Athletic Trainers’ Perceptions of and Experiences With Unlearning in Clinical and Educational Practice

Abstract

Context Unlearning is a critical component of evidence-based practice, yet research related to its role in athletic training practice is limited. Objective To explore athletic trainers’ (ATs’) perceptions of and experiences with unlearning. Design Cross-sectional. Setting Online survey with open-ended questions. Patients or Other Participants Seven hundred fifteen of 6925 ATs accessed the survey (access rate = 10.3%) with 640 ATs completing it (completion rate = 94%). Main Outcome Measure(s) We distributed a survey consisting of 8 to 10 demographic questions, 1 Likert-scale item on familiarity with unlearning, and 4 to 5 open-ended questions. Descriptive statistics summarize demographic information. Open-ended data were analyzed using the consensual qualitative research approach. Respondents who self-reported familiarity with unlearning were asked to described its meaning. To ensure data quality, these responses were compared with definitions of unlearning by 2 research team members. If consensus was reached that a participant’s understanding of unlearning aligned with the definitions, the remaining responses from that participant were included in the qualitative data analyses reported in this manuscript. Results Most respondents were minimally or not at all familiar with unlearning (n = 505/652, 77%). Approximately 46% (n = 181/391; 120 clinicians, 61 educators) accurately described the meaning of unlearning. Analysis of open-ended responses yielded 2 themes: barriers to unlearning and facilitators of unlearning. Reported barriers were intrinsic and extrinsic in nature and involved key stakeholders that frequently interact with ATs. Facilitators of unlearning included continued education, mentorship and team mindset, resources and evidence, and stakeholder education. Conclusions Respondents were largely unfamiliar with unlearning despite its role in promoting evidence-based practice. Continued education for ATs and relevant stakeholders is needed and may be accomplished through the creation and dissemination of accessible resources that highlight knowledge and skills that should be unlearned. These educational efforts may help to normalize unlearning in athletic training practice to continually improve the delivery of patient care.