A focus group discussion study exploring general surgery trainees’ views on evidence-based medicine within their training program in the United Kingdom

INTRODUCTION: Evidence-based Medicine (EBM) is fundamental to modern healthcare and its integration into postgraduate curricula is strongly advocated. Despite its relevance, incorporating EBM in postgraduate training, specifically in general surgery, is fraught with challenges. This study aims to explore the perceptions of general surgical trainees regarding EBM, focusing on the process of achieving competency, assessment and its associated challenges.

METHODS: Four semi-structured focus group discussions were conducted, involving participants with varying experience in general surgery. Sessions were audio-recorded, de-identified and transcribed verbatim to facilitate data analysis. Thematic analysis was employed to identify recurring patterns and themes within the dataset, ensuring rigor and reliability in the findings. Saturation was achieved when no new themes or codes emerged from the data.

RESULTS: Eighteen trainees at different levels of training, academic experience and from different regions of the UK took part. The discussions were thematically analysed. Four key themes were identified: "Knowledge and understanding of EBM," "Developing EBM competencies," "Assessment in EBM," and "Barriers for EBM." Thematic saturation was achieved by the fourth focus group.

CONCLUSION: This study provides insights into the landscape of EBM in general surgery in the United Kingdom. Trainees demonstrated knowledge and understanding of EBM and the process of achieving relevant competencies. EBM assessment was perceived to be part of their training. Nevertheless, systemic barriers and inherent challenges appear to hinder the development of EBM competencies within postgraduate general surgical training. Achieving this requires a participatory approach to engage stakeholders to further develop the existing competency-based curriculum.