Evidence in Sports Medicine: A Changing Paradigm
The importance of informing clinical practice with research evidence is now not only well recognised but mandated. Evidence based practice (EBP) is considered as an integral tool in ensuring safety and quality in health care practices. Evidence based practice was first defined by Sackett and colleagues as the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. It is the process by which individual clinical expertise is integrated with the best available external clinical evidence from the research literature. Evaluating and integrating the best available evidence into practice can empower clinicians by providing strong rationale to underpin clinical decisions.
Sports medicine is a unique field of health care as it encompasses a wide range of athletes, sports, sporting bodies and health care practitioners. It is a dynamic and rapidly evolving field of practice and successful sports medicine practitioners must develop a thorough understanding of the demands and needs of their particular sport. The fundamental roles of the sports medicine practitioner are to improve athletic condition, nutrition and performance and to manage and prevent sporting injuries. These objectives can be achieved, and improved, by the integration of research evidence into practice. Adding further complexity to this field is the importance of synchrony between sports medicine practitioners. Seamless multidisciplinary care is an essential element to a successful sports medicine team.
Evidence based practice in sports medicine, especially for allied health practitioners in this area, is an emerging field. The traditional model of sports medicine was driven primarily by expert opinion and extensive clinical experiences. However, the need to underpin clinical management in this elite field of practice, with research evidence is now well recognized and is advocated by many sports medicine bodies. Increasingly sports medicine practitioners around the world are required to interpret research evidence and implement it as part of their routine clinical practice.
Not surprisingly, a commonly reported barrier for integrating research into practice is that sports medicine practitioners have limited time, and/or limited skills, in interpreting research findings. Conferences, websites, journals and mainstream media may provide a vehicle for addressing issues of access to up to date research evidence. Journal clubs have been demonstrated to be effective in improving knowledge and skills relating to EBP and online journal clubs are an excellent alternative for the time poor. The ongoing promotion of EBP in sports medicine by clinicians and sporting bodies will help to encourage sports medicine clinicians to adopt and embed research evidence into their daily clinical practice.
Despite such calls, it is likely that lack of time and skills in applying research findings to clinical practice, especially in such a high pressure rapidly evolving environment, will continue to be integral barriers in the incorporation of evidence in sports medicine. However, strategies can be put in place to address these barriers. Access to highly synthesised research evidence can be improved by developing pathways, protocols and clinical guidelines. These should be presented in a simple, user friendly format.
Sports medicine practitioners need to be engaged and educated about EBP processes using innovative time and resource efficient means. The International Centre for Allied Health Evidence (iCAHE) is currently in the process of trialling an innovative online journal club for a multidisciplinary group of sports medicine practitioners. This pilot, undertaken in partnership with Sports Medicine Australia, aims to bridge the gap between research evidence and clinical practice using tailored and targeted strategies. This unique model firstly aims to educate sports medicine practitioners on fundamental aspects of EBP. Subsequently, a facilitator from iCAHE will mentor sports medicine practitioners accessing, appraising and implementing evidence into practice. This will be undertaken using clinical questions derived from clinical scenarios. Discussions about implications for practice will be facilitated via online discussion boards. Continuing professional development points will be provided for those participating sports medicine practitioners. By engaging with stakeholders of sports medicine, and developing tailored approaches for EBP, one can ensure the action is not just limited to on-field.
Kumar S, Machotka Z, Perraton L. Evidence in Sports Medicine: A Changing Paradigm. The Internet Journal of Allied Health Sciences and Practice. 2010 Jan 01;8(1), Article 4.