Table 3 High quality instruments (achieved ≥3 types of established validity evidence) used in some of the included studies

Ramos et al. 2003 [11] (Fresno Test)

43 Family practice residents and faculty members, 53 experts in EBM, and 19 family practice teachers (US).

Knowledge and skills

The Fresno test was originally developed and validated to assess medical professionals’ knowledge and skills in EBP, however, it has been adapted for use in other health disciplines (e.g. occupational therapy [37], physical therapy [38], and pharmacy [39]) and in other languages (e.g. Brazilian-Portuguese version [40]).

It consists of two clinical scenarios with 12 open-ended questions. It needs about 40–60 min to complete and 10–15 min to mark using standardised grading rubrics (scores ranged from 0 to 21).

Content Internal consistency Discriminative Inter-rater reliability

Fritsche et al. 2002 [12]; Akl et al. 2004 [41] (Berlin Questionnaire)

43 experts in EBM, 20 medical students, 203 participants in EBP course (Germany); 49 Internal medicine residents in Non-randomized controlled trial of EBP curriculum (US)

Knowledge and skills

The Berlin questionnaire was developed and validated to assess EBP knowledge and skills in medicine, but has been translated and validated in other languages (e.g. Dutch [42]). It consists of two separate sets of 15 multiple choice questions with 5 response option each, which mainly focus on epidemiological knowledge and skills (scores ranged from 0 to 15).

Content Internal consistency Discriminative Responsive

Ilic et al. 2014 [19] (ACE tool)

342 medical students: 98 EBM-novice, 108 EBM-intermediate and 136 EBM advanced (Australia).

Knowledge and Skill

ACE tool was also developed and validated to assess EBP knowledge and skills in medicine and consists of 15 dichotomous-choice (yes or no) questions, based on a short patient scenario, a relevant search strategy and a hypothetical article extract (Scores ranged from 0 to 15).

Content Internal consistency Discriminative Responsive Inter-rater reliability

Taylor et al. 2001 [18]; Bradley et al. 2005 [43]; Sánchez-Mendiola et al. 2012 [44] (Spanish version)

152 health care professionals (UK); 175 medical students (Norway); 289 medical students (Mexico)

Attitude, knowledge, skill

Part I: 6 multiple-choice questions each with three items, with 3 potential answers, each requiring a true, false, or “don’t know” response; the range of scores is − 18 to 18. Part II: 7 statements related to the use of evidence in practice, and each scored using a five-point Likert scale; the range of scores is 7 to 35.

Content Internal consistency Discriminative Responsive

Kortekaas et al. 2017 [20] (Utrecht questionnaire “U-CEP”) in Dutch

219 general practice (GP) trainees, 20 hospital trainees, 20 GP supervisors, and 8 expert academic GPs or clinical epidemiologists (The Netherlands)

Knowledge

Two formats: two sets of 25 comparable questions (6 open-ended and 19 multiple-choice questions) and a combined set of 50 questions. Multiple-choice question scored 1 for correct and 0 for incorrect answer. Open-ended questions scored 0 to 3. Scores ranged from 0 to 33 for set A and 0–34 for set B.

Content Internal consistency Discriminative Responsive Inter-rater reliability

MacRae et al. 2004 [21]

44 Surgery residents (Canada)

Skill

3 Journal articles, each followed by a series of short-answer questions and 7-point scales to rate the quality of elements of the study design; short-answer questions based on cards from an EBP textbook (Evidence-Based Medicine: How To Practice And Teach It [1])

Internal consistency Discriminative Responsive