Date of Award

2015

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Psychology

Abstract

Context: Posterolateral corner (PLC) knee injuries are often complex and frequently overlooked. Diagnosis of PLC injuries may be difficult when symptoms are masked by those of cruciate ligament injury. Failure to diagnose and appropriately treat underlying PLC injury can increase the risk of an individual experiencing graft failure after reconstruction of a concomitantly injured cruciate ligament. Objective: Our purpose was to identify if a knowledge gap exists in the Athletic Training population by comparing pre-test perceived knowledge to actual knowledge of PLC injury assessment and to determine the effect of taking a test on perceived knowledge. The relationship between perceived and actual knowledge helps us to identify a knowledge gap, or a discrepancy between what we think we know and what we actually know. Further, the act of taking a test is theorized to initiate self-directed and life-long learning values in respondents. Design: Cross-sectional design. Setting: Web-basedEducational assessment. Participants: We recruited certified athletic trainers from the National Athletic Trainers' Association (n=294; age=37±10y; male n=114, female n=122; years of experience=14±10y) that practice within the college/university (n=134), secondary school (n=73), clinic (n=40), physician extender (n=22), and other (n=25) settings. Forty-seven percent of respondents completed the instrument in its entirety (137/294=46.5% completion rate). Interventions: Participants completed a questionnaire with three components: pre and post-perceived knowledge assessment and an actual knowledge assessment. We adapted the perceived knowledge assessment tools (PKAT) from a previously validated instrument. We constructed a 25 item actual knowledge assessment tool (AKAT) and it was reviewed by an expert on orthopedic injury assessment. Main Outcome Measures: We analyzed the pre- and post-PKAT and AKAT with descriptive statistics on the total scores. We used a Pearson correlation to assess the relationship between AKAT and pre-PKAT and we used a paired t-test to determine the effect of taking the AKAT on PKAT. Partial data were included for all comparisons. Results: We identified a poor, but significant relationship (r=0.195, p=0.003) between the pre-PKAT and the AKAT. We also identified a significant decrease (8.5%, t137=7.784, p<0.001) in pre (4.4±0.8) and post-PKAT (4.0±1.0) after taking the AKAT (9.7±5.2, 38.8±20.7%). Conclusions: Our findings suggest that a knowledge gap exists in the certified athletic trainer population regarding PLC and knee injury assessment. We were also able to identify that perceived knowledge of athletic trainers regarding PLC and knee injury assessment ability decreased following the completion of our AKAT, suggesting some recognition of that knowledge gap. However, participants still maintained that they "somewhat agreed" with feelings of knowledge and expertise regarding PLC injuries. This is inconsistent with participant performance on the AKAT and has potential to negatively impact patient care, particularly considering the likelihood of graft failure when not recognized and treated in conjunction with cruciate ligament reconstructions.

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