LAUSR

The evidence-based practice movement in health care has gained both momentum and scrutiny since its inception. Previous IJATT editorials have highlighted the dynamic interplay among evidence sources including the clinician’s internal evidence, best available external evidence, and patient evidence.1,2 In general, health care professions have applauded the integration of these three sources for making clinical decisions, as it incorporates science/knowledge (external evidence), expertise/experience (internal evidence), and the values/preferences/experiences of the individual patient (patient evidence).1,2 However, it seems that athletic training has focused predominantly on the utilization of the best available external evidence as the largest contributor to evidence-based practice (EBP); thus, our EBP education has primarily focused on the development of PICO questions (Patient or Population of interest, Intervention, Control or Comparison, Outcome of interest), searching and critically appraising external evidence. In our quest to become evidence-based practitioners, we have not given enough appreciation to the third source—patient evidence2 (e.g., the patient’s values, preferences, experiences, etc.). The integration of the patient in to decision-making in traditional athletic training settings is obscured by a lack of (a) clear clinical standards for achieving patient engagement and (b) the documentation and quanti?cation of the patient’s perspective. These challenges, combined with the nuances of patient individuality, have made a complex topic much more challenging.