Date of Award

Spring 2012

Document Type


Degree Name

Doctor of Philosophy (PhD)


Human Movement Sciences


Human Movement Sciences

Committee Director

Bonnie L. Van Lunen

Committee Member

Danica G. Hays

Committee Member

William A. Pitney


As evidence-based practice (EBP) becomes a necessity in athletic training, it is essential to recognize current barriers and modes of accessibility to information for enhancement of clinical decision-making. Furthermore, the effectiveness of educational interventions (EI) to enhance knowledge of EBP concepts must be investigated. The aim of Project I was to assess attitudes and beliefs, perceived barriers, and accessibility to resources of EBP among athletic trainers (AT). Project II was designed to investigate the effect of an EI on enhancing AT's knowledge of EBP concepts. Project III explored ATs' experiences of the EI and whether it elicited changes within their educational or clinical practices.

The Evidence-Based Concepts Assessment (EBCA) was utilized in Project I to survey 1,209 athletic training educators, clinicians, and post-professional students. Overall, participants "agree" (3.27) EBP has various benefits to clinical practice and "disagree" (2.23) that there are negative perceptions associated with EBP. Clinical prediction rules (22.1%) and Cochrane databases (22.8%) were the two resources with the least direct access. Time (76.6%) and availability of EBP mentors (69.6%) were the two most prevalent barriers towards implementation of EBP.

Project II consisted of the development of 10 online modules focusing on various EBP concepts; these online modules were assessed through a randomized controlled trial design among 164 athletic training educators, clinicians, and students. Composite scores on the Evidence-Based Practice Knowledge Assessment prior to implementation phase did not differ between the control and experimental group (MCPre=30.12±5.73, M EPre=30.65±5.93); however, the experimental group (M EPost=36.35±8.58) obtained significantly higher scores (P=0.013) on the post-assessment compared to the control group (MCPost=30.99±6.33). No differences were identified between time instances within the control group ( P=0.080); however the experimental group obtained significantly higher scores on the post-assessment than the pre-assessment (P<0.001).

The 25 ATs (12 educators, 13 clinicians) interviewed six months following the implementation of the online modules identified knowledge gain and enhanced importance of EBP as beneficial outcomes of the modules. Educators described a positive impact on teaching as well as the ability to instill value and practice of EBP among students. Clinicians reported an enhanced ability to implement EBP following the modules, but that the EI did not directly impact behavioral changes within daily clinical practice. Strategies to incorporate EBP throughout the athletic training profession were also identified.


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