The most common definition of Evidence-Based Practice (EBP) is from Dr. David Sackett. EBP is “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of the individual patient. It means integrating individual clinical expertise with the best available external clinical evidence from systematic research.” (Sackett D, 1996) EBP is the integration of clinical expertise, patient values, and the best research evidence into the decision making process for patient/athlete care. Clinical expertise refers to the athletic trainer's cumulated experience, education and clinical skills. The patient/athlete brings to the encounter his or her own personal preferences and unique concerns, expectations, and values. The best research evidence is usually found in clinically relevant research that has been conducted using sound methodology. (Sackett D, 2002)
The evidence, by itself, does not make the decision, but it can help support the patient care process. The full integration of these three components into clinical decisions enhances the opportunity for optimal clinical outcomes and quality of life. The practice of EBP is usually triggered by patient/athlete encounters which generate questions about the effects of therapy, the utility of diagnostic tests, the prognosis of diseases, and/or the etiology of disorders.
Evidence-Based Practice requires new skills of the athletic trainer, including efficient literature searching, and the application of formal rules of evidence in evaluating the clinical literature.
These steps are based on Athletic Training Education Competencies created by NATA.
| 1. ASK the question using PICO |
Create a well built clinical question derived from the case using PICO |
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| 2. SEARCH for evidence |
Select the appropriate resource(s) and conduct a search |
| 3. APPRAISE the evidence |
Appraise that evidence for its validity (closeness to the truth) and applicability (usefulness in clinical practice) |
| 4. APPLY: talk with the athlete |
Return to the athlete -- integrate that evidence with clinical expertise, athlete preferences and apply it to practice. |
| 5. EVALUATE the outcomes |
Evaluate the desired outcomes with the athlete |
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6. INFORM |
Communicate what you learned in your evidence-based practice with the greater athletic training and allied health community. |
