Patient-rated outcome measures in athletic training: an exploratory study

UNCG Author/Contributor (non-UNCG co-authors, if there are any, appear on document)
Beverly R. Justice (Creator)
The University of North Carolina at Greensboro (UNCG )
Web Site:
Diane Gill

Abstract: Healthcare has transitioned away from a focus solely on clinician-oriented evidence to include patient-oriented evidence or considering what is important to the patient. Patient-rated outcome measures (PROs) are one mechanism through which patient-oriented evidence can be obtained, and these tools have been implemented with athletic populations, both in practice and research. Despite documented relevance, athletic trainers (ATs) often fail to implement PROs in clinical practice. Obtaining information from ATs who use PROs may help promote wider use and improve clinical practice. Therefore, the purpose of this study was to learn how ATs use PROs in clinical practice, and the factors that influence implementation. A cross-sectional exploratory sequential mixed-methods design was used with an online survey and individual phone interviews. Credentialed, practicing ATs in post-professional athletic training programs (Masters, Doctorate in Athletic Training, and Residencies) were invited to participate in the study via email sent to program directors. Secondary recruiting of ATs occurred through direct contact and snowball techniques with ATs. ATs from varied clinical settings and all 10 NATA districts participated in the study. An online survey, modified with permission from the original authors (Lam et al., 2019) was administered via the Qualtrics platform. The 37-item questionnaire consisted of a combination of Likert scale questions, other objective items and open-ended questions. A link was provided at the survey’s conclusion for ATs interested in completing an interview. Descriptive statistics were calculated for Likert and objective items to determine frequencies and central tendencies related to PRO use. Open-ended items were coded along with interview transcripts to learn AT perspectives on PRO use. Trustworthiness was ensured with member checking of interview transcripts prior to analysis. Results indicate that ATs are using a variety of PROs, administered through several mediums with both surgical and non-surgical cases throughout the continuum of patient care. Even though ATs are seeking patient perspectives through dialogue, wider use of formal PRO instruments is needed. Improved patient outcomes and clinical decision-making, clinician education, and obtaining patient perspective are factors influencing PRO use. Without the use of PROs in clinical practice, ATs continue to rely on mostly clinician-based evidence. If PRO use is to increase among ATs, the perspectives of peer ATs using PROs in clinical practice is paramount to facilitate the development of best practices for PRO use in athletic training.

Additional Information

Language: English
Date: 2020
Athletic training, Disablement models, Evidence-based practice, Patient-centered care, Patient-rated outcome measures
Outcome assessment (Medical care)
Physical education and training
Patient-centered health care

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