title: Use of evidence-based practice among athletic training educators, clinicians, and students, part 2: attitudes, beliefs, accessibility, and barriers.
abstract: BACKGROUND
  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.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Online survey instrument.
  
  
  METHODS
  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).
  
  
  METHODS
  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.
authors.affiliation: Center for Clinical Outcomes Studies, A.T. Still University, Mesa, AZ 85206, USA. cwmccarty@atsu.edu
authors.forename: Cailee
authors.initials: C
authors.lastname: W McCarty
authors.forename: Dorice A
authors.initials: DA
authors.lastname: Hankemeier
authors.forename: Jessica M
authors.initials: JM
authors.lastname: Walter
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Newton
authors.forename: Bonnie L
authors.initials: BL
authors.lastname: Van Lunen
mesh_terms: D002983:Clinical Competence; D003430:Cross-Sectional Studies; D055317:Evidence-Based Practice; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D009985:Orthopedics / Q000193:education*; D010806:Physical Education and Training; D015203:Reproducibility of Results; D013178:Sports Medicine / Q000193:education*; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D000078329:Workforce