title: Comparison of residents' approaches to clinical decisions before and after the implementation of Evidence Based Medicine course.
abstract: BACKGROUND
  It has been found that the decision-making process in medicine is affected, to a large extent, by one's experience, individual mentality, previous models, and common habitual approaches, in addition to scientific principles. Evidence-based medicine is an approach attempting to reinforce scientific, systematic and critical thinking in physicians and provide the ground for optimal decision making. In this connection, the purpose of the present study is to find out to what extent the education of evidence based medicine affects clinical decision making.
  
  
  METHODS
  The present quasi-experimental study was carried out on 110 clinical residents, who started their education in September, 2012 and finally 62 residents filled out the questionnaires. The instrument used was a researcher-made questionnaire containing items on four decision-making approaches. The questionnaire was used both as a pre-test and a post-test to assess the residents' viewpoints on decision making approaches. The validity of the questionnaire was determined using medical education and clinical professionals' viewpoints, and the reliability was calculated through Chronbach alpha; it was found to be 0.93. The results were analyzed by paired t-test using SPSS, version 14.
  
  
  RESULTS
  The results demonstrated that evidence-based medicine workshop significantly affected the residents' decision-making approaches (p<0.001). The pre-test showed that principles-based, reference-based and routine model-based approaches were more preferred before the program (p<0.001). However, after the implementation of the program, the dominant approaches used by the residents in their decision making were evidence-based ones.
  
  
  CONCLUSIONS
  To develop the evidence-based approach, it is necessary for educational programs to continue steadily and goal-orientedly. In addition, the equipment infrastructure such as the Internet, access to data bases, scientific data, and clinical guides should develop more in the medical departments.
authors.affiliation: Quality improvement in clinical education Research Center, Shiraz University of Medical Science, Shiraz, Iran;
authors.forename: Zahra
authors.initials: Z
authors.lastname: Karimian
authors.affiliation: Quality improvement in clinical education Research Center, Shiraz University of Medical Science, Shiraz, Iran;
authors.forename: Javad
authors.initials: J
authors.lastname: Kojuri
authors.affiliation: Quality improvement in clinical education Research Center, Shiraz University of Medical Science, Shiraz, Iran;
authors.forename: Mohammad Mahdi
authors.initials: MM
authors.lastname: Sagheb
authors.affiliation: English Language Department, Paramedical School, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Mahboudi
authors.affiliation: Quality improvement in clinical education Research Center, Shiraz University of Medical Science, Shiraz, Iran;
authors.forename: Mahboobeh
authors.initials: M
authors.lastname: Saber
authors.affiliation: Quality improvement in clinical education Research Center, Shiraz University of Medical Science, Shiraz, Iran;
authors.forename: Mitra
authors.initials: M
authors.lastname: Amini
authors.affiliation: Quality improvement in clinical education Research Center, Shiraz University of Medical Science, Shiraz, Iran;
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Dehghani
keywords: Clinical; Decision making; Evidence-based medicine; Resident