Background Ankle injuries are among the most common reasons for urgent care visits. Evidence-based guidelines, particularly the Ottawa Ankle Rules (OAR), aim to standardize assessment and reduce unnecessary imaging. Despite strong evidence supporting their diagnostic accuracy, clinicians' adherence remains variable. This variability can lead to suboptimal patient outcomes, such as chronic joint instability and increased healthcare costs. This study assesses physicians' compliance with OAR and related management recommendations and identifies barriers that hinder appropriate guideline use. Objectives The primary objective is to measure the prevalence of adherence to evidence-based guidelines, specifically the OAR, among urgent care physicians. Secondary objectives include evaluating physicians' self-reported familiarity with these guidelines, identifying associated factors affecting compliance, and exploring perceived barriers to implementation. Methods A cross-sectional analytical survey was distributed electronically to physicians working in urgent care and emergency services. A total of 74 participants completed the questionnaire. The survey addressed physicians' use of OAR, rehabilitation advice, perceived barriers, and training background. Results While only 41.9% routinely applied structured rehabilitation protocols, 70.3% of physicians reported using the OAR. Most respondents (83.8%) provided patient education regarding prevention and rehab. However, 68.9% indicated a need for further training. The most commonly cited barriers were time constraints (32.4%), inadequate guideline training (31.1%), insufficient resources (14.9%), and patient non-adherence (19.4%). Additionally, 87.7% had not attended recent workshops, though 85.1% expressed willingness to receive further education. Conclusion The study reveals inconsistencies in adhering to ankle injury guidelines in urgent care. Enhancing clinician training and implementing standardized protocols can reduce diagnostic errors and unnecessary imaging. Ongoing education and quality improvement initiatives are essential for providing better care for ankle injuries.
Alharbi et al. (2026) studied this question.