Integrating Evidence-Based Practice into a Therapeutic Exercise Course: Real-Time Patient Experience

2014 ◽  
Vol 9 (2) ◽  
pp. 94-95
Author(s):  
Jennifer K. Popp

Athletic training students need real-time patient experiences in order to transfer the knowledge and skills learned in the classroom into clinical practice. The objective is to present a description of an assignment that could be incorporated into a therapeutic exercise course giving the student an opportunity to evaluate a patient, design a program utilizing evidence-based practice (EBP), and work with the patient in a 1-on-1 capacity over a period of time to implement the program. Students may not always have the opportunity in the clinical education environment to develop a rehabilitation program for a patient based on their own evaluation of the patient and utilize EBP concepts in the development of a program. This assignment involves utilizing patient evaluation techniques, including the use of a patient-rated outcome measures instrument, as well as the use of clinician-based measures, to develop a rehabilitation program. The program must be anchored in sound evidence and patient needs, incorporating multiple facets (eg, range of motion exercises, strengthening exercises) within the limitations of the injury/condition. Students report increased confidence in their ability to design a rehabilitation program, as well as their ability to utilize EBP in the clinical setting. They also develop problem-solving skills and cultivate professional attributes (communication skills, interpersonal skills) through this activity. In conclusion, this assignment is 1 way to infuse EBP concepts into a classroom assignment that requires real-time patient care experience over a period of time.

2013 ◽  
Vol 8 (4) ◽  
pp. 131-134
Author(s):  
J. Jordan Hamson-Utley ◽  
Jennifer L. Stiller-Ostrowski

Evidence-based practice (EBP) and educational technology have become fundamental skills within athletic training programs. The objective of this article is to share experiences implementing clinical orthopaedic evaluation applications (“apps”) that can be integrated into classroom and clinical education to enhance students' proficiency and efficiency utilizing and interpreting special test findings. Today's entry-level allied health professional is expected to have a deeper understanding of special tests than ever before. In addition to developing proficiency in clinical skills, these future clinicians must understand validity statistics in order to select appropriate special tests and interpret the results. The Clinical ORthopedic Exam (C.O.R.E.) application is a database of nearly 250 special tests with descriptions of the test, a video of the special test being performed, and statistical support for the use of the test in reported sensitivity/specificity and likelihood ratios. The series of anatomy applications developed by 3D4Medical.com allows the user to view, zoom, and rotate the joint in 3 dimensions, providing cross-sectional views and virtual layer removal (revealing muscles, connective tissue, bones, vessels, and nerves). Textbooks that overview clinical special tests are not updated often enough to reflect the growing body of research surrounding these techniques. Students and clinicians require the most up-to-date information in order to make sound clinical decisions. The C.O.R.E. application provides access to the most recent peer-reviewed validity statistics. Patient education is also highly valued; the series of applications by 3D4Medical provides vivid anatomical images that can aid in explanation of injury to patients. With EBP a required educational content area within athletic training education and with medical technology becoming commonplace in allied health settings, it is essential that athletic training programs engage students in the use of technology during their classroom and clinical experiences.


2010 ◽  
Vol 20 (3) ◽  
pp. 100-105 ◽  
Author(s):  
Anne K. Bothe

This article presents some streamlined and intentionally oversimplified ideas about educating future communication disorders professionals to use some of the most basic principles of evidence-based practice. Working from a popular five-step approach, modifications are suggested that may make the ideas more accessible, and therefore more useful, for university faculty, other supervisors, and future professionals in speech-language pathology, audiology, and related fields.


2014 ◽  
Vol 9 (1) ◽  
pp. 22-28 ◽  
Author(s):  
Mary Beth Zwart ◽  
Bernadette Olson

Context It is the responsibility of athletic training educators, through curriculum and clinical experiences, to engage students towards adopting evidence-based practice (EBP) into their practice. The initial task of implementing EBP into a curriculum or course can seem like a large task for educators and students. As a way to start scaffolding EBP concepts across the curriculum, a modified critical appraisal assignment was developed to teach therapeutic modality concepts. Objective The purpose of this action research project was to demonstrate how a modified critical appraisal assignment can be used to introduce the process and aspects of critical appraisal and begin scaffolding the development of critical appraisal skills over time. The objectives of this study were to evaluate the students' ability to (1) successfully locate relevant research needed to answer clinical questions and (2) successfully appraise the literature according to basic EBP strategy. From a program perspective, the modified critical appraisal assignment was a starting point from which to include EBP principles into didactic coursework. Design Seventeen athletic training students completed 3 modified critical appraisal assignments pertaining to the use of therapeutic modalities. Each paper included 5 sections: (1) clinical question, (2) key clinical findings, (3) clinical applicability based on information from the appraisal and significance of results, (4) article comparison table, and (5) implications for clinical practice, patient education, and future research. The instructor evaluated the assignments blind. Conclusions Students were generally able to complete the critical appraisal assignment; however, students had difficulty locating research that answered the clinical question. Students struggled to relate the key clinical findings of the research articles and implications for clinical practice to the given clinical question. Findings from this study have informed faculty teaching, including introducing EBP skills earlier in the curriculum and inserting assignments that stress various aspects of the critical appraisal process.


2013 ◽  
Vol 48 (3) ◽  
pp. 405-415 ◽  
Author(s):  
Cailee W. McCarty ◽  
Dorice A. Hankemeier ◽  
Jessica M. Walter ◽  
Eric J. Newton ◽  
Bonnie L. Van Lunen

Context: Successful implementation of evidence-based practice (EBP) within athletic training is contingent upon understanding the attitudes and beliefs and perceived barriers toward EBP as well as the accessibility to EBP resources of athletic training educators, clinicians, and students. Objective: To assess the attitudes, beliefs, and perceived barriers toward EBP and accessibility to EBP resources among athletic training educators, clinicians, and students. Design: Cross-sectional study. Setting: Online survey instrument. Patients or Other Participants: A total of 1209 athletic trainers participated: professional athletic training education program directors (n = 132), clinical preceptors (n = 266), clinicians (n = 716), postprofessional athletic training educators (n = 24) and postprofessional students (n = 71). Main Outcome Measure(s): Likert-scale items (1 = strongly disagree, 4 = strongly agree) assessed attitudes and beliefs and perceived barriers, whereas multipart questions assessed accessibility to resources. Kruskal-Wallis H tests (P ≤ .05) and Mann-Whitney U tests with a Bonferroni adjustment (P ≤ .01) were used to determine differences among groups. Results: Athletic trainers agreed (3.27 ± 0.39 out of 4.0) that EBP has various benefits to clinical practice and disagreed (2.23 ± 0.42 out of 4.0) that negative perceptions are associated with EBP. Benefits to practice scores (P = .002) and negative perception scores (P < .001) differed among groups. With respect to perceived barriers, athletic trainers disagreed that personal skills and attributes (2.29 ± 0.52 out of 4.0) as well as support and accessibility to resources (2.40 ± 0.40 out of 4.0) were barriers to EBP implementation. Differences were found among groups for personal skills and attributes scores (P < .001) and support and accessibility to resources scores (P < .001). Time (76.6%) and availability of EBP mentors (69.6%) were the 2 most prevalent barriers reported. Of the resources assessed, participants were most unfamiliar with clinical prediction rules (37.6%) and Cochrane databases (52.5%); direct access to these 2 resources varied among participants. Conclusions: Athletic trainers had positive attitudes toward the implementation of EBP within didactic education and clinical practice. However, accessibility and resource use remained low for some EBP-related resources. Although the perceived barriers to implementation are minimal, effective integration of EBP within athletic training will present challenges until these barriers dissolve.


2013 ◽  
Vol 32 (4) ◽  
pp. 412-423
Author(s):  
Jonathan D. Eldredge ◽  
Holly E. Phillips ◽  
Philip J. Kroth

2015 ◽  
Vol 10 (3) ◽  
pp. 256-266 ◽  
Author(s):  
Drue Stapleton ◽  
Andrew Hawkins

Objective The trend of utilizing evidence-based practice (EBP) in athletic training is now requiring clinicians, researchers, educators, and students to be equipped to both engage in and make judgments about research evidence. Single-case design (SCD) research may provide an alternative approach to develop such skills and inform clinical and pedagogical practices. The purpose of this paper is to review the literature related to SCD and its potential contributions to EBP in athletic training. Data Source(s) We searched PubMed, CINAHL, Proquest Dissertation and Theses, and Google Scholar using terms “single case design”, “single subject design”, “within subjects”, and combined search terms of “single case design AND athletic training, AND allied health, AND medicine, AND nursing”. Data Synthesis Textual support for the use of SCD in athletic training and a brief review of literature pertaining to: general features, strengths, limitations, and design options commonly associated with the use of SCD. Conclusions Use of SCD in allied health professions is limited, with fewer studies in athletic training settings. Low awareness and misinterpretation of SCD may be contributing to the low use of SCD in athletic training research. The key characteristics of SCD make it appropriate for use in clinical and educational settings and may provide clinicians, educators, and researchers an alternative tool for the development of evidence necessary to engage in evidence-based practice.


2011 ◽  
Vol 6 (1) ◽  
pp. 5-14 ◽  
Author(s):  
Cailee E. Welch ◽  
Bonnie L. Van Lunen ◽  
Stacy E. Walker ◽  
Sarah A. Manspeaker ◽  
Dorice A. Hankemeier ◽  
...  

Context: Before new strategies and effective techniques for implementation of evidence-based practice (EBP) into athletic training curricula can occur, it is crucial to recognize the current knowledge and understanding of EBP concepts among athletic training educators. Objective: To assess athletic training educators' current knowledge, comfort, and perceived importance of evidence-based concepts. Design: Cross-sectional survey design. Setting: Online survey instrument. Patients or Other Participants: 141 respondents (28.3% response rate) from a convenience sample of 498 athletic training educators. Main Outcome Measure(s): Demographic information and knowledge, comfort, and perceived importance of 11 EBP concepts (definition of EBP, steps of EBP, reliability, validity, intra-class correlation coefficient, kappa coefficient, specificity, sensitivity, likelihood ratio, positive predictive value, negative predictive value) were obtained. Results: Participants' overall EBP knowledge score was 64.4%. Characteristics associated with higher knowledge scores were terminal degree (69.92% ± 10.36, P < .001), hours of research per week (66.96% ± 12.61, P = .029), and hours of teaching-related tasks conducted per week (67.47% ± 12.48, P = .002). Overall EBP comfort was 2.37/4.0 (“uncomfortable”). Characteristics associated with higher comfort scores were terminal degree (2.51 ± 0.67, P = .017), hours of research per week (2.52 ± 0.69, P = .025), and EBP workshops previously attended (2.56 ± 0.66, P = .002). Overall EBP perceived importance was 3.34/4.0 (“important”). The characteristic associated with higher importance scores was hours of research per week (3.44 ± 0.45, P = .009). Conclusions: Athletic training educators' current knowledge of EBP concepts needs to be improved. This study indicates that athletic training educators are uncomfortable with evidence-based concepts, yet believe it is important for curricular implementation. The future development of workshops and teaching models should focus on the varying levels of EBP concepts. Distinguishing modes for curricula implementation might also be an effective way to increase knowledge, comfort, and perceived importance levels.


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