Challenges and Obstacles to Clinical Guidelines from the Perspectives of Urology Residents: A Qualitative Study

Abstract

Background and Objectives: Clinicians rely on clinical guidelines for decision making. Carefully formulated clinical guidelines are the result of a combination of relevant researches that links evidence to clinical practice. The purpose of this study was to determine the barriers to the use of clinical guidelines from viewpoints of residents. Material and Methods: This study is a qualitative phenomenological study that examines the experiences of the residents of Urology Department of Imam Reza Hospital in Tabriz City of Iran. The sampling method was purposive. Qualitative content analysis used to analyze this study. To validate the results, the interviews were repeatedly read and the opinions of colleagues were regularly used. External monitoring was used to increase its reliability. Results: 11 semi-structured interviews were conducted with the urology residents of Imam Reza Hospital. The results showed that the challenges and barriers to the implementation of clinical guidelines were classified into three main themes: 1. Structural challenges: doctors' distrust of clinical guidelines, Illegitimacy and lack of local clinical guidelines. 2. Executive challenges: routine processes, Lack of agreeable atmosphere, resistance to change among physicians and high number of patients and lack of facilities. 3. Educational challenges: lack of residency time and lack of practical educational structure for students. Conclusion: Given the importance of proper implementation of clinical guidelines as a link to up-to-date knowledge and practice and given the existing structural, executive and educational problems, obstacles and challenges, it is hoped that researchers, managers, policymakers and Patients should take steps to remove barriers to the proper implementation of clinical guidelines and provide high quality services to patients.