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

2017 ◽  
Vol 12 (2) ◽  
pp. 121-133 ◽  
Author(s):  
Sarah A. Manspeaker ◽  
Dorice A. Hankemeier

Context: The Board of Certification (BOC) requires 10 continuing education units (CEUs) in evidence-based practice (EBP) each reporting period. It is unknown whether participation in programming in the Foundations category for CEUs results in improved knowledge of and confidence in EBP. Objective: To examine a continuing professional education (CPE) program in relation to perceived knowledge of and confidence in EBP concepts among athletic trainers (ATs) and to determine ATs' perceptions regarding barriers to, use of, and resources for EBP. Design: Mixed-methods, within-subjects design; preintervention-postintervention evaluation of ATs' EBP knowledge and perceptions. Setting: A CPE workshop hosted at 2 Division I universities. Patients or Other Participants: Convenience sample of 123 AT workshop attendees. Intervention(s): Five-hour BOC-approved Foundations of EBP workshop. Main Outcome Measure(s): The Evidence-Based Concepts: Knowledge, Attitudes, and Use survey. The ATs' EBP knowledge was assessed via multiple-choice questions. Descriptive statistics, differences between scores, and correlations were ascertained. Open-ended questions were classified according to common themes and coded. Results: The 11-point knowledge score showed knowledge increased significantly (t = −12.42, P < .001, d = 1.31, 95% confidence interval = −2.41, −1.75) preworkshop (mean = 6.39 ± 1.63) to postworkshop (mean = 8.47 ± 1.55). Confidence in knowledge increased significantly (z = −9.51, P < .001) preworkshop (median = 26) to postworkshop (median = 38). The ATs identified barriers to EBP use as time, resources, environment, and experience in EBP; envisioned use of EBP included implementing patient-reported outcomes and internet resources. Conclusions: This workshop demonstrated improved immediate perceived knowledge and confidence in EBP concepts. Although a larger number of clinical EBP programs have been approved by the BOC, Foundations of EBP programming is valuable for CEU opportunities to narrow the gap regarding EBP knowledge. Future investigations may evaluate transference of EBP knowledge into professional practice.

2018 ◽  
Vol 13 (3) ◽  
pp. 239-247 ◽  
Author(s):  
Sarah A. Manspeaker ◽  
Dorice A. Hankemeier

Context: To maintain certification, athletic trainers (ATs) are required to obtain continuing education units (CEUs) in the area of evidence-based practice (EBP). Longitudinal analysis of outcomes after attending a Board of Certification–approved Foundations of EBP course is lacking. Objective: To evaluate ATs' knowledge retention of and confidence in EBP concepts 12 months after a Foundations of EBP course. A secondary aim was to determine ATs' perceptions regarding barriers to, use of, and resources for EBP. Design: Repeated measures within-subjects survey. Setting: Online survey. Patients or Other Participants: Twenty-seven respondents (22% response rate) from a convenience sample of 123 ATs. Intervention(s): Board of Certification–approved Foundations of EBP category workshop. Main Outcome Measure(s): The survey instrument, Evidence-Based Concepts: Knowledge, Attitudes, and Use (EBCKAU), ascertained ATs' perceived EBP knowledge over a 12-month period. Descriptive statistics and correlations were calculated; repeated measures analysis of variance determined differences between scores. Responses to open-ended questions were catalogued according to themes and coded. Results: For the knowledge score, a statistically significant increase in perceived knowledge (F2.0,52.0 = 18.91, P < .001) from preworkshop (6.40 ± 1.77) to immediately postworkshop (8.15 ± 1.51) and from before to 12 months after workshop (7.30 ± 1.64) was noted. Confidence in knowledge was statistically significantly different over time (z = −4.55, P < .001). Both before and since the workshop, ATs reported low levels of incorporating patient-reported outcome measures (PROM) and were equally likely to use compilation research findings in their clinical practice. Barriers of time and available resources were identified, and patient care was reported as the primary area in which ATs envision future use of EBP. Conclusions: Athletic trainers improved immediate perceived knowledge and retained knowledge of EBP concepts over time; however, confidence in knowledge decreased over time. ATs did not implement the workshop concepts into their daily clinical 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.


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.


Author(s):  
Vilanice Alves de Araújo Püschel ◽  
Larissa Bertacchini de Oliveira ◽  
Eduardo Tavares Gomes ◽  
Kelli Borges dos Santos ◽  
Fábio da Costa Carbogim

ABSTRACT Objective: To present the JBI evidence implementation methodology and report the Brazilian experience in educating health professionals. Method: This is an experience report on professional education in the Brazilian context as per the JBI methodology. Results: In four years, 29 clinical fellows were trained in Brazil, with technical and scientific theoretical bases and tools for evidence-based practice, focusing on the transformation of the health contexts in which they are inserted. Conclusion: The JBI methodology offers systems and tools to evaluate existent practices; it also reinforces and disseminates evidence-based healthcare, potentializing the achievement of effective change in healthcare.


Author(s):  
Liang Fu ◽  
Wei Su ◽  
Xianghong Ye ◽  
Ming Li ◽  
Jun Shen ◽  
...  

This study aimed to describe the status and related factors of evidence-based practice (EBP) competency among nurses in China. A convenience sample of 1036 nurses were recruited from 13 public hospitals in Shanghai through an anonymous online survey. Nurses’ demographic data, working data, and evidence-based nursing (EBN)-related conditions were collected by a structured questionnaire and EBP competency was assessed using the Chinese version of Evidence-based Nursing Competency Rating Scale (EBNCRS). The original score of EBNCRS among nurses was not good. The original score of evidence searching, critical appraisal, and synthesis subscale was lower than the original score of evidence transfer, situation assessment, and evidence implementation subscale. Nurses’ age, hospital level, and perceived EBN knowledge were identified as significant related factors of EBP competency. There is an urgent need to upgrade the EBP competency of nurses in Shanghai, especially competency in evidence transfer, situation assessment, and evidence implementation.


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 ◽  
...  

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.


2018 ◽  
Vol 24 (3) ◽  
pp. 103-108 ◽  
Author(s):  
Elaine Lehane ◽  
Patricia Leahy-Warren ◽  
Cliona O’Riordan ◽  
Eileen Savage ◽  
Jonathan Drennan ◽  
...  

Internationally, evidence-based practice (EBP) is recognised as a foundational element of healthcare professional education. Achieving competency in this area is a complex undertaking that is reflected in disparities between ‘best EBP’ and actual clinical care. The effective development and implementation of professional education to facilitate EBP remains a major and immediate challenge. To ascertain nuanced perspectives on the provision of EBP education internationally, interviews were conducted with five EBP education experts from the UK, Canada, Australia and New Zealand. Definitive advice was provided in relation to (1) EBP curriculum considerations, (2) teaching EBP and (3) stakeholder engagement in EBP education. While a considerable amount of EBP activity throughout health profession education is apparent, effectively embedding EBP throughout curricula requires further development, with a ‘real-world’ pragmatic approach that engenders dialogue and engagement with all stakeholders required.


2020 ◽  
Vol 8 (4_suppl3) ◽  
pp. 2325967120S0024
Author(s):  
Tamara Valovich McLeod ◽  
Nicholas Hattrup ◽  
Hayley J. Root

Background: Recent recommendations suggest incorporating patient-report outcome measures (PROMs) into concussion assessment batteries. Utilizing PROMs provides information on the patient’s perspective and how the concussion may influence the patient’s health status. Past studies evaluating PROM use among athletic trainers (ATs) found varying practices and barriers to implementation. However, there is limited data on use of PROMs in managing concussion among adolescent patients. Hypothesis/Purpose: To describe the use of PROMs as part of concussion assessment and treatment practices of ATs working in middle and high school settings. Methods: An online survey regarding concussion treatment perceptions and practices was distributed to a convenience sample of 5000 ATs through the NATA Survey Research Program. The survey included personal and institutional demographics, healthcare provider access and referral practices, perceptions of concussion treatment, clinical practice characteristics of concussion treatment and PROM use. The survey was pilot tested and validated in a sample of ATs prior to distribution. Analysis of the PROM section was conducted using descriptive statistics (percentages, frequencies) for this study. Results: The survey was accessed by 304 ATs (6.1% access rate) and completed by 153 ATs (58.3% completion rate). Of those, 27.2% (n=57) were employed in the middle school or high school setting and were analyzed for this study. Just over half of respondents had <10 years of experience (52.7%, n=30). Only 35.1% (n=20) of ATs reported they use PROMs as part of their clinical management of concussion. Of those who use PROMs, 75% (n=15) indicated that they use them always or almost always. The most commonly used generic PROMs were the Short Form 12 or 36 (25%, n=5) and Patient Reported Outcomes Measurement Information System (25%, n=5) and the most common specific PROMs were the Headache Impact Test (45%, n=9) and Dizziness Handicap Inventory (15%, n=3). Figure 1 shows the level of self-reported confidence of those utilizing PROMs. Barriers for PROM use included it being too time consuming (24.6%, n=14/57), lacking a support structure (15.8%, n=9/57), and not familiar with PROMs (14%, n=8/57). Close to one-fourth (22.8%, n=13/57) of respondents would be willing to use PROMs, but lacked time. Conclusion: While the use of PROMs is recommended in the evaluation and treatment of adolescent athletes, just over one-third of ATs providing care to these patients, use PROMs. Educational efforts for ATs should look to increase their familiarity and confidence when using PROMs for concussion while suggesting strategies to incorporate PROMs into practice. [Figure: see text]


2013 ◽  
Vol 48 (3) ◽  
pp. 394-404 ◽  
Author(s):  
Dorice A. Hankemeier ◽  
Jessica M. Walter ◽  
Cailee W. McCarty ◽  
Eric J. Newton ◽  
Stacy E. Walker ◽  
...  

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% ± 1.29%) and mild to moderate confidence (2.71 ± 0.55 out of 4.0). They valued EBP as moderately to extremely important (3.49 ± 0.41 out of 4.0). Perceived importance scores differed among roles (clinicians unaffiliated with an education program scored lower than postprofessional educators, P = .001) and highest educational degree attained (athletic trainers with terminal degrees scored higher than those with bachelor's or master's degrees, P &lt; .001). Postprofessional athletic training students demonstrated the highest total EBP knowledge scores (4.65 ± 0.91), whereas clinicians demonstrated the lowest scores (3.62 ± 1.35). Individuals with terminal degrees had higher (P &lt; .001) total knowledge scores (4.31 ± 1.24) than those with bachelor's (3.78 ± 1.2) or master's degrees (3.76 ± 1.35). Postprofessional educators demonstrated greater confidence in knowledge scores (3.36 ± 0.40 out of 4.0) than did those in all other athletic training roles (P &lt; .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.


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