Use of Evidence-Based Practice Among Athletic Training Educators, Clinicians, and Students, Part 1: Perceived Importance, Knowledge, and Confidence

Abstract

Context: Although evidence-based practice (EBP) has become more prevalent, athletic trainers' perceptions of importance and knowledge of these concepts and their confidence in EBP are largely unknown.Objective: To assess perceived importance and knowledge of and confidence in EBP concepts in athletic trainers in various roles and with different degree levels.Design: Cross-sectional study. Setting: Online survey instrument.Patients or Other Participants: The survey was sent to 6702 athletic training educators, clinicians, and postprofessional students. A total of 1209 completed the survey, for a response rate of 18.04%.Main Outcome Measure(s): Demographic information and perceived importance and knowledge of and confidence in the steps of EBP were obtained. One-way analysis of variance, a Kruskal-Wallis test, and an independent-samples t test were used to determine differences in scores among the demographic variables.Results: Athletic trainers demonstrated low knowledge scores (64.2% 6 1.29%) and mild to moderate confidence (2.71 6 0.55 out of 4.0). They valued EBP as moderately to extremely important (3.49 6 0.41 out of 4.0). Perceived importance scores differed among roles (clinicians unaffiliated with an education program scored lower than postprofessional educators, P ¼ .001) and highest educational degree attained (athletic trainers with terminal degrees scored higher than those with bachelor's or master's degrees, P , .001). Postprofessional athletic training students demonstrated the highest total EBP knowledge scores (4.65 6 0.91), whereas clinicians demonstrated the lowest scores (3.62 6 1.35). Individuals with terminal degrees had higher (P , .001) total knowledge scores (4.31 6 1.24) than those with bachelor's (3.78 6 1.2) or master's degrees (3.76 6 1.35). Postprofessional educators demonstrated greater confidence in knowledge scores (3.36 6 0.40 out of 4.0) than did those in all other athletic training roles (P , .001).Conclusions: Overall knowledge of the basic EBP steps remained low across the various athletic trainers' roles. The higher level of importance indicated that athletic trainers valued EBP, but this value was not reflected in the knowledge of EBP concepts. Individuals with a terminal degree possessed higher knowledge scores than those with other educational preparations; however, EBP knowledge needs to increase across all demographics of the profession.Key Words: athletic training setting, educational preparation, clinical practice Key PointsAthletic trainers valued the concept of evidence-based practice and recognized its importance to the profession. However, their level of knowledge about evidence-based practice and their level of confidence in that knowledge were both low. Evidence-based practice should be taught not only in the educational curricula for athletic training students but also to practicing clinicians.

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

“…These findings are in agreement with previous research on perceptions of EBP in athletic training [2][3][4][5][6] and in other health care professions.…”

Athletic Trainers' Beliefs About and Implementation of Evidence-Based Practice

“…However, the moderate effect size demonstrates that the magnitude of effect a degree has on the response may be of limited practical significance in the larger population. Similar results in regard to level of education were shown in ATs, 29,30 physiotherapists, 25 and nurses. 31,32 By completing a terminal degree program, clinicians are exposed to the components necessary to understand research and improve confidence in one's skills, such as finding, appraising, and applying evidence.…”

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

“…11 After the workshop, confidence increased to a moderately confident level exceeding that of confidence reported in previous athletic training research. 13 This increase in confidence correlates positively to the gain in EBP knowledge and may, in theory, translate to overall improved confidence in the process of EBP, which is an important factor in support of implementation and potential transference to practice. Athletic trainers having moderate to extreme confidence in the EBP process could, in the future, transition to expanded use of EBP in clinical practice and better understanding of the clinical EBP programming approved by the BOC.…”

“…Previous research [10][11][12][13][14] in athletic training shows that foundational knowledge of EBP concepts is low. Stand-alone workshops, journal clubs, and clinically integrated teaching improve knowledge of EBP and critical appraisal in medicine, 15 whereas web-based modules increase foundational EBP knowledge in athletic trainers (ATs).…”