Abstract
The field of health care needs to change in order to address challenges such as rising health care costs, aging populations and the need to treat increasing numbers of people with chronic health conditions. All of this must be accomplished while reducing costs and maintaining quality of care. Health care professionals are being tasked with facilitating this change. Like many other health care professions, athletic training has turned to evidence-based practice to assure that athletic trainers are trained to deliver the highest quality of care in the most efficient way to their patients. The transition to integrating evidence-based practice will be challenging and will require a massive diffusion of innovation throughout the field of athletic training.
TopBackground
The National Athletic Trainers’ Association (NATA) introduced the use of evidence-based practice (EBP) in both the education of new ATs, and in the clinical setting with athletic trainers already working in the field (Hankemeier & Van Lunen, 2013; Hankemeier et al., 2013; McCarty Hankemeir, Walter, Newton, & Van Lunen, 2013; Welch, Van Lunen, & Hankemeier, 2014b). There are many benefits to increasing the use of evidence-based medicine (EBM). A benefit frequently discussed is improving both the image and recognition of athletic trainers as health care professionals and not personal trainers, physical education teachers, or the people carrying water bottles on the sideline of games. Other benefits to using EBM include improving the care provided to the patients and justifying third party reimbursement (McCarthy et al., 2013; Welch et al., 2014a).
Using EBP can be broken down into five steps as shown by Sackett et al. (1996). These steps include: defining clinically relevant questions, searching for the best evidence, critically appraising the evidence, applying the evidence, and evaluating how effective evidence-based medicine was when put to use. While these steps seem relatively simple when written out, most athletic training clinicians are not using EBP in their current treatment practice, but 98% of them were found to believe that it is important for the credibility of the profession (McCarty et al., 2013). Hankemeier et al. (2013b) showed that clinicians had a lower perceived importance score and a lower knowledge score when compared with post-professional educators. ATs who work in athletic training education programs have more exposure to the notion of EBP and therefore are more knowledgeable about the importance of EBP than individuals that only work in clinical settings.
Since EBP is very new to the field of athletic training, practicing clinicians that are not recent graduates likely did not learn about EBP in the educational curriculum and would not be familiar with it unless the individual took initiative to learn the process independently. In a study completed by Hankemeier and Van Lunen (2013a) less than 20% of the surveyed clinicians received any form of EBP training. Based on the information provided in this survey, very few clinicians have been trained to use EBP. These clinicians with no background in using the five steps would need some training in order to be able to effectively integrate EBP into daily clinical practice.
Key Terms in this Chapter
Knowledge Broker: Individuals who work to bridge the gap between researchers and users ( Hoens, Reid, & Camp, 2013 ).
Athletic Trainers (ATs): Healthcare professionals who collaborate with physicians to provide prevention, emergency care, clinical diagnosis, therapeutic intervention and rehabilitation of injuries and medical conditions (Profile of athletic trainers, 2014, para. 1).
Continuing Education: Education provided for adults after they have left the formal education system, consisting typically of short or part-time courses.
Knowledge Translation: A dynamic and iterative process that includes synthesis, dissemination, exchange and ethically-sound application of knowledge to improve the health of patients, provide more effective health services and products, and strengthen the health care system ( Graham et al., 2006 ).
Allied Health: The segment of the workforce that delivers services involving the identification, evaluation and prevention of diseases and disorders; dietary and nutrition services; and rehabilitation and health systems management.
National Athletic Trainers’ Association (NATA): A professional membership association serving certified athletic trainers and others who support the athletic training profession in the United States.
Transitions: Change processes that involve a beginning, middle, and an end.
Evidence-Based Practice: Evidence-based medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients ( Sackett et al., 1996 ).