Implementation of Evidence-Based Practice Concepts in Undergraduate Athletic Training Education: Experiences of Select Educators

2010 ◽  
Vol 5 (2) ◽  
pp. 51-60 ◽  
Author(s):  
Sarah A. Manspeaker ◽  
Bonnie Van Lunen
Keyword(s):  
Athletic Training ◽  
Evidence Based Practice ◽  
Athletic Training Education ◽  
Evidence Based ◽  
Clinical Practices ◽  
Student Activities ◽  
Teaching Objectives ◽  
Athletic Training Educators ◽  
Based Instruction ◽  
Emergent Design

Context: Professional athletic training education must transition toward instruction of evidence-based practice in order to maintain progress with other health professions' clinical practices and educational standards. Objective: To evaluate athletic training educators' experience with implementation of evidence-based practice concepts in CAATE accredited professional athletic training education programs in order to establish the current state of instructional approaches and incorporation of evidence-based practice concepts. Design and Setting: Interviews of emergent design and modified-grounded theory. Instructors currently teaching at 11 undergraduate institutions were interviewed regarding their experience and perceptions of teaching evidence-based concepts. Participants: Eleven educators (3 males, 8 females; average [SD] years teaching 14.73 [7.06]) were interviewed to evaluate their implementation of evidence-based concepts within their courses. Measure(s): Instructors' experiences regarding teaching of these concepts was explored qualitatively through coding by the researcher. Established categories were triangulated and member checked to establish trustworthiness of the findings. Results: The analysis determined that instructors have three primary approaches to evidence-based practice concept implementation within their programs: curricular emphasis, teaching strategies, and student activities. Analysis also revealed that teaching objectives for concept implementation transcended the cognitive levels of Bloom's revised taxonomy. Conclusions: Athletic training educators should be creative in how they implement EBP within their programs and share their experience with the profession. The teaching objectives, strategies, and activities presented should provide other educators with a foundation to initiate evidence-based instruction. Educating the future of our profession in EBP concepts will promote critical thinking, potential research interest, and further development of the available body of knowledge of our growing clinical practice.

scholarly journals Incorporating Foundational Evidence-Based Practice Concepts and Skills Across an Athletic Training Education Program

2010 ◽  
Vol 5 (3) ◽  
pp. 119-125 ◽  
Author(s):  
Lisa S. Jutte ◽  
Stacy E. Walker
Keyword(s):  
Athletic Training ◽  
Medical Practice ◽  
Education Program ◽  
Evidence Based Practice ◽  
Athletic Training Education ◽  
Evidence Based ◽  
Athletic Training Educators ◽  
Clinical Advantage

Objective: The purpose of this article is to provide an example of how to develop and implement an evidence-based practice (EBP) concepts and skills plan in an athletic training education program (ATEP). Background: Evidence-based practice is an integral part of medical practice today. As stated in the Athletic Training Educational Competencies 4th edition, athletic training educators are expected to develop their students' abilities to engage in EBP. However, foundational concepts and skills are needed to effectively practice EBP. Description: To eliminate redundancy and better prepare our students for EBP, a plan based on incorporating foundational concepts and skills concepts in small, sequential doses in our ATEP was devised and implemented. Clinical Advantage(s): Exposure to foundational EBP concepts and skills is necessary for students to actively engage in EBP. Conclusion(s): Despite the challenges for both students and faculty, the plan ensures we expose our students to EBP concepts and skills, therefore better enabling them to engage in EBP.

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.

scholarly journals Overcoming Barriers to Implementation of Evidence-Based Practice Concepts in Athletic Training Education: Perceptions of Select Educators

2011 ◽  
Vol 46 (5) ◽  
pp. 514-522 ◽  
Author(s):  
Sarah Manspeaker ◽  
Bonnie Van Lunen
Keyword(s):  
Decision Making ◽  
Athletic Training ◽  
Evidence Based Practice ◽  
Athletic Training Education ◽  
Evidence Based ◽  
Clinical Practices ◽  
Education Programs ◽  
Entry Level ◽  
Starting Point ◽  
Barriers To Implementation

Context: The need to include evidence-based practice (EBP) concepts in entry-level athletic training education is evident as the profession transitions toward using evidence to inform clinical decision making. Objective: To evaluate athletic training educators' experience with implementation of EBP concepts in Commission on Accreditation of Athletic Training Education (CAATE)-accredited entry-level athletic training education programs in reference to educational barriers and strategies for overcoming these barriers. Design: Qualitative interviews of emergent design with grounded theory. Setting: Undergraduate CAATE-accredited athletic training education programs. Patients or Other Participants: Eleven educators (3 men, 8 women). The average number of years teaching was 14.73 ± 7.06. Data Collection and Analysis: Interviews were conducted to evaluate perceived barriers and strategies for overcoming these barriers to implementation of evidence-based concepts in the curriculum. Interviews were explored qualitatively through open and axial coding. Established themes and categories were triangulated and member checked to determine trustworthiness. Results: Educators identified 3 categories of need for EBP instruction: respect for the athletic training profession, use of EBP as part of the decision-making toolbox, and third-party reimbursement. Barriers to incorporating EBP concepts included time, role strain, knowledge, and the gap between clinical and educational practices. Suggested strategies for surmounting barriers included identifying a starting point for inclusion and approaching inclusion from a faculty perspective. Conclusions: Educators must transition toward instruction of EBP, regardless of barriers present in their academic programs, in order to maintain progress with other health professions' clinical practices and educational standards. Because today's students are tomorrow's clinicians, we need to include EBP concepts in entry-level education to promote critical thinking, inspire potential research interest, and further develop the available body of knowledge in our growing clinical practice.

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.

Athletic Training Educators' Knowledge, Comfort, and Perceived Importance of 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 ◽  
...  
Keyword(s):  
Athletic Training ◽  
Predictive Value ◽  
Online Survey ◽  
Evidence Based Practice ◽  
Current Knowledge ◽  
Evidence Based ◽  
Convenience Sample ◽  
Athletic Training Educators ◽  
Perceived Importance ◽  
Terminal Degree

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.

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

2013 ◽  
Vol 48 (3) ◽  
pp. 394-404 ◽  
Author(s):  
Dorice A. Hankemeier ◽  
Jessica M. Walter ◽  
Cailee W. McCarty ◽  
Eric J. Newton ◽  
Stacy E. Walker ◽  
...  
Keyword(s):  
Athletic Training ◽  
Online Survey ◽  
Evidence Based Practice ◽  
Athletic Trainers ◽  
Cross Sectional Study ◽  
Evidence Based ◽  
Cross Sectional ◽  
Master's Degrees ◽  
Athletic Training Educators ◽  
Perceived Importance

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 < .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 < .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 < .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.

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.

Evidence-Based Practice & Practice-Based Evidence Applied to Adult, Medical Speech-Language Pathology

2013 ◽  
Vol 18 (1) ◽  
pp. 14-26 ◽  
Author(s):  
Rik Lemoncello ◽  
Bryan Ness
Keyword(s):  
Evidence Based Practice ◽  
Single Case ◽  
Quality Data ◽  
Evidence Based ◽  
Speech Language Pathology ◽  
Clinical Practices ◽  
High Quality ◽  
Randomized Controlled Clinical Trials ◽  
Relative Paucity ◽  
Language Pathology

In this paper, we review concepts of evidence-based practice (EBP), and provide a discussion of the current limitations of EBP in terms of a relative paucity of efficacy evidence and the limitations of applying findings from randomized controlled clinical trials to individual clinical decisions. We will offer a complementary model of practice-based evidence (PBE) to encourage clinical scientists to design, implement, and evaluate our own clinical practices with high-quality evidence. We will describe two models for conducting PBE: the multiple baseline single-case experimental design and a clinical case study enhanced with generalization and control data probes. Gathering, analyzing, and sharing high-quality data can offer additional support through PBE to support EBP in speech-language pathology. It is our hope that these EBP and PBE strategies will empower clinical scientists to persevere in the quest for best practices.

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