Evidence-based surgery: creating the culture.

Hospitals and professional bodies require a culture that supports surgeons in their quest for knowledge, and provides the technological and educational environment in which they can promote evidence-based surgery. Surgeons must influence the development of their local information technology systems for data collection and outcome analysis, and deliver training programs that instill an attitude of continually seeking evidence. Identification of clinical problems and critical appraisal of the literature need to be taught. Management structures and relationships that facilitate a joint approach to delivering high-quality systematic clinical care should be developed. The culture that supports these aims is also one in which patients can rely on safely receiving up-to-date and effective treatments from well-trained and trusted surgeons.