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.

Integrating Evidence-Based Practice in Athletic Training

2017 ◽  
pp. 1368-1378
Author(s):  
Brittany A. Vorndran ◽  
Michelle Lee D'Abundo
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Continuing Education ◽  
Athletic Training ◽  
Health Care Professional ◽  
Clinical Decision Making ◽  
Evidence Based Practice ◽  
Athletic Trainers ◽  
Clinical Decision ◽  
Evidence Based

Evidence-based practice (EBP) involves a health care professional using his or her own knowledge, the current research published, and the needs of the patient to make the best clinical decision. This has been a hot topic in many different branches of healthcare and recently athletic trainers have begun to embrace its importance. In December of 2015, athletic trainers (ATs) will need to have completed ten of their fifty continuing education units (CEUs) in EBP to maintain certification. While ATs recognize the significance of implementing EBP into clinical decision making, there are many barriers slowing the change. This chapter includes information about how EBP is currently being used by athletic training clinicians and educators, the barriers ATs perceive to using EBP, the importance of using EBP, and managing the transition needed to successfully adopt the use of EBP.

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.

Health Literacy: A Brief Primer for the Otolaryngologist

2016 ◽  
Vol 156 (3) ◽  
pp. 395-396 ◽  
Author(s):  
Uchechukwu C. Megwalu
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Clinical Practice ◽  
Health Literacy ◽  
Medical Care ◽  
Vital Sign ◽  
Shared Decision ◽  
Health Care Environment ◽  
Care Environment ◽  
Newest Vital Sign

Health literacy has been shown to affect outcomes in a number of medical conditions. Despite the complexity of care that is often required among otolaryngology patients, the literature on health literacy in this field is sparse. Otolaryngologists need to be aware of issues related to health literacy due to the changing health care environment. The increased complexity of medical care, the greater involvement of patients in shared decision making, and the higher administrative burden on patients have increased their health literacy requirements. Assessing health literacy in clinical practice may help identify patients who might require additional help in navigating the health care system. The Brief Health Literacy Screen and the Newest Vital Sign are 2 measures that are easy to apply in clinical practice.

scholarly journals Promoting Interprofessional Communication through Situation, Background, Assessment, and Recommendation (SBAR): An Educational Technique

2021 ◽  
Vol 16 (4) ◽  
pp. 255-261
Author(s):  
Jennifer Cuchna ◽  
Sarah Manspeaker ◽  
Alison Wix
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Athletic Training ◽  
Clinical Decision Making ◽  
Athletic Trainers ◽  
Clinical Decision ◽  
Content Standards ◽  
Athletic Training Students ◽  
Interprofessional Communication ◽  
Curricular Content

Context The Board of Certification Standards of Professional Practice and the 2020 Curricular Content Standards indicate athletic trainers should establish working relationships with collaborating medical professionals and be able to communicate effectively. In addition, increased emphasis on interprofessional collaboration (IPC) in practice is apparent throughout health care professions and their educational programs. However, integrating both interprofessional communication and IPC within 1 learning opportunity can be difficult. Objective To share an educational approach aimed to enhance athletic training students' abilities and confidence in delivering patient information to physician assistant students via the situation, background, assessment, and recommendation (SBAR) technique. Background As part of the health care team, athletic trainers need to communicate with various providers while making clinically based decisions. Anecdotally, learners in their final year of health care education are not confident in their ability to make recommendations to other health care professionals. The SBAR communication strategy from the evidence-based framework TeamSTEPPS has become widely adopted in health care disciplines and may help to enhance confidence in communication. Description This learning activity enables athletic training students to use a patient case scenario to develop an SBAR for delivery via phone to a physician assistant studies student. This article describes the content, delivery methods, outcomes to date, and connection to the 2020 Curricular Content Standards. Clinical Advantage(s) This clinically relevant activity provides a low-stakes, real-life opportunity for students to practice communication skills, including the following: condensing the evaluation process, clinical decision-making skills, and the ability to make recommendations for a plan of care. Active participation in the communication process enhances reasoning skills needed for collaborative clinical decision making and the transfer of care, when applicable. Conclusion(s) Developing and implementing an interprofessional SBAR communication experience with 2 health care disciplines is an innovative strategy that bridges the gap between clinical education and actual patient care experiences while addressing curricular content needs.

An Ontology-Driven Approach to Clinical Evidence Modelling Implementing Clinical Prediction Rules

2013 ◽  
pp. 257-284 ◽  
Author(s):  
Derek Corrigan ◽  
Lucy Hederman ◽  
Haseeb Khan ◽  
Adel Taweel ◽  
Olga Kostopoulou ◽  
...  
Keyword(s):  
Primary Care ◽  
Evidence Based Medicine ◽  
Clinical Evidence ◽  
Evidence Based ◽  
Clinical Prediction ◽  
Clinical Prediction Rules ◽  
Prediction Rules ◽  
Support Provision ◽  
Primary Care Clinicians ◽  
Based Medicine

Diagnostic error is a major threat to patient safety in the context of the primary care setting. Evidence-based medicine has been advocated as one part of a solution. The ability to effectively apply evidence-based medicine implies the use of information systems by providing efficient access to the latest peer-reviewed evidence-based information sources. A fundamental challenge in applying information technology to a diagnostic clinical domain is how to formally represent known clinical knowledge as part of an underlying evidence repository. Clinical prediction rules (CPRs) can provide the basis for a formal representation of knowledge. The TRANSFoRm project defines the architectural components required to deliver a solution by providing an ontology driven clinical evidence service to support provision of diagnostic tools, designed to be maintained and updated from electronic sources of research data, to assist primary care clinicians during the patient consultation through delivery of up to date evidence based diagnostic rules.

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 Evidence-Based Considerations and Recommendations for Athletic Trainers Caring for Patients With Attention-Deficit/Hyperactivity Disorder

2016 ◽  
Vol 51 (10) ◽  
pp. 813-820 ◽  
Author(s):  
Elizabeth S. Wolfe ◽  
Kelly J. Madden
Keyword(s):  
Health Care ◽  
Attention Deficit Hyperactivity Disorder ◽  
Athletic Training ◽  
Attention Deficit ◽  
Athletic Trainers ◽  
Physical Rehabilitation ◽  
Successful Outcome ◽  
Evidence Based ◽  
Care Providers ◽  
Hyperactivity Disorder

Context: Patients with attention-deficit/hyperactivity disorder (ADHD) can be noncompliant, impulsive, and disruptive in an athletic training or physical rehabilitation facility. Athletic trainers (ATs) are valuable and essential health care providers for active patients with ADHD. However, for a patient with ADHD to have a successful outcome in a busy athletic training environment, the AT or health care provider must tailor the treatment setting to the patient's needs. Objective: To educate and raise awareness among ATs about patients with ADHD and to provide ATs with strategies and tools that will allow them to treat patients with ADHD more effectively. Data Sources: We retrieved and reviewed articles from PubMed, PsychINFO, and Ovid without date restrictions. Search words were attention deficit hyperactivity disorder plus 1 of the following topics or search words: athletic training, athletics, coaching, sport, or sport psychology. Study Selection: Any ADHD articles that were not applicable or translatable in good faith to athletic training, physical rehabilitation, or sport and exercise were excluded. Data Extraction: Nonpharmacologic interventions were reviewed and amassed into categories from which the recommendations were created. No statistical analyses were conducted for this review. Data Synthesis: We identified 1241 articles, and 86 met the inclusion criteria. Five groups of evidence were observed: (1) goal setting and coaching, (2) reinforcements and outcomes, (3) routines and treatment timing, (4) simplified feedback and instructions, and (5) environmental control. Reliable evidence suggests that these techniques can be translated and applied within an athletic training and physical rehabilitation setting. Conclusions: Athletic trainers are a vital component in providing health care for patients with ADHD. Using goal contagion creates a structured environment and positive reinforcements that accommodate patients with ADHD. Furthermore, ATs may use the evidence-based recommendations in this review to create a treatment and physical rehabilitation program and space that are tailored to the needs of the ADHD patient to increase the chance of a successful outcome.

scholarly journals Tips for Teachers of Evidence-based Medicine: Clinical Prediction Rules (CPRs) and Estimating Pretest Probability

2008 ◽  
Vol 23 (8) ◽  
pp. 1261-1268 ◽  
Author(s):  
Thomas McGinn ◽  
Ramiro Jervis ◽  
Juan Wisnivesky ◽  
Sheri Keitz ◽  
Peter C. Wyer ◽  
...  
Keyword(s):  
Evidence Based Medicine ◽  
Pretest Probability ◽  
Evidence Based ◽  
Clinical Prediction ◽  
Clinical Prediction Rules ◽  
Prediction Rules ◽  
Based Medicine
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