Future Directions of Evidence-Based Practice in Athletic Training: Perceived Strategies to Enhance the Use of Evidence-Based Practice

Abstract

Context:The shift to a culture of evidence-based practice (EBP) in athletic training is a necessary step in both the optimization of patient care and the advancement of athletic trainers (ATs) as health care professionals. Whereas individuals have gained knowledge in this area, most ATs still are not practicing in an evidence-based manner. Exploring perceived strategies to enhance the use of EBP will help to determine the best approaches to assist ATs in applying EBP concepts to practice to improve patient care.Objective: To explore beneficial strategies and techniques ATs perceived would promote successful implementation of EBP within athletic training education and clinical practice.Design: Qualitative study. Setting: Individual telephone interviews.Patients or Other Participants: Twenty-five ATs (12 educators, 13 clinicians; athletic training experience ¼ 16.00 6 9.41 years) were interviewed.Data Collection and Analysis: One phone interview was conducted with each participant. After the interview was transcribed, the data were analyzed and coded into common themes and categories. Triangulation of the data occurred via the use of multiple researchers and member checking to confirm the accuracy of the data.Results: Participants identified several components they perceived as essential for enhancing the use of EBP within the athletic training profession. These components included the need for more EBP resources, more processed information, focused workshops, peer discussion and mentorship, and continual repetition and exposure. Participants also indicated that ATs need to accept their professional responsibilities to foster EBP in their daily practices.Conclusions: The proper shift to a culture of EBP in athletic training will take both time and a persistent commitment by ATs to create strategies that will enhance the implementation of EBP across the profession. Researchers should focus on continuing to identify effective educational interventions for ATs and to determine successful strategies to implement EBP into didactic curricula and clinical practice. Additional focus should be given to which strategies most effectively produce changes in clinical practice.Key Words: professional responsibility, mentorship, evidence-based medicine, qualitative research Key PointsParticipants perceived that certain strategies might enhance the inclusion of evidence-based practice concepts throughout athletic training. Researchers should continue to identify effective educational interventions for athletic trainers and determine successful strategies to implement evidence-based practice into didactic curricula and clinical practice. Focus also needs to be placed on strategies that most effectively achieve knowledge translation to effect change in clinical practice.

Athletic Trainers' Current Knowledge and Envisioned Use of Foundational Evidence-Based Practice Concepts

“…17,18,20,21,35 The acknowledged lack of accessibility, availability, and applicability of evidence is also supportive of previous findings. [16][17][18][19][20][21] Participants within this study addressed resources within both the barriers question and the envisioned-use question, thus suggesting that resources are a barrier to envisioned use of EBP.…”

“…Although teaching EBP was an identified envisioned-use category by some participants in this study, evidence supporting best practices for teaching CPE, 37 particularly in relation to EBP, 20,35 is lacking. Whereas it is recommended that ATs serving in educator and/or preceptor roles not only instruct EBP concepts but also be able to model these skills, 20 it is unknown how often these techniques are occurring and what the resulting impact on patient care is, if any.…”

“…Specifically, evidence targeting clinically based questions, perhaps on topics suggested by practicing clinicians, should help to improve the body of applicable evidence. 17,35 In further discussion of resources, a portion of this workshop was designated to identification of resources varying from free access to paid subscription and to ranking the preferred sources for information. It is interesting to note that less than 5% of responses for databases and resources used to identify evidence included the Cochrane Database of Systematic Reviews, which is considered to house the highest level of clinical evidence.…”

“…Transitioning to a culture of EBP will come with constant repetition and exposure. 35 In order for athletic training as a profession to be competent and inclusive in all knowledge areas identified by the National Academy of Medicine, formerly the Institute of Medicine, 3 ATs have a professional responsibility to learn and integrate EBP into practice to align with other health care professions. Learning theories indicate that CPE and postgraduate education decisions tend to be driven by self-motivation and clinical practice.…”

Athletic Trainers’ Perceived Challenges Toward Comprehensive Concussion Management in the Secondary School Setting

“…15,16 The CQR approach has been previously established in athletic training research. [17][18][19][20] This study was approved by the A.T. Still University Institutional Review Board and email consent was obtained from each participant, along with verbal consent prior to each participant's interview.…”