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.

The Clinical Practice Model for Persons with Dementia: Application to Music Therapy

2021 ◽  
Author(s):  
Alaine E Reschke-Hernández
Keyword(s):  
Clinical Practice ◽  
Music Therapy ◽  
Behavioral Interventions ◽  
Clinical Decision Making ◽  
Evidence Based Practice ◽  
Intervention Development ◽  
Well Being ◽  
Future Research ◽  
Evidence Based ◽  
Practice Model

Abstract Currently, no drug can cure or effectively mitigate symptoms for the growing number of individuals who live with Alzheimer’s disease and related dementias. As they experience declines in memory, communication, and thinking—symptoms that undermine social initiative, autonomy, and well-being—these individuals become increasingly dependent on others. Evidence regarding the benefits of music therapy for persons with dementia is growing. Nonetheless, limitations in existing research have hindered knowledge regarding the use and appropriate application of music as a form of treatment with this population. This article describes the development of The Clinical Practice Model for Persons with Dementia, which provides a theoretical framework to inform evidence-based practice, illustrated here in application to music therapy. Specifically, the model is intended to prompt purposeful application of strategies documented within a broad literature base within 6 thematic areas (Cognition, Attention, Familiarity, Audibility, Structure, and Autonomy); facilitate clinical decision-making and intervention development, including music interventions; and encourage discourse regarding relationships between characteristics of the intervention, the therapist, the person with dementia, and their response to intervention. The model comprises a set of testable assumptions to provide direction for future research and to facilitate the description and investigation of mechanisms underlying behavioral interventions with this population. Although the model is likely to evolve as knowledge is gained, it offers a foundation for holistically considering an individual’s needs and strengths, guidance for applying music and nonmusic strategies in evidence-based practice, and direction for future research.

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.

Mapping similarities and differences to progress mutual understanding and dialogue: A comparison and contrast of evidence-based practice and person-centered healthcare

2018 ◽  
Vol 6 (3) ◽  
pp. 462
Author(s):  
James Marcum
Keyword(s):  
Medical Education ◽  
Clinical Practice ◽  
Common Ground ◽  
Evidence Based Practice ◽  
Integrated Approach ◽  
Mutual Understanding ◽  
Evidence Based ◽  
Quality Healthcare ◽  
Starting Point ◽  
Similarities And Differences

Evidence-based practice and person-centered healthcare are often seen as opposing approaches to clinical practice. And yet both offer advantages to providing quality healthcare. In this paper, both approaches to clinical practice are analyzed and mapped philosophically by comparing and contrasting their key foundational principles. The goal is to progress the dialogue between them in order to determine whether a common ground exists in which they might be integrated and how best to operationalize, both clinically and pedagogically, an integrated approach. To that end, key principles undergirding them are enumerated and then integrated by shifting the focus from evidence to the person - whether patient or clinician - for the delivery of quality healthcare. In this way, person-centered healthcare provides the optimal starting point for framing evidence-based practice. Next, operationalizing the integrated approach to clinical practice and medical education is addressed. Finally, the root of modern healthcare must be a person’s, whether patient’s or clinician’s, dignity. For the goal of healthcare is to relieve suffering associated with illness, whether that involves curing a disease or not and not adding to the suffering associated with illness.

scholarly journals Dietetic interns’ perceptions and use of evidence-based practice: an exploratory study

2018 ◽  
Vol 106 (1) ◽  
Author(s):  
Rachel J. Hinrichs
Keyword(s):  
Clinical Practice ◽  
Focus Group ◽  
Exploratory Study ◽  
Evidence Based Practice ◽  
Group Discussion ◽  
Future Research ◽  
Evidence Based ◽  
Clinical Rotations ◽  
Focus Group Data ◽  
Dietetic Interns

Objective: This study explored dietetic interns’ perceptions and knowledge of evidence-based practice (EBP), their use and observation of EBP principles during their clinical rotations, and their intentions to use EBP in their careers.Methods: A mixed methods design combining a survey and focus group was employed. Dietetic interns (n=16) from a large Midwestern university were recruited in person and via email to participate in the survey, focus group, or both. Perceptions and experiences of EBP were analyzed through the focus group (qualitative), and EBP knowledge and clinical practice behaviors were analyzed through the survey (quantitative). The focus group discussion was recorded, transcribed, and analyzed using thematic analysis.Results: Four major themes emerged from the focus group data: (1) observations of EBP in clinical practice, (2) use of EBP during clinical rotations, (3) barriers to EBP, and (4) perceived use of EBP as future registered dietitians. Interns considered EBP important for their profession and future careers. They struggled, however, with the discrepancies between current research and practice, and highlighted differences that they observed and barriers that they experienced across different clinical settings.Conclusions: This exploratory study is the first to examine dietetic interns’ perceptions of and experiences with EBP in the clinical setting. Future research is needed to identify how dietetics educators, librarians, and preceptors can address the barriers that interns perceive in applying EBP in their internships.

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 Current Literature Summary

2011 ◽  
Vol 6 (2) ◽  
pp. 121-123
Author(s):  
Jennifer Doherty-Restrepo
Keyword(s):  
Health Care ◽  
Clinical Practice ◽  
Athletic Training ◽  
Research Evidence ◽  
Evidence Based Practice ◽  
Evidence Based ◽  
Health Care Decisions ◽  
Reform Legislation ◽  
Cost Of Health Care ◽  
The Cost

Evidence-based practice collectively involves research evidence, clinician expertise, and patient preference while making health care decisions. Due to health care reform legislation, there is greater emphasis on evidence-based practice as a means for improving the quality, and lowering the cost, of health care. Principles of evidence-based practice must be integrated into athletic training curricula for students to develop the skill set of accessing, understanding, and evaluating research to appropriately apply evidence–based procedures in clinical practice. We will provide brief synopses of current research related to teaching evidence-based practice and discuss possible applications to athletic training.

scholarly journals Preparing entry-level practitioners for evidence-based practice

2005 ◽  
Vol 26 (1) ◽  
pp. 13 ◽  
Author(s):  
Michelle Villeneuve ◽  
Suzanne Maranda
Keyword(s):  
Literature Search ◽  
Critical Appraisal ◽  
Evidence Based Practice ◽  
Occupational Therapists ◽  
Background Information ◽  
Evidence Based ◽  
Clinical Question ◽  
Entry Level ◽  
Effective Strategies ◽  
Clinical Conditions

The authors report on a collaborative instructional method used to prepare entry-level practitioners with strategies for systematically employing an evidence-based practice process as an approach to clinical inquiry, while acknowledging the students' shortage of clinical experience and knowledge of critical appraisal. Challenges to evidence-based practice can be categorized as difficulties in obtaining evidence, analyzing evidence, and transferring evidence into practice decisions. For student occupational therapists, additional challenges are encountered as they seek to fill gaps in their knowledge about client-centred occupational therapy (OT) practice, acquire necessary background information regarding clinical conditions, and formulate a clinical question. Students need to develop literature search skills and learn effective strategies to locate appropriate information to answer the clinical question. This paper will encourage OT faculty to begin a dialogue with librarian colleagues at their institution to develop an evidence-based approach to the teaching of both the clinical inquiry and the literature search process.

scholarly journals The art and craft of scientific writing and critical appraisal of a research paper

2017 ◽  
Vol 4 (1) ◽  
pp. 23-28
Author(s):  
Bikal Ghimire
Keyword(s):  
Clinical Practice ◽  
Critical Appraisal ◽  
Evidence Based Practice ◽  
Research Paper ◽  
Scientific Writing ◽  
Research Articles ◽  
Evidence Based ◽  
Online Publishing ◽  
Art Form

Writing is an art and like any art form, it needs perseverance, dedication and practice. However, to write a good quality paper, the habit of reading scientific articles and analyzing them is very important. With the advent of internet and online publishing, we have access to colossal research articles on myriads of subjects making extraordinary conclusions.  Evidence based practice requires us to rely on literature for our clinical practice, and we have abundant publications on all aspects claiming to justify all sides of the argument. In this context it becomes more important for all in clinical practice to be able to dissect an article and analyze it in details.

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.

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