical practice and understanding the EBM uptake in the rural surgery context.
authors.affiliation: Wilson Centre, University of Toronto, Toronto, ON, Canada. simon.kitto@utoronto.ca
authors.forename: Simon C
authors.initials: SC
authors.lastname: Kitto
authors.forename: Jennifer C
authors.initials: JC
authors.lastname: Peller
authors.forename: Elmer V
authors.initials: EV
authors.lastname: Villanueva
authors.forename: Russell L
authors.initials: RL
authors.lastname: Gruen
authors.forename: Julian A
authors.initials: JA
authors.lastname: Smith
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D004059:Diffusion of Innovation; D019317:Evidence-Based Medicine; D005260:Female; D013502:General Surgery; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009864:Ontario; D010820:Physicians / Q000523:psychology*; D019035:Rural Health Services