scholarly journals Knowledge Translation in Athletic Training: Considerations for Bridging the Knowledge-to-Practice Gap

2021 ◽  
Author(s):  
Cailee E. Welch Bacon ◽  
Alicia M. Pike Lacy ◽  
Kenneth C. Lam
Keyword(s):  
Clinical Practice ◽  
Knowledge Translation ◽  
Athletic Training ◽  
Patient Outcomes ◽  
Athletic Trainers ◽  
Educational Interventions ◽  
Evidence Based ◽  
Quality Patient Care ◽  
Knowledge Translation Strategies ◽  
Practice Gap

Abstract As the athletic training profession continues to embrace evidence-based practice, athletic trainers should not only critically appraise the best available evidence, but also effectively translate it into clinical practice to optimize patient outcomes. While previous research has investigated the effectiveness of educational interventions on increasing knowledge of critical appraisal of evidence, little attention has been given to strategies for both researchers and clinicians to effectively translate evidence into clinical practice. The use of knowledge translation strategies has potential to bridge the knowledge-to-practice gap, which could lead to reduced health costs, improved patient outcomes, and enhanced quality of care. The purpose of this paper is to 1) highlight current challenges prohibiting successful translation of evidence into practice, 2) discuss knowledge translation and describe conceptual frameworks behind effectively translating evidence into practice, and 3) identify considerations for athletic trainers as they continue to provide high quality patient care in an evidence-based manner.

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 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 Integrating Clinical Prediction Rules Throughout the Curriculum

2018 ◽  
Vol 13 (1) ◽  
pp. 49-56
Author(s):  
Dorice A. Hankemeier ◽  
Jessica L. Kirby
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Clinical Practice ◽  
Athletic Training ◽  
Athletic Trainers ◽  
Evidence Based ◽  
Clinical Prediction ◽  
Health Care Environment ◽  
Clinical Prediction Rules ◽  
Prediction Rules

Context: Knowledge and understanding of how to evaluate and implement clinical prediction rules (CPRs) is necessary for athletic trainers, but there is a lack of information on how to best teach students about CPRs. Objective: To provide an overview of the derivation, validation, and analysis of the different types of CPRs and to provide examples and strategies on how to best implement CPRs throughout didactic and clinical athletic training curricula. Background: Clinical prediction rules are used in a variety of health care professions to aid in providing patient-centered care in diagnosis or intervention. Previous research has identified that many athletic trainers have a limited knowledge of CPRs and often do not implement them in clinical practice even if they do know about them. Using these evidence-based decision-making tools can help improve patient outcomes while also decreasing unnecessary medical costs. Description: This article discusses the derivation and validation of CPRs as well as how to implement the concepts of CPRs in multiple courses to allow students numerous opportunities to understand how CPRs can be beneficial. Clinical Advantage(s): Teaching students how to critically analyze CPRs and understand the derivation process of CPRs will develop students' decision-making skills and encourage students to be evidence-based clinicians. In addition, the teaching strategies described here aim to create dialogue between students and preceptors regarding evidence-based practice concepts. Conclusion(s): Athletic trainers must be able to function in the larger health care environment, and understanding how to correctly evaluate and apply CPRs will be helpful. Teaching students a variety of CPRs and how to evaluate their impact on clinical practice will prepare students to step into this role when they become independent clinicians.

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

2014 ◽  
Vol 49 (2) ◽  
pp. 234-244 ◽  
Author(s):  
Cailee E. Welch ◽  
Dorice A. Hankemeier ◽  
Aimee L. Wyant ◽  
Danica G. Hays ◽  
William A. Pitney ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Patient Care ◽  
Athletic Training ◽  
Health Care Professionals ◽  
Evidence Based Practice ◽  
Improve Patient Care ◽  
Educational Interventions ◽  
Successful Implementation ◽  
Evidence Based ◽  
Training Experience

Context: The shift to a culture of evidence-based practice (EBP) in athletic training is a necessary step in both the optimization of patient care and the advancement of athletic trainers (ATs) as health care professionals. Whereas individuals have gained knowledge in this area, most ATs still are not practicing in an evidence-based manner. Exploring perceived strategies to enhance the use of EBP will help to determine the best approaches to assist ATs in applying EBP concepts to practice to improve patient care. Objective: To explore beneficial strategies and techniques ATs perceived would promote successful implementation of EBP within athletic training education and clinical practice. Design: Qualitative study. Setting: Individual telephone interviews. Patients or Other Participants: Twenty-five ATs (12 educators, 13 clinicians; athletic training experience = 16.00 ± 9.41 years) were interviewed. Data Collection and Analysis: One phone interview was conducted with each participant. After the interview was transcribed, 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 identified several components they perceived as essential for enhancing the use of EBP within the athletic training profession. These components included the need for more EBP resources, more processed information, focused workshops, peer discussion and mentorship, and continual repetition and exposure. Participants also indicated that ATs need to accept their professional responsibilities to foster EBP in their daily practices. Conclusions: The proper shift to a culture of EBP in athletic training will take both time and a persistent commitment by ATs to create strategies that will enhance the implementation of EBP across the profession. Researchers should focus on continuing to identify effective educational interventions for ATs and to determine successful strategies to implement EBP into didactic curricula and clinical practice. Additional focus should be given to which strategies most effectively produce changes in clinical practice.

A Knowledge Translation Framework for Optimizing Physical Therapy in Patients With Heart Failure

2021 ◽  
Author(s):  
Konrad J Dias ◽  
Michael J Shoemaker ◽  
Kristin M Lefebvre ◽  
John D Heick
Keyword(s):  
Heart Failure ◽  
Clinical Practice ◽  
Physical Therapy ◽  
Knowledge Translation ◽  
Cardiorespiratory Fitness ◽  
Practice Guideline ◽  
Physical Therapist ◽  
Evidence Based ◽  
Patients With Heart Failure ◽  
The Continuum

Abstract The American Physical Therapy Association (APTA) has supported the development of clinical practice guidelines to promote and support evidence-based practice and reduce unwarranted practice variation. Essential to the success of this effort is the generation of knowledge translation—a concept that emphasizes the translation of global knowledge to an application that can be effectively integrated into clinical practice. The Physical Therapy Clinical Practice Guideline for the Management of Individuals with Heart Failure published in the Physical Therapy Journal in January 2020 provides a broad base of knowledge related to evidence-based treatment interventions for patients with heart failure. However, the application and integration of this knowledge in clinical practice need further elucidation. Therefore, this perspective paper aims to serve as a complementary knowledge translation resource to the recently published practice guideline to maximize the utilization of contemporary evidence in clinical practice. This resource provides the physical therapist with practical guidance in the management of patients with heart failure by placing research findings in the context of other knowledge and practice norms that can be applied at the point of care and across the continuum of care. We propose a novel ABCDE (Assessment, Behavior, Cardiorespiratory Fitness, Dosage, and Education) practical framework. This clinical paradigm is grounded in ongoing physical therapist assessment throughout the episode of care, along with behavior modification, assessment of cardiorespiratory fitness, appropriate selection and dosing of interventions and patient education. Examples highlighting the use of this model in patients with heart failure across the continuum of care are provided for application in clinical care.

scholarly journals Teaching Dermatology Using a Cognitive Learning Theory Approach: An Educational Technique

2021 ◽  
Vol 16 (4) ◽  
pp. 300-306
Author(s):  
Sarah A. Manspeaker ◽  
Alison N. Wix
Keyword(s):  
Clinical Practice ◽  
Athletic Training ◽  
Learning Theory ◽  
Disease Transmission ◽  
Clinical Decision Making ◽  
Athletic Trainers ◽  
Cognitive Learning ◽  
Theory Approach ◽  
Cognitive Learning Theory ◽  
Educational Technique

Context Athletic trainers must develop the knowledge and skills to recognize signs and symptoms of dermatologic conditions in the physically active population. Objective To present an overview of an educational technique aimed at promoting the development of skills related to dermatological care that meets clinical practice needs and accreditation requirements for athletic training programs at all levels. Background Curricular content standards in athletic training education require learners to obtain the skills necessary to perform an evaluation, formulate a diagnosis, and establish a plan of care relevant to the integumentary system, including dermatological conditions. Cognitive Learning Theory uses specific sequencing of content and learning sessions to promote student engagement in the learning process. Description Within an evaluation course for nonorthopaedic conditions, a 3–class session learning module was developed to target instruction, application, and assessment of dermatological conditions. This article describes the development, overview of content, delivery methods, outcomes to date, and connection to the instructional standards in athletic training. Clinical Advantage(s) Integrating evaluation of dermatological conditions into athletic training curricula enhances clinical decision-making skills and direct application of these skills to clinical practice. Conclusion(s) Athletic trainers should be able to effectively identify, manage, and potentially refer patients with dermatological conditions. Educating future athletic trainers to be able to prevent the spread of infection, decrease disease transmission, and enhance their ability to recognize and manage dermatological conditions is vital to their development toward independent clinical practice.

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.

Using a health improvement methodology to standardise leg ulcer management

2020 ◽  
Vol 25 (Sup9) ◽  
pp. S20-S25
Author(s):  
Kirsten Mahoney ◽  
Wendy Simmonds
Keyword(s):  
Clinical Practice ◽  
Patient Outcomes ◽  
Best Practice ◽  
Leg Ulcer ◽  
Health Improvement ◽  
Evidence Based ◽  
Leg Ulcers ◽  
Venous Leg Ulcers ◽  
Poor Patient ◽  
Pdsa Cycle

Despite guidelines, best-practice statements and CQUIN targets, venous leg ulcers have been highlighted as an area that continues to demonstrate lack of evidence-based practice and variation in practice, which contribute to poor patient outcomes and escalating costs. Leg ulcer services that use a systematic and standardised approach to leg ulcer management are highly successful in improving healing rates, preventing recurrence and contributing to patients' wellbeing. This article seeks to explore the use of the plan-do-study-act (PDSA) cycle in clinical practice to improve and standardise leg ulcer management.

scholarly journals Future Strategies to Enhance Patient Care Documentation Among Athletic Trainers: A Report From the Athletic Training Practice-Based Research Network

2018 ◽  
Vol 53 (6) ◽  
pp. 619-626 ◽  
Author(s):  
Cailee E. Welch Bacon ◽  
Tricia M. Kasamatsu ◽  
Kenneth C. Lam ◽  
Sara L. Nottingham
Keyword(s):  
Patient Care ◽  
Athletic Training ◽  
Athletic Trainers ◽  
School Setting ◽  
Research Network ◽  
High Quality ◽  
Quality Patient Care ◽  
Quality Of Patient Care ◽  
Practice Based Research ◽  
Enhance Patient Care

Context:  High-quality patient care documentation is an essential component of any health care professional's daily practice. Whereas athletic trainers (ATs) recognize the importance of patient care documentation, several barriers may prevent them from producing high-quality patient care documentation. Objective:  To explore beneficial strategies and techniques that ATs perceived would enhance the quality of patient care documentation in the secondary school setting. Design:  Qualitative study. Setting:  Individual telephone interviews. Patients or Other Participants:  Ten ATs who were members of the Athletic Training Practice-Based Research Network and employed in the secondary school setting were interviewed (4 men, 6 women with 7.1 ± 7.8 years of athletic training experience). Data Collection and Analysis:  An individual telephone interview was conducted with each participant. Once transcribed, data were analyzed into common themes and categories per the consensual qualitative research tradition. Trustworthiness of the data was achieved through triangulation strategies: (1) the inclusion of multiple researchers to ensure accuracy and representativeness of the data and (2) participant member checking. Results:  Participants identified several documentation strategies they perceived would be helpful to improve the quality of patient care documentation, including mode and consistency of documentation and the need for a standardized process as well as the need for system standardization. In addition, participants discussed the need for more education on patient care documentation. Specifically, they identified ways of learning and strategies for future education to enhance patient care documentation across the profession. Conclusions:  As athletic training continues to evolve, it is crucial that ATs are well educated on how to produce high-quality patient care documentation as a part of routine practice. Continuing professional development opportunities are needed to promote lifelong learning in the area of patient care documentation.

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