Critically Appraised Topic Athletic Training

So You Need to Write a Critically Appraised Topic for Athletic Training

A critically appraised topic in athletic training is basically a quick literature summary written to solve one specific clinical question you ran into on the training table. It's not a full systematic review. It's not a thesis. You take a patient scenario that came up that morning, hunt down the best available evidence, appraise it with a validated tool, and write up what you found in a structured format that other athletic trainers can use at practice tomorrow. I ran into a weird edge-case last year that made me rethink how I approach these. I had a linebacker with recurrent lateral ankle instability who'd already done six weeks of balance board work and neuromuscular re-education without meaningful improvement. The question was whether adding kinematic chain exercises would change the outcome. Every search I ran kept pulling studies on isolated ankle exercises. I had to go into the PEDro and CINAHL databases and manually cross-reference gait cycle studies with peroneal activation data. Eventually I found a small 2019 study that used a force plate analysis comparing isolated versus kinetic-chain protocols in collegiate athletes with chronic ankle instability. It wasn't perfect. The sample was 24 subjects. But it was the best available evidence at the time, and I built the whole CAT around it. That's the thing about these topics — you rarely find a clean answer. You find what's there and work with it.

Critically Appraised Topic Athletic Training: The Actual Process

Here is how I actually do them now after writing maybe forty-something of them over the years. First, you frame the question using PICO. Patient or problem, Intervention, Comparison, Outcome. Don't skip this. A poorly framed question is what makes most CATs useless. I've read student papers where the intervention was just "treatment" and the comparison was "nothing." That's not a CAT. That's a guess. Then you search. I use PubMed and CINAHL as my primary sources, sometimes Google Scholar if I'm trying to find gray literature or conference abstracts. The trick is knowing when to stop searching. You don't need to read every paper. You need enough to feel confident in your conclusion. I usually find what I need within the first twenty results if my search terms are tight. If I'm still searching past result twenty-five, I'm probably fishing instead of working.

After that comes the appraisal. This is where most people mess up. You pick a critical appraisal tool that matches your study design. For randomized controlled trials I use the PEDro scale. For cohort studies I use the Newcastle-Ottawa scale. For case reports I use the Joanna Briggs Institute checklist. You don't get to just say a study is "good" or "bad." You score it and justify the score. Then you write it up in the standard CAT format. Background, clinical question, search strategy, results of the appraisal, clinical takeaway. Keep it under two pages. The whole point is that someone reads this between ice baths and taping stations, not that they sit down with a cup of coffee and a highlighter. I'll be honest about the limitations. These topics are only as good as the evidence available, which in athletic training is often thin. We're a field that relies heavily on level 3 and level 4 evidence, sometimes level 5. You'll write a CAT and realize the entire evidence base for your question is three case reports and a textbook chapter. That's fine. You note that. You still write the CAT. The value isn't in finding a perfect answer. It's in being honest about what we know and what we don't.

The biggest mistake I see is people treating the CAT like an academic exercise instead of a clinical decision-making tool. They write it to satisfy a professor. The format exists because NATA requires it for certification prep and it's genuinely useful for building clinical reasoning. If you approach it like a checkbox, you'll produce something that looks correct but tells you nothing new. Approach it like you're trying to figure out whether that kid's ankle wrap is actually doing anything, and you'll write something you'd actually use.