# Knowledge, attitudes, and skills towards evidence-based medicine among Palestinian undergraduate medical students: a cross-sectional study

## TL;DR

This study assesses Palestinian medical students' knowledge, attitudes, and skills in evidence-based medicine, finding positive attitudes but limited skills and access to resources.

## Contribution

The study provides insights into EBM education challenges in Palestine, highlighting the need for curriculum integration and improved resource access.

## Key findings

- Students showed positive attitudes toward EBM but limited skills and understanding of advanced terminology.
- Prior EBM training significantly improved knowledge and skill scores compared to non-trained peers.
- Limited access to paid databases and inconsistent mentorship were major barriers to EBM practice.

## Abstract

Evidence-based medicine (EBM) has been increasingly emphasized within undergraduate medical education; however, its implementation remains inconsistent across many low- and middle-income countries. In Palestine, restricted access to scientific resources, inconsistent mentorship, and limited institutional funding and support may have affected students’ competencies in EBM. This study evaluated the knowledge, attitudes, skills, and information-seeking behaviours related to EBM among undergraduate medical students in the West Bank.

A cross-sectional study was conducted between 14 September 2025 and 1 November 2025, among second to sixth-year medical undergraduates at five Palestinian universities. The questionnaire was distributed through convenience sampling and included five sections: demographics, information-seeking behaviours, EBM knowledge, skills, and students’ attitudes towards it. Analyses were performed using Jamovi 2.6.44 statistical package.

A total of 709 students participated, with a mean age of 21.3 years, of whom 37% had trained in EBM. Practical workshops were the most preferred learning modality (31%), while medical books were the most frequently used source of information (83.6%). Regarding search engines, PubMed, Google and Google scholar were the most accessed. Attendance at biostatistics or research methodology courses was significantly associated with prior EBM training. Overall, students showed positive attitudes towards EBM, and average self-rated skills. However mean score for each skill was significantly higher in EBM-trained undergraduates compared to non-trained peers (p value < 0.001). Understanding of EBM-related terms varied, with participants being more familiar with basic terms than advanced terms, such as heterogeneity, and number needed to treat (NNT), and prior EBM training was consistently associated with higher knowledge scores for key terms. As for research barriers, the majority reported limited access to paid databases, limited funding, and inconsistent mentorship.

Palestinian medical students held positive stance towards evidence-based medicine, recognizing its clinical value. However, their skills and terminology knowledge were still somehow limited. Integrating EBM training into curriculum, enhancing faculty support, and expanding access to resources can strengthen students’ competency and prepare them for evidence-based clinical practice.