scholarly journals Approved Clinical Instructors' Perspectives on Implementation Strategies in Evidence-Based Practice for Athletic Training Students

2011 ◽  
Vol 46 (6) ◽  
pp. 655-664 ◽  
Author(s):  
Dorice A. Hankemeier ◽  
Bonnie L. Van Lunen
Keyword(s):  
Critical Thinking ◽  
Clinical Practice ◽  
Athletic Training ◽  
Evidence Based Practice ◽  
Implementation Strategies ◽  
Athletic Training Education ◽  
Evidence Based ◽  
Clinical Instructors ◽  
Approved Clinical Instructors ◽  
Ebp Implementation

Context: Understanding implementation strategies of Approved Clinical Instructors (ACIs) who use evidence-based practice (EBP) in clinical instruction will help promote the use of EBP in clinical practice. Objective: To examine the perspectives and experiences of ACIs using EBP concepts in undergraduate athletic training education programs to determine the importance of using these concepts in clinical practice, clinical EBP implementation strategies for students, and challenges of implementing EBP into clinical practice while mentoring and teaching their students. Design: Qualitative study. Setting: Telephone interviews. Patients or Other Participants: Sixteen ACIs (11 men, 5 women; experience as a certified athletic trainer = 10 ± 4.7 years, experience as an ACI = 6.8 ± 3.9 years) were interviewed. Data Collection and Analysis: We interviewed each participant by telephone. Interview transcripts were analyzed and coded for common themes and subthemes regarding implementation strategies. Established themes were triangulated through peer review and member checking to verify the data. Results: The ACIs identified EBP implementation as important for validation of the profession, changing paradigm shift, improving patient care, and improving student educational experiences. They promoted 3 methods of implementing EBP concepts with their students: self-discovery, promoting critical thinking, and sharing information. They assisted students with the steps of EBP and often faced challenges in implementation of the first 3 steps of EBP: defining a clinical question, literature searching, and literature appraisal. Finally, ACIs indicated that modeling the behavior of making clinical decisions based on evidence was the best way to encourage students to continue using EBP. Conclusions: Athletic training education program directors should encourage and recommend specific techniques for EBP implementation in the clinical setting. The ACIs believed that role modeling is a strategy that can be used to promote the use of EBP with students. Training of ACIs should include methods by which to address the steps of the EBP process while still promoting critical thinking.

scholarly journals Perceptions of Approved Clinical Instructors: Barriers in the Implementation of Evidence-Based Practice

2013 ◽  
Vol 48 (3) ◽  
pp. 382-393 ◽  
Author(s):  
Dorice A. Hankemeier ◽  
Bonnie L. Van Lunen
Keyword(s):  
Athletic Training ◽  
Evidence Based Practice ◽  
Athletic Training Education ◽  
Academic Program ◽  
Evidence Based ◽  
Clinical Instructors ◽  
Clinical Practices ◽  
Telephone Interviews ◽  
Data Collection And Analysis ◽  
Approved Clinical Instructors

Context: As evidence-based practice (EBP) becomes prevalent in athletic training education, the barriers that Approved Clinical Instructors (ACIs) experience in implementing it with students need to be understood. Objective: To investigate barriers ACIs face when implementing EBP concepts in clinical practice and in teaching EBP to professional athletic training students and to investigate the educational emphases to improve the barriers. Design: Qualitative study. Setting: Telephone interviews. Patients or Other Participants: Sixteen ACIs (11 men, 5 women; experience as an athletic trainer = 10 ± 4.7 years, experience as an ACI = 6.81 ± 3.9 years) were interviewed. Data Collection and Analysis: We interviewed each participant by telephone. Interview data were analyzed and coded for common themes and subthemes regarding barriers and educational emphases. Themes were triangulated through multiple-analyst triangulation and interpretive verification. Results: Barriers to EBP incorporation and educational emphasis placed on EBP were the main themes reported. Resources, personnel, and student characteristics were subthemes identified as barriers. Resource barriers included time, equipment, access to current literature, and knowledge. Coworkers, clinicians, and coaches who were unwilling to accept evidence regarding advancements in treatment were identified as personnel barriers. Programmatic improvement and communication improvement were subthemes of the educational emphasis placed on EBP theme. The ACIs reported the need for better integration between the clinical setting and the classroom and expressed the need for EBP to be integrated throughout the athletic training education program. Conclusions: Integration of the classroom and clinical experience is important in advancing ACIs' use of EBP with their students. Collaborative efforts within the clinical and academic program could help address the barriers ACIs face when implementing EBP. This collaboration could positively affect the ability of ACIs to implement EBP within their clinical practices.

What Does Evidence-Based Practice Mean to You? A Follow-Up Study Examining School-Based Speech-Language Pathologists' Perspectives on Evidence-Based Practice

2020 ◽  
Vol 29 (2) ◽  
pp. 688-704
Author(s):  
Katrina Fulcher-Rood ◽  
Anny Castilla-Earls ◽  
Jeff Higginbotham
Keyword(s):  
Clinical Practice ◽  
Research Evidence ◽  
Evidence Based Practice ◽  
Evidence Based ◽  
Clinical Expertise ◽  
Speech Language Pathologists ◽  
School Based ◽  
Research Findings ◽  
Ebp Implementation

Purpose The current investigation is a follow-up from a previous study examining child language diagnostic decision making in school-based speech-language pathologists (SLPs). The purpose of this study was to examine the SLPs' perspectives regarding the use of evidence-based practice (EBP) in their clinical work. Method Semistructured phone interviews were conducted with 25 school-based SLPs who previously participated in an earlier study by Fulcher-Rood et al. 2018). SLPs were asked questions regarding their definition of EBP, the value of research evidence, contexts in which they implement scientific literature in clinical practice, and the barriers to implementing EBP. Results SLPs' definitions of EBP differed from current definitions, in that SLPs only included the use of research findings. SLPs seem to discuss EBP as it relates to treatment and not assessment. Reported barriers to EBP implementation were insufficient time, limited funding, and restrictions from their employment setting. SLPs found it difficult to translate research findings to clinical practice. SLPs implemented external research evidence when they did not have enough clinical expertise regarding a specific client or when they needed scientific evidence to support a strategy they used. Conclusions SLPs appear to use EBP for specific reasons and not for every clinical decision they make. In addition, SLPs rely on EBP for treatment decisions and not for assessment decisions. Educational systems potentially present other challenges that need to be considered for EBP implementation. Considerations for implementation science and the research-to-practice gap are discussed.

Using a Critical Appraisal Assignment to Infuse Evidence-Based Practice into a Therapeutic Modality Course

2014 ◽  
Vol 9 (1) ◽  
pp. 22-28 ◽  
Author(s):  
Mary Beth Zwart ◽  
Bernadette Olson
Keyword(s):  
Clinical Practice ◽  
Athletic Training ◽  
Critical Appraisal ◽  
Evidence Based Practice ◽  
Clinical Findings ◽  
Therapeutic Modality ◽  
Future Research ◽  
Evidence Based ◽  
Clinical Question ◽  
Starting Point

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.

scholarly journals Athletic Training Approved Clinical Instructors' Reports of Real-Time Opportunities for Evaluating Clinical Proficiencies

2009 ◽  
Vol 44 (6) ◽  
pp. 630-638 ◽  
Author(s):  
Kirk J. Armstrong ◽  
Thomas G. Weidner ◽  
Stacy E. Walker
Keyword(s):  
Real Time ◽  
Athletic Training ◽  
Clinical Experience ◽  
Athletic Trainers ◽  
Athletic Training Education ◽  
Demographic Characteristics ◽  
Clinical Instructors ◽  
Content Areas ◽  
Entry Level ◽  
Approved Clinical Instructors

Abstract Context: Appropriate methods for evaluating clinical proficiencies are essential to ensuring entry-level competence in athletic training. Objective: To identify the methods Approved Clinical Instructors (ACIs) use to evaluate student performance of clinical proficiencies. Design: Cross-sectional design. Setting: Public and private institutions in National Athletic Trainers' Association (NATA) District 4. Patients or Other Participants: Approved Clinical Instructors from accredited athletic training education programs in the Great Lakes Athletic Trainers' Association, which is NATA District 4 (N  =  135). Data Collection and Analysis: Participants completed a previously validated survey instrument, Methods of Clinical Proficiency Evaluation in Athletic Training, that consisted of 15 items, including demographic characteristics of the respondents and Likert-scale items (1  =  strongly disagree to 5  =  strongly agree) regarding methods of clinical proficiency evaluation, barriers, educational content areas, and clinical experience settings. We used analyses of variance and 2-tailed, independent-samples t tests to assess differences among ACI demographic characteristics and the methods, barriers, educational content areas, settings, and opportunities for feedback regarding clinical proficiency evaluation. Qualitative analysis of respondents' comments was completed. Results: The ACIs (n  =  106 of 133 respondents, 79.7%) most often used simulations to evaluate clinical proficiencies. Only 59 (55.1%) of the 107 ACIs responding to a follow-up question reported that they feel students engage in a sufficient number of real-time evaluations to prepare them for entry-level practice. An independent-samples t test revealed that no particular clinical experience setting provided more opportunities than another for real-time evaluations (t119 range, −0.909 to 1.796, P ≥ .05). The occurrence of injuries not coinciding with the clinical proficiency evaluation timetable (4.00 ± 0.832) was a barrier to real-time evaluations. Respondents' comments indicated much interest in opportunities and barriers regarding real-time clinical proficiency evaluations. Conclusions: Most clinical proficiencies are evaluated via simulations. The ACIs should maximize real-time situations to evaluate students' clinical proficiencies whenever feasible. Athletic training education program administrators should develop alternative methods of clinical proficiency evaluations.

scholarly journals Use of Evidence-Based Practice Among Athletic Training Educators, Clinicians, and Students, Part 2: Attitudes, Beliefs, Accessibility, and Barriers

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
Keyword(s):  
Clinical Practice ◽  
Athletic Training ◽  
Evidence Based Practice ◽  
Athletic Trainers ◽  
Perceived Barriers ◽  
Successful Implementation ◽  
Evidence Based ◽  
Attitudes And Beliefs ◽  
Athletic Training Educators ◽  
Personal Skills

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.

scholarly journals Student’s Perception On Implementation Of Evidence Based Practice In Clinical Practice

2021 ◽  
pp. 96-109
Author(s):  
Hafidz Triantoro Aji Pratomo
Keyword(s):  
Clinical Practice ◽  
Clinical Setting ◽  
Scientific Literacy ◽  
Speech Therapy ◽  
Clinical Decision Making ◽  
Evidence Based Practice ◽  
Survey Method ◽  
Evidence Based ◽  
Speech Therapist ◽  
Ebp Implementation

Background: Evidence Based Practice (EBP) is an important component in clinical practice of a Speech Therapist. Students can develop critical thinking pattern using credible literature. The sustainable implementation of EBP can improve practical quality of Speech Therapist, particularly in clinical decision making. EBP use in speech therapy clinical setting has been unknown in Indonesia. This research aims to identify the implementation of EBP by speech therapy students in clinical setting. Methods: The respondents employed in this study consisted of 35 students. The research was conducted using survey method. Survey was distributed online using Google form application. Sample comprised last-year students of Speech and Language Therapy Applied Bachelor Study Program. The students were those who have undertaken clinical practice in hospital, clinical, or other healthcare service facilities. Analysis was conducted descriptively with correlational analysis technique. Results: Descriptive analysis shows that students’ perceptions are varying. Inter-variable cororelation was analyzed using correlation test. The result of analysis shows coefficient of correlation (r) > 0.2, meaning that there is a correlation between case experience, EBP level knowledge, knowledge on EBP, speech therapist’s attitude and role, and EBP implementation Conclusion: Survey informs that scientific literacy culture is still weak. This study found the correlation between experience, knowledge, attitude, and EBP implementation. In-depth investigation is required on the different data appearing.

scholarly journals Perceived Outcomes of Web-Based Modules Designed to Enhance Athletic Trainers' Knowledge of Evidence-Based Practice

2014 ◽  
Vol 49 (2) ◽  
pp. 220-233 ◽  
Author(s):  
Cailee E. Welch ◽  
Bonnie L. Van Lunen ◽  
Dorice A. Hankemeier ◽  
Aimee L. Wyant ◽  
Jessica M. Mutchler ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Athletic Training ◽  
Evidence Based Practice ◽  
Athletic Trainers ◽  
Knowledge Gain ◽  
Evidence Based ◽  
Web Based ◽  
Didactic Instruction ◽  
Telephone Interviews ◽  
National Athletic Trainers Association

Context: The release of evidence-based practice (EBP) Web-based learning modules to the membership of the National Athletic Trainers' Association has provided athletic trainers (ATs) the opportunity to enhance their knowledge of the various EBP concepts. Whereas increasing the knowledge of EBP among ATs is important, assessing whether this newfound knowledge is being translated into clinical practice and didactic education is crucial. Objective: To explore the effectiveness of an educational intervention regarding EBP on the didactic instruction patterns of athletic training educators and the clinical practice behaviors of clinicians. Design: Qualitative study. Setting: Individual telephone interviews. Patients or Other Participants: A total of 25 ATs (12 educators, 13 clinicians; experience as an AT = 16.00 ± 9.41 years) were interviewed. Data Collection and Analysis: We conducted 1 individual telephone interview with each participant. After transcription, 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 perceived the EBP Web-based modules to produce numerous outcomes regarding education and clinical practice. These outcomes included perceived knowledge gain among participants, an increase in the importance and scope of EBP, a positive effect on educators' didactic instruction patterns and on instilling value and practice of EBP among students, and an enhanced ability among clinicians to implement EBP within clinical practice. However, some clinicians reported the Web-based modules had no current effect on clinical practice. Conclusions: Although the EBP Web-based modules were successful at enhancing knowledge among ATs, translation of knowledge into the classroom and clinical practice remains limited. Researchers should aim to identify effective strategies to help ATs implement EBP concepts into didactic education and clinical practice.

scholarly journals Feedback in Clinical Education, Part I: Characteristics of Feedback Provided by Approved Clinical Instructors

2014 ◽  
Vol 49 (1) ◽  
pp. 49-57 ◽  
Author(s):  
Sara Nottingham ◽  
Jolene Henning
Keyword(s):  
Athletic Training ◽  
Clinical Education ◽  
National Collegiate Athletic Association ◽  
Athletic Training Education ◽  
Comparative Approach ◽  
Outpatient Rehabilitation ◽  
Clinical Instructors ◽  
Entry Level ◽  
Extensive Field ◽  
Approved Clinical Instructors

Context Providing students with feedback is an important component of athletic training clinical education; however, little information is known about the feedback that Approved Clinical Instructors (ACIs; now known as preceptors) currently provide to athletic training students (ATSs). Objective To characterize the feedback provided by ACIs to ATSs during clinical education experiences. Design Qualitative study. Setting One National Collegiate Athletic Association Division I athletic training facility and 1 outpatient rehabilitation clinic that were clinical sites for 1 entry-level master's degree program accredited by the Commission on Accreditation of Athletic Training Education. Patients or Other Participants A total of 4 ACIs with various experience levels and 4 second-year ATSs. Data Collection and Analysis Extensive field observations were audio recorded, transcribed, and integrated with field notes for analysis. The constant comparative approach of open, axial, and selective coding was used to inductively analyze data and develop codes and categories. Member checking, triangulation, and peer debriefing were used to promote trustworthiness of the study. Results The ACIs gave 88 feedback statements in 45 hours and 10 minutes of observation. Characteristics of feedback categories included purpose, timing, specificity, content, form, and privacy. Conclusions Feedback that ACIs provided included several components that made each feedback exchange unique. The ACIs in our study provided feedback that is supported by the literature, suggesting that ACIs are using current recommendations for providing feedback. Feedback needs to be investigated across multiple athletic training education programs to gain more understanding of certain areas of feedback, including frequency, privacy, and form.

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

2016 ◽  
Vol 51 (1) ◽  
pp. 35-46 ◽  
Author(s):  
Kimberly Keeley ◽  
Stacy E. Walker ◽  
Dorice A. Hankemeier ◽  
Malissa Martin ◽  
Thomas A. Cappaert
Keyword(s):  
Patient Care ◽  
Athletic Training ◽  
Evidence Based Practice ◽  
Athletic Trainers ◽  
Doctoral Degree ◽  
Third Party ◽  
Evidence Based ◽  
Professional Journals ◽  
Ebp Implementation ◽  
Third Party Reimbursement

Context Understanding the beliefs about and use of evidence-based practice (EBP) among athletic trainers (ATs) will help to determine appropriate strategies to improve implementation. Objective To examine the ATs' beliefs about and use of EBP. Design Cross-sectional study. Setting Online survey instrument. Patients or Other Participants A total of 467 ATs responded to the survey request, a response rate of 11.67%. A total of 385 (9.6%) completed the EBP Beliefs Scale and 342 (8.5%) completed the EBP Implementation Scale. Main Outcome Measure(s) The EBP Beliefs Scale and EBP Implementation Scale were administered. The surveys collected demographic information in addition to information about participants' beliefs regarding EBP and implementation of EBP in clinical practice. Results The ATs demonstrated a level of neither agree nor disagree (56.00 ± 7.86) on the EBP Beliefs Scale. Belief scores were higher among those ATs required to document for third-party reimbursement (P = .001), those with access to current research through professional journals other than the Journal of Athletic Training (P = .02), and those with a doctoral degree (P = .01). A low level of implementation (9.00 ± 11.38), representing the implementation of EBP approximately 0 times in the previous 8 weeks, was found on the EBP Implementation Scale. Implementation scores were higher among preceptors (P = .01), those required to document for third-party reimbursement (P < .001), those with access to current research through professional journals (P = .002), and those with a doctoral degree (P = .01). Conclusions Participants had a positive attitude toward EBP; however, they were not implementing EBP concepts when providing patient care. This suggests that additional information and EBP resources are needed so ATs can better implement EBP in practice. To provide the best patient care and to promote EBP within the profession, clinicians should make EBP a priority and advocate for EBP implementation.

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