Celebrating the Culture of Interprofessional Collaboration in Athletic Training

Context: New Commission on Accreditation of Athletic Training Education accreditation standards were implemented in summer 2020 and will require the entry-level degree in athletic training to be at the postbaccalaureate level in fall 2022. Many institutions have already transitioned their respective degree level or are seeking initial accreditation for a postbaccalaureate program. An exploration into admission requirements across those programs was conducted. Objective: The purpose of this study was to describe the current admission requirements of professional postbaccalaureate programs during the 2019–2020 application cycle. Design: Cross-sectional, online survey. Setting: Higher education institutions with accredited professional athletic training programs at the postbaccalaureate level. Patient or Other Participants: Program directors (n = 71) from 223 institutions representing both public (59.15%, n = 42) and private institutions (40.85%, n = 29). Data Collection and Analysis: Survey was piloted to establish content validity, then distributed with a consent form via email to participants. Descriptive statistics were performed using SPSS (version 27; IBM Corp) to summarize the demographic and admission requirements for the 2019–2020 application cycle. Results: Among respondents, 78.87% (n = 56) reported an accreditation status of active, 4.22% (n = 3) as degree change pending, and 9.86% (n = 7) were seeking initial accreditation. Regionally, 31.25% of programs in District IV, 25.81% of programs in District IX, 43.33% of programs in District II, and 16.67% of programs in District V responded to the survey, representing the 4 districts with the largest number of professional programs. Less than one-third of program directors (32.4%, n = 23) indicated having an admissions counselor dedicated to the program. Of those who provided data on application processes (n = 63), the majority (68.3%, n = 43) of respondents reporting using ATCAS as an application portal. A minimum 3.0 GPA was the most common academic requirement (69.8%, n = 44), and 5.0% of respondents (n = 3) identified the minimum overall grade point average (GPA) requirement for admission was greater than a 3.0. Over half (57.4%, n = 36) of respondents require a minimum prerequisite GPA for program admission. A total of 63 respondents (74.1%) provided data on standardized testing, recommendation letters, observation hours, and interview requirements for admission. The GRE was required for admission by 22.2% (n = 14) of respondents. Completion of 50 observation hours was the most common expectation (41.3%, n = 26) for program admission, and 28.6% of respondents (n = 18) identified that the program required 0 observation hours by the applicant. Only 12.7% of respondents (n = 8) required 100 or more observation hours as an admissions requirement. Nearly all respondents (93.6%, n = 58) required at least 1 letter of recommendation as part of the application, and 69.8% (n = 44) conducted interviews in the admissions process. Conclusions: A majority of programs required application submission via ATCAS; however, less than one-third of programs had a dedicated admissions counselor. Among professional athletic training programs at the postbaccalaureate level, common academic requirements for admission included a 3.0 GPA and a minimum prerequisite GPA. However, less than 25% of programs required the GRE for admission. If requiring observation hours, 50 hours was the most common expectation, but 28.6% did not require any observations to apply to the postbaccalaureate program. Key Words: Admissions, athletic training education, master's degree.Context: Beginning fall 2022, Commission on Accreditation of Athletic Training Education accreditation standards will require that the entry-level degree in athletic training be at the postbaccalaureate level. An investigation of enrollment trends across professional programs at the postbaccalaureate level was conducted, given that many institutions are amid transition to the master's degree level or starting new postbaccalaureate programs in athletic training. Objective: The purpose of this study was to describe the current status of applicant numbers and enrollment yields at postbaccalaureate program during the 2019–2020 application cycle. Design: Cross-sectional, online survey. Setting: Higher education institutions with professional athletic training programs at the postbaccalaureate level. Patients or Other Participants: Program directors (n = 71) from 223 institutions representing both public (59.15%, n = 42) and private institutions (40.85%, n = 29). Data Collection and Analysis: The survey was piloted to establish content validity and was then distributed electronically with a consent form to all qualified program directors (n = 223). Descriptive statistics were performed using SPSS (version 27; IBM Corp) to summarize the demographic, application, and enrollment data reported by program directors for the 2019–2020 application cycle. Results: The survey's 38.12% response rate (n = 85) from 223 institutions yielded 71 (31.84%) program directors who were able to report data from the 2019–2020 application cycle. Program directors (n = 62) reported a mean 18.71 ± 7.05 available admissions slots and a mean 17.98 ± 11.95 applications received. More than half of respondents, 54.8% (n = 33), indicated there were fewer applicants than total number of available seats in the cohort. The composition of applicant pools was reported by program directors (n = 61). The mean percentage of applicants who had completed a bachelor's degree at another institution was 60.2% ± 30.5%. The mean number of denied applicants was 2.53 ± 4.04. The overall program enrollment among responding postbaccalaureate programs (n = 60) for 2020 was 16.05 ± 9.86 students. The mean class size for the 2020–2021 admits among programs that successfully enrolled students (n = 59) was 9.31 ± 5.51. Among the respondents who provided data on enrollment goals (n = 63) for the 2019–2020 application cycle, 79.4% (n = 50) indicated that the program had not met its enrollment goal for the academic year. Among respondents who provided data on both 2020 admits and enrollment goals (n = 61), the mean difference between available admission slots and first-year students who enrolled in the program was 9.44 ± 6.53, with 49.2% of program directors (n = 30) reporting that the cohort was underenrolled by 10 or more students. Conclusions: The mean number of applications received during the 2019–2020 cycle by postbaccalaureate athletic training programs was less than the mean enrollment goal. The majority of the program applicants were external to the institution. Nearly 80% of respondents reported not meeting the institution's enrollment goal for the 2020–2021 academic year, and the overall mean admitted class size was under 10 students. Key Words: Enrollment, athletic training education, master's degree.Context: When authentic clinical experiences are unavailable, instructors may need to consider alternatives for evaluating clinical reasoning. Objective: Describe an educational technique that simulates clinical experiences to allow students to demonstrate clinical reasoning. Background: The COVID-19 pandemic created a situation in which providing clinical experiences became impossible. Yet, students still needed to exercise clinical judgment as part of their athletic training education program. The unfolding case study technique aligns well with Kolb's theory of experiential learning and can be used to help students improve clinical reasoning and critical thinking skills. Description: An unfolding case study was used to simulate a clinical experience for students when clinical sites became unavailable to students due to COVID-19. The technique involved using a case study over time in which the student received information, evaluated the information, made a clinical decision in response to the information, and received further information and feedback based on their decision. This repeated until the student reached the conclusion of the case. Clinical Advantages: Students found this assignment to be beneficial because it allowed them to practice clinical reasoning and critical thinking in a realistic yet low-risk environment. Students were able to learn new skills in documentation and billing for services. The assignment allowed for critical feedback to be given to the students at multiple points.Context: Coordinators of clinical education (CCEs) play an important role in clinical education, yet they often receive little to no formal training in the role. The Commission on Accreditation of Athletic Training Education (CAATE) Standards outline basic roles of the CCE; however, institutional autonomy dictates that the role may be more nuanced than the Standards outline. The experiences of the CCE and preparation for their role is unknown; therefore, the purpose of this study was to explore the professional socialization of CCEs into their roles. Methods: A total of 36 CCEs with a minimum of 1-year experience as a CCE (31 women, 5 men; 5.2 ± 4.7 years of experience as CCE) participated in this qualitative study. Data saturation guided the number of participants. Participants were recruited via purposive sampling. Seven focus group interviews were completed following a semistructured interview guide developed on the basis of previous socialization research. There were 5–8 CCEs in each focus group. Interviews were recorded and transcribed verbatim. Data were analyzed through consensual qualitative review, with data coded for common themes and subthemes. Trustworthiness was established via peer review and multianalyst triangulation. Results: Two themes emerged from the data: role and socialization. Role was described as the responsibilities, collaboration, and challenges of the CCE. Participants described many responsibilities including complete oversight of students within clinical education, preceptor development, evaluation and assessment of clinical skills, clinical placements, and administrative duties such as documentation and maintaining accreditation. The CCEs described the importance of collaboration, both internally and externally. Internal collaboration included primarily communication with the program director and other health care faculty, whereas external collaboration included other health care providers, CCEs, and alumni. The CCEs faced challenges tied to their role such as time management, conflict management, and navigating institutional policies. Socialization was defined as preparation necessary for the role, integration into the role, resources and development needed to be successful. Some CCEs described their preparation before taking the role including coursework, assistantships, and working clinically. However, most did not feel prepared to take on all aspects of the role as CCE. CCEs described a variety of ways in which they were integrated into their role. This included meeting with the program director, reviewing the job description and Standards, and trial and error. During the socialization process, they identified many needs including a specific job description with an outline of functions, a flowchart or timeline for tasks, professional development on the new standards, and institutional policies, procedures. Last, they described a variety of resources such as the CAATE accrediation conference and Athletic Training Educator Conference, the CAATE Standards, and published research to provide guidance. Areas in which CCEs felt they needed additional development included training on legal aspects of contracts and mentoring specific to university policy. Conclusions: Overall, participants felt prepared for some aspects of their roles (eg, assigning students to clinical sites), but less prepared for other aspects (eg, affiliation agreements, conflict management, time management). Additional professional development is necessary to make CCEs more successful.Context: Health information technology (HIT) is quintessential to contemporary athletic training practice. The tool most associated with HIT is the electronic medical/health record (EMR/EHR). Previous research has demonstrated that athletic training students' (ATS') role during patient encounters (PEs) affects their report of how often they are able to implement HIT. However, it is still unclear to what extent ATS' role affects the inclusion of HIT behaviors during individual PEs. Objective: To assess how student role influences ATS' integration of HIT behaviors during PEs throughout their clinical experiences. Design: Multisite, panel design. Setting: Convenience sample of 12 Commission on Accreditation of Athletic Training Education–accredited professional athletic training programs (5 baccalaureate, 7 postbaccalaureate). Patients or Other Participants: A total of 329 ATSs at 278 clinical sites entered 30 630 PEs during clinical experiences. Data Collection and Analysis: After formal training, ATS used E*Value software to track PEs during clinical experiences for 3 semesters (spring 2018–spring 2019). Student role (observed, assisted, performed) was collected per PE. During each PE, students were asked to report whether either of 2 behaviors (or none) associated with HIT occurred. The behaviors associated with HIT (documenting information obtained in an EMR/EHR, use of data from EMR/HER to assist in decision-making, and none of the above) were each analyzed to determine differences by student role using generalized estimated equations with a logit link to accommodate the multiple reported PEs within participants and a Bonferroni post hoc correction (P < .05). Results: Among the 30 630 PEs logged, ATS observed 3669 PEs, assisted in 5053 PEs, and performed 21 801 PEs (107 missing). A significant main effect was observed for both HIT behaviors and the answer none of the above. When asked about documenting the PE in an EMR/EHR (P < .001), students who observed the encounter were more likely to document in an EMR/EHR (mean = 0.77) that those that assisted in (mean = 0.71; 95% CI = 0.01, 0.12, P = .010) and those who performed (mean = 0.67; 95% CI = 0.04, 0.16, P < .001) the PE. When asked about using information from an EMR/EHR to assist in clinical decision-making (P = .003), students who performed the PE were more likely to report this behavior (mean = 0.96) than those who observed the PE (mean = 0.92; 95% CI = 0.01, 0.07, P = .004). Finally, for PEs in which none of the above was reported (P = .001), students who performed the PE (mean = 0.34) were more likely to select none of the above for HIT than were those who observed (mean = 0.25; 95% CI 0.03, 0.16, P = .001), and those who assisted with (mean = 0.32) were also more likely to select none of the above than were those who observed (95% CI = 0.02, 0.12, P = .006). Conclusions: Students who observed a PE were more likely to document the encounter in an EMR/EHR, whereas ATSs who performed a PE were more likely to use information from the EMR/EHR to assist in decision-making. These findings suggest that although students were learning to document in an EMR/EHR while they observed PEs, the habitual practice of patient care documentation was not being translated as students shifted toward performing PEs. Further research is needed to explore the factors that influence students' decisions to document in and use information from EMRs/EHRs during patient care. Key Words: Electronic medical records, patient encounters, core competencies, health care informatics.Context: The inclusion of evidence-based practice (EBP) principles within athletic training programs is required by the Commission on Accreditation of Athletic Training Education. However, an important skill that drives EBP, unlearning, often receives little to no attention. Unlike deskilling (ie, decline of skill proficiency over time, often due to lack of use), unlearning is an intentional act of removing knowledge and skills that are no longer effective to implement techniques better supported by evidence. Educators play an important role in ensuring students have the decision-making capability to implement unlearning as their careers progress. Objective: To explore athletic training educators' familiarity with and perceptions of unlearning. Design: Cross-sectional. Setting: Online survey with open-ended questions. Patients or Other Participants: A total of 679 of 6925 athletic trainers accessed the survey, with 640 completing it in full (94% completion rate). Of those who accessed the survey, 189 identified as an educator and were included in the analysis (age = 42.7 ± 9.7 years; years of experience as an educator = 12.6 ± 9.0). Data Collection and Analysis: We distributed a survey composed of 10 demographic variables, 1 quantitative item assessing participants' familiarity with unlearning, and 5 open-ended questions via Qualtrics. Participants' responses regarding the meaning of unlearning were coded as correct or incorrect on the basis of an operational definition. Responses coded as an accurate understanding of unlearning were included in the succeeding analyses. Following the consensual qualitative research approach, 3 research team members developed a consensus codebook through the analysis of the first 30 open-ended responses. Two researchers confirmed the codebook by analyzing the next 30 responses. After analysis of all open-ended responses, our findings were verified by an external auditor. Summary statistics (counts, percentages) were calculated. Results: Of the educators, 74% (n = 130/175; missing = 14) self-reported being minimally to not at all familiar with unlearning. Of those who reported some level of familiarity (n = 115), 55% (n = 61/110; missing = 5) provided an accurate explanation of the concept. Analysis of open-ended responses revealed 2 themes: (1) barriers to unlearning and (2) facilitators for unlearning. Educators identified barriers that were personal in nature, such as lack of time, habitual practice, and keeping up with the evolving evidence base, as well as external factors, including pushback from stakeholders (eg, colleagues, students), Board of Certification exam, and technology access, which were typically out of their direct control. Suggested facilitators for unlearning largely involved formal continuing education opportunities and increased access to different resources and evidence. Educators emphasized the importance of a team approach to unlearning, characterized by encouragement and discussions among colleagues, and support from administration to make necessary changes because the best available evidence adapts and evolves over time. Conclusions: Given the limited understanding of unlearning among athletic training educators, educational opportunities, either through formal continuing education or the production and dissemination of easily accessible and digestible resources, should be provided to improve educators' knowledge and abilities to perform and teach this skill. Integrating unlearning concepts in athletic training curricula may enhance students' abilities to incorporate evidence in clinical practice. Key Words: Evidence-based practice, lifelong learning, self-reflection.Context: Clinical education is essential in helping students develop competency of athletic training skills and knowledge. However, with the challenges posed to traditional in-person simulation by the current pandemic, telehealth simulations have become a popular alternative to achieving learning objectives. Telehealth is rapidly gaining attention and use in athletic training to provide safe and effective patient care in spite of pandemic restrictions. In addition, telehealth can also be implemented to provide equitable health care access to rural or underserved populations, making telehealth an important tool for athletic trainers (AT) to implement into clinical practice well beyond the pandemic. Objective: To create an opportunity for students to apply athletic training clinical skills using telehealth through simulation-based experiences. Background: simulation to create a realistic and safe learning in which students can be observed by faculty, and also the opportunity for to experience medical that they may not during their In addition, contemporary technology such as telehealth may be integrated into simulation to teach students the skills to with telehealth is the use of electronic and technology to provide health care from a In response to the COVID-19 pandemic, telehealth has identified as an important tool for health care are among the using technology to to new health and to patient care. Description: students participated in multiple telehealth simulations to perform a clinical for and Telehealth simulations used participants recruited from the as well as the medical class to students to with different abilities and students integrated students into the clinical evaluation to improve and Telehealth simulations were by the simulation and integrated a of a and a software software with access in simulation was by a using the with judgment in which students their to the their overall and and their students were also required to complete a assignment on their clinical the of their and regarding health and with medical Clinical students skills regarding the telehealth process, and In addition, students their understanding and skills providing health care for patient and Conclusions: Telehealth simulations are an effective and safe to practice clinical reasoning and athletic training skills with participants. In addition, there is a need for students to be to patient to develop their and provide health care. Key Words: A learning experience between athletic training students and students to care of a Objective: The goal of this educational collaboration between athletic training and is to further develop the skills of team and before clinical practice. The use of simulation student during clinical education, ensuring and effective of through student skills, patient care. Patients from provided by and athletic training students to development of important team skills. Finally, this experience can as a for opportunities between and athletic training programs. Background: Health care have in and other health are prepared to their specific of practice. best in health care require collaboration with other to of care and patient an to this by to their prepared to the among This simulation and athletic training students to the need for Description: Students were into of team to assess a patient a patient with a Students were to assessment findings and on care during the and were completed in this student experience to that the standards of best practice for simulation were was A student evaluation to assess learning was completed through at the conclusion of the Clinical This on and created a clinical experience for and athletic training students. This the and application of was an development and between the 2 The educational experience clinical assessment skills in both professional programs as identified by their respective Accreditation also learning This experience was not in either program and on the to incorporate across the This experience used simulation to assess of care by an team of and students. Students who develop and communication skills through simulation the of and effective team care. through this experience can to with other health care Key Words: education clinical education, the education is the from stakeholders to be able to report student learning in student learning has its in educational such as health are of educational student learning as a of ensuring public The development of standardized and of assessment is a in health care education but more limited in athletic training To this in the it is important to first which student learning that athletic training programs are can be developed that are most to athletic training programs. Objective: The purpose of this study was to the of student learning that professional athletic training programs are Design: This as a survey design. Setting: professional athletic training programs. Patients or Other Participants: were to program directors of all professional athletic training programs that were in with the Commission on Accreditation of Athletic Training Education programs at the time of data rate was (n = Data Collection and Analysis: The developed a of health care and athletic training or professional from the different The survey was to program The survey allowed program directors to demographic information about their program and then to select the number of the program and select each of that the program a Descriptive statistics were to the number of that programs and to determine the most across programs. To a the of the sample was with the using a of Results: with a response the was found to be of the The number of that the participants reported in their assessment was reported a between 3 and in their assessment A on the number of for each is in The 2 most student learning were or and Clinical or Clinical (n = for each of (n = (n = and (n = out the 5 most There is some among programs in to the they are in their assessment If and research to develop and assessment for athletic training they should focus on most evidence-based practice and critical Key Words: student learning athletic Many athletic training programs are to program standards that are based on of student including and and and overall on the Board of Certification to standards not athletic training programs to but also students their program may not them for a in athletic training. have that of student are associated with factors, such as and by on factors, athletic training program and may be able to student and program Objective: The purpose of this study was to determine whether of student including to or grade point and academic be by (ie, external identified and and Design: with a Setting: athletic training programs of all degree and in all university Participants: Participants included Athletic members who a student for the 2020 year. Data Collection and Analysis: from all were using an electronic survey and to the using the Survey the the survey to members who met the were 4 additional over an data analysis included an analysis and a A multiple analysis was used as the main Results: was by = = P < .001) and 1 of identified = = P < to was by = = P = A of grade point average was academic = = P < academic was by another of = = P < Conclusions: Athletic training program and may be able to influence program and student by student and by ensuring students have of identified and and a academic of student and program programs will their accreditation and students that they can them for a in athletic training. research is needed to the between factors and Board of Certification Key Words: Student program

Evidence-based practice collectively involves research evidence, clinician expertise, and patient preference while making health care decisions. Due to health care reform legislation, there is grea...

Editors and Readers,Having finished the last weeks of the spring 2020 semester, never in my imagination did I envision having led a department and an athletic training program through a pandemic, a sudden shift to remote teaching and learning, and planning and strategizing for a Fall semester that may continue remotely. Like many readers of the Athletic Training Education Journal, I have been amazed at my students' resilience, have been concerned for the patients, preceptors, and partners in clinical practice that are essential to athletic training education, and have been relying on the innovative offers of support to continue teaching. Regrettably, during this most difficult time, I was also responsible for the difficult task of announcing the closure of a graduate professional education athletic training program, before it had even had the chance to enroll students. We were in the “teach-out phase” of our undergraduate program—one remaining class of seniors preparing to graduate in May 2020. We had spent the 2018 to 2019 and 2019 to 2020 academic years recruiting for an inaugural class in 2020. In February, before the pandemic, I was asked to reconsider starting the graduate program. Ultimately, it was decided: we would never finish the final step in the Substantive Change Process. We announced Voluntary Withdrawal of Accreditation and program closure in April 2020.Given the uncertainty that the COVID-19 pandemic has foisted upon institutions of higher education, I suspect that other program directors and administrators are considering what may come. Unfortunately, I anticipate that others will be making similar announcements in the near future. As institutions of higher education are examining their financial status, anticipating a decline in enrollment and tuition revenue and increased costs for operational processes, administrators will be hard-pressed not to examine educational programming with a view toward return on investment (ROI). Though the mission of higher education is to teach, to discover, and to serve, in order to do so, it must also be able to function as a business, meeting its expenses and planning for the future. I offer this editorial (and eulogy of sorts) to (1) assist those who may be watching their athletic training program for signs of distress and (2) prepare those who remain for the continued turbulent times ahead. Readers are encouraged to consider the questions presented in the Table within their own institutional contexts.Athletic training education has responded to previous periods of growth and change. Readers are encouraged to read the extensive review by Delforge and Behnke1 of the history and evolution of athletic training education published in 1999 to commemorate the 50th anniversary of the National Athletic Trainers' Association (NATA). These first 50 years were marked by growth, refinement, and recognition of the unique skill set that the athletic trainer brings to the sports medicine team. As athletic training neared its golden anniversary, the profession was poised for another moment of significant change. In 1997, the Education Reform Task Force's recommendations were formally endorsed by the NATA Board of Directors to establish the Education Council and set-in motion the elimination of the internship route to certification and the mandate that all programs be accredited by 2000. Institutions that had previously sponsored exam candidates for the Board of Certification (BOC) through the internship route to certification had to decide if they were going to pursue accreditation by the (then) Joint Review Committee on Educational Programs in Athletic Training and the Commission on Accreditation of Allied Health Education Programs to meet the 2004 deadline for BOC eligibility. Some colleges and universities chose not to pursue accreditation, while others committed the resources needed to meet the standards for initial accreditation. Between 2000 and 2004, the number of accredited programs doubled from 120 to over 250. Throughout the 2000s, improvements and adjustments were made to athletic training curriculum content, qualifications for preceptors and affiliated clinical sites, workloads and financial support, and establishment of program outcomes.Moving ahead to 2009, during the Great Recession and soon thereafter, institutions of higher education experienced a wave of furloughs, budget cuts, and enrollment declines, but relatively few athletic training programs were eliminated. Programs successfully navigated the first round of re-accreditations and prepared for revisions to the Commission on Accreditation of Athletic Training Education (CAATE) Standards, the NATA Educational Competencies, and the BOC Practice Analysis. With the establishment of Standard 11 with the 2012 CAATE Standards, that programs must meet a 3-year aggregate first-time pass rate of 70% or greater, it was speculated by many that the number of professional athletic training programs would diminish as programs that were on probation or unsuccessful in meeting the standard would be eliminated. While some programs did voluntarily withdraw, the vast majority of programs responded by bolstering their curricula and improving student performance. But disparities existed in program outcomes; questions remained about the future of the profession and how to best prepare students for clinical practice.In 2014, when the NATA Board of Directors published the Executive Committee for Education's White Paper, examining the professional degree level for athletic training, program directors and faculty were once more forced to consider the future and their place in it. With the Strategic Alliance's announcement in 2015 that athletic training education was moving to the master's degree level, another round of discussions had to take place at the program, department, school, and institutional levels. Over the last 5 years, institutions have announced voluntary withdrawal; others have begun the process of growing graduate programs, recognizing their potential impact on bottom lines. Others, with a history of postprofessional master's degree programs, began offering professional education programs as well as or in lieu of accredited postprofessional degrees.So, in 2020, with the manner and structure of the coming academic year in question, program administrators and faculty are looking again at a monumental shift in athletic training education—not solely due to the implementation of the 2020 Standards for Accreditation for Professional Programs, the decision to discontinue accreditation of Post-Professional Degree Programs, and the revision to CAATE-accredited residency program and fellowship program standards. The impact of the novel corona virus, COVID-19, on higher education as a whole now places additional pressures on athletic training education and its processes.Readers would do well to use the months ahead for introspection and planning. Two additional recruiting cycles remain in which entering students may choose between enrolling at an institution offering a 4-year undergraduate professional degree program, enrolling at an institution offering a 5- or 6-year combined preprofessional and professional degree program, or enrolling at an institution not affiliated with an athletic training program and decide to adjust their academic career plans. Higher education institutions, researchers, market analysts, and consulting firms spend considerable time, energy, and resources trying to understand the decision-making processes of traditional-aged high school graduates and their families. Similar efforts are made to understand undergraduate students who are balancing the options of applying to professional or graduate schools or entering the workforce. Alternatively, individuals in the labor market are also weighing the ROI of returning to school on a full-time or part-time basis to augment their earning potential, or change careers for improved personal fulfillment or family circumstances or as a result of job loss. Recruiting for an athletic training program regardless of degree level requires an understanding of the current landscape and the market for potential students.When transitioning from an undergraduate program to a graduate program, program personnel spend considerable time preparing—conducting an environmental scan, negotiating with administration, developing a financial projection model, completing the substantive change applications or “mini self-study,” organizing curricula and marketing to future students. The launch of a new graduate program brings excitement and energy—a good story to tell and to showcase: an institution poised for growth.Over the past 5 years, my faculty and I pursued a dual strategy, expanding our offerings in health, wellness, and exercise science while being creative and innovative in our athletic training curriculum. Our goals were to showcase all that undergraduate education should offer in preparing students for professional graduate study in the health sciences (critical thinking, quantitative and informed reasoning, ethical decision making, an understanding of the biopsychosocial determinants of health and health disparities, and the essential elements of humanity in the liberal arts), while simultaneously encouraging students to consider a career in athletic training to promote physical activity, to prevent and address the prevalence of chronic disease, to manage acute illness and injury, and to promote exercise as a therapeutic intervention. While navigating the self-study process and gaining a 10-year reaccreditation in 2019 and completing the degree transition process, I am confident in saying we tried our best.Regrettably, this fall as applicants did not materialize, as program head count for the summer was tenuous, I had to make one of the most difficult decision of my career as an athletic training educator: to recommend closing my own program. How did we get there? As a program based in Cincinnati, Ohio, we are blessed to be located in a metropolitan region with a high population density. We have significant numbers of graduates from the surrounding region and robust clinical placement opportunities. We have over a 30-year history of graduating athletic trainers (ATs) for professional practice. The hospital systems in the region hire recent athletic training graduates in a variety of employment settings, and our students were able to find work easily. We have a robust network of affiliated clinical sites and an active advisory board. We had had such high aspirations and projections that making the transition would be fruitful and the right thing to do. We had completed the self-study as well as a business plan to demonstrate how we would fill our class and meet our benchmarks.Unfortunately, as the months progressed in our recruitment cycle, the data has demonstrated expanding options for students, regionally and statewide, and declining interest in athletic training education at the graduate level. Cincinnati has more than 10 institutions of higher education in a 60-mile radius. Of those institutions, remarkably, 8 offered professional athletic training programs (4 public institutions: University of Cincinnati, Miami University [Ohio], Northern Kentucky University, and Wright State University; 4 private institutions: Xavier University, Thomas More University, Wilmington College, and Mount St. Joseph University). Three of the private institutions (1 National Collegiate Athletic Association Division I, 1 National Collegiate Athletic Association Division III, and 1 National Association of Intercollegiate Athletics) had already transitioned to the graduate level, having led the region with a year's head start, before my institution received final approval from the CAATE and the Higher Learning Commission. The 2 largest public universities (1 Football Bowl Subdivision Division I/Very High Research University and the other a Division I/Comprehensive Master's University) have transitioned or planned to transition but have delayed the start of their graduate programs. When we had originally proposed the Master of Athletic Training degree, there was 1 graduate professional program in Ohio (more than 5 hours away). By the time we were approved 2 years later and began recruiting, there were 11 graduate programs in the state (2 within our own county). Our program's historic niche had been to recruit traditional-aged students to the institution, with about half of those students also having plans to pursue graduate study in physical therapy. As we expanded our exercise science offerings, fewer students decided on athletic training as a career goal. This trend was also evident as the entering classes of athletic training students at the graduate professional programs in the state hovered at 10 students or less per cohort. Despite considerable efforts to market the athletic training program to undergraduate students at other like-sized institutions in surrounding states and connecting with pre-health students and advisors at larger universities, the numbers had not materialized.In February, as my dean and I prepared the summer and fall schedules for 2020, answered questions from Admissions and the Provost's Office, and began preparing the annual department budget, there were few remaining justifications for continuing to offer an accredited professional athletic training education program. Faced with market saturation, declining interest both internally and externally, and the obvious costs of weathering an unknown time period of low enrollment, we determined that it was in the best interests of the institution to announce program closure.It was the right thing to do for the well-being and future of my institution, but it was no less painful for myself, my students, and my colleagues. We made the decision based on data and the common good. Announcing program closure is much more reserved and measured than announcing a new program or expanded program offerings. It requires a delicate balance of showing compassion while also defending calculated decision making. Instead of celebrating an opening, announcing a program closure requires informing undergraduate students that their hoped-for destination will not be accepting students, perhaps announcing the elimination of faculty positions, and saying good-bye to trusted and respected colleagues. When advising students, faculty should be able to provide contingency plans and consider working with nearby programs to establish articulation agreements whereby students can pursue accelerated acceptance into another graduate athletic training program.To be clear, the decision to close our athletic training program was made in the opening days of the Spring 2020 semester, before the stay-at-home orders were issued, before Fall 2020 semester formats were in question, before our fiscal year budget was devastated by having to return income from residence hall room and board, and before our enrollment projections for the Fall semester had become so much more critical. Despite recruitment efforts over the past 18 months, it was determined that the anticipated enrollment we needed in order to sustain the athletic training graduate program was not going to materialize without significant investment of time, talent, and money. Providing a high-quality, accredited health care professional program is costly and resource-intensive. As more programs have transitioned from the bachelor's degree level to the graduate level, the recruiting landscape has become more predictably difficult. Despite a strong reputation in the health sciences generally, and a history of preparing ATs, programs may not be able to draw undergraduate students from other institutions to meet expectations and financial plans to keep the education reasonably priced for students. Smaller, regionally focused, comprehensive liberal arts universities without broad brand recognition will struggle to recruit students for graduate education in athletic training. The ability to recruit students to newly accredited programs in physician assistant studies, for entry-level nursing, and for physical therapy requires investment, but for athletic training, more so. The varied stakeholders in athletic training education (the NATA, the CAATE, the newly formed Association of Athletic Training Educators [AATE], the faculty, the future employers, and the alumni of these programs) will need to focus considerable effort and resources toward marketing athletic training as a destination career to potential students whether they be traditional-aged undergraduate students or career changers resulting in an older student population.So, as others are likely facing similar circumstances, now compounded by the ramifications of the COVID-19 pandemic, I encourage athletic training educators to take a hard look at their institutions' long-term well-being and the well-being of the remaining athletic training programs in their region to determine a path forward. I am certain that athletic training programs will continue to thrive and will take on the best elements of the programs that have closed and ensure their legacy.With deepest regards and hope for future ATs, BC Charles-Liscombe.

Attitudes toward Healthcare Teamwork between Osteopathic Medical Students in an Interprofessional or Intraprofessional Clinical Education Program

Framing the Future: Exploring Inter-Professional Education and Practice in an Undergraduate Course

The effectiveness of interprofessional education in university based health professional programs: A systematic review

The effectiveness of interprofessional education in university based health professional programs: A systematic review.

The past decade witnessed momentum toward redesigning the U.S. health care system with the intent to improve quality of care. To achieve and sustain this change, health professions education must likewise reform to prepare future practitioners to optimize their ability to participate in the new paradigm of health care delivery. Recognizing that interprofessional education (IPE) is gaining momentum as a crucial aspect of health care professions training, this article provides an introduction to IPE programs from three different academic health centers, which were developed and implemented to train health care practitioners who provide patient-centered, collaborative care. The three participating programs are briefly described, as well as the processes and some lessons learned that were critical in the process of adopting IPE programs in their respective institutions. Critical aspects of each program are described to allow comparison of the critical building blocks for developing an IPE program. Among those building blocks, the authors present information on the planning processes of the different institutions, the competencies that each program aims to instill in the graduates, the snapshot of the three curricular models, and the assessment strategies used by each institution. The authors conclude by providing details that may provide insight for academic institutions considering implementation of IPE programs.

Pursuing Excellence: Innovations in Designing an Interprofessional Clinical Learning Environment.

Mini-Editorial Compilation for Special Section

Context As required elements of accreditation, interprofessional education (IPE), and interprofessional collaborative practice (IPCP) are key considerations for athletic training educators, students, and practicing professionals. Objective Despite the emphasis on IPE and IPCP, little information exists regarding which health care professionals athletic trainers should collaborate with outside of physicians. In addition, no study has established which professionals athletic training students should be educated alongside in preparation for future interprofessional collaboration. Design Cross-sectional survey. Setting Clinical practice settings. Patients or Other Participants Stratified sample of 105 athletic trainers across various employment settings. Data Collection and Analysis Participants selected the top 5 health care professionals with whom they currently interact, desire to collaborate, and believe students should be learning to interact with during clinical practice. Participants indicated how much time they spent in collaborative practice and the frequency and method of their interactions. We analyzed data using descriptive statistics including means, standard deviations, and frequency counts. Results In addition to physicians, participants identified physical therapists, physician assistants, nurses, and nurse practitioners as the primary professionals with whom they interacted in the past 12 months. Participants identified a desire to collaborate with sport and exercise psychologists, physical therapists, nutritionists, physician assistants, and certified or licensed professional counselors. In addition, participants indicated that athletic training students should learn with physical therapists, paramedics or emergency medical technicians (EMTs), physician assistants, nutritionists, and sport and exercise psychologists in preparation for future clinical practice. Regarding time, the majority (64.7%) of participants interact with other health care professionals multiple times a day or week. Conclusions These results are indicative of the need to prepare athletic training students to engage in collaboration with professionals beyond the naturally occurring partnerships with physicians. Educators could use these findings in the development or modification of IPE experiences, and the results may be considered in the development of continuing education opportunities to enhance practicing athletic trainers’ collaborations.

Athletic trainers (ATs) are healthcare providers who work in collaboration with physicians, nurses, physical therapists and others to provide care to physically active individuals. Founded in 1950, the National Athletic Trainers’ Association (NATA) represents certified ATs and other individuals who support the athletic training profession. The Board of Certification (BOC) has the only accredited certification program for ATs in USA. It establishes and regularly reviews both the standards for the practice of athletic training and the continuing education requirements for certified ATs. In order to attain certification, candidates must demonstrate successful completion of either a bachelor’s degree or master’s degree program accredited by the Commission on Accreditation of Athletic Training Education (CAATE) and pass the BOC certification exam. Currently, there are ∼42 000 ATs practicing in USA, with 48 states who regulate their practice. The purpose of this article is to provide a background for the profession of athletic training as well as describe and discuss the importance of including ATs in interprofessional education and practice initiatives.

Context Sexual harassment is a concern in health care professions and on college campuses nationwide. Athletic trainers are health care professionals who work in close conjunction with athletes, coaches, officials, and other stakeholders, predisposing them to potential sexual harassment occurrences. Objective To examine the experiences of sexual harassment of professional master's ATSs during their clinical education experiences. Design Mixed-method study. Setting Online questionnaire. Patients or Other Participants Eighty-seven athletic training students (68 women, 19 males; age = 23.40 ± 1.85 years; 44 first-year students, 43 second-year students) currently enrolled in Commission on Accreditation of Athletic Training Education (CAATE)–accredited professional master's athletic training programs. Data Collection and Analysis We sent an online questionnaire to CAATE-accredited professional master's athletic training program directors, along with a recruitment email encouraging program directors to send the questionnaire to students currently enrolled in the programs they lead. We validated the questionnaire using expert and peer review. We used a general inductive approach to analyze the results and used multi-analyst triangulation and peer review to ensure credibility. Results Our study revealed that 28.70% of participants reported they felt as though they were subjected to sexual harassment behaviors during clinical education. Themes reported through recipients' accounts of sexual harassment defined a timeline that started when sexual harassment most commonly manifested through inappropriate comments, followed by ATSs having to adjust after incidents instead of the perpetrators, and finally ended with insufficient resolution in which victims felt the situations should have been handled differently. Conclusions Sexual harassment affects some professional master's ATSs in clinical education settings. Athletic training program administrators should educate students on clearly defined policies and procedures that will lead to resolution when sexual harassment occurs during athletic training clinical education.

Context Professional master's (PM) athletic training programs (ATPs) are becoming more popular as the profession debates what the entry-level degree should be for athletic training. More information is needed related to the potential benefits of PM ATPs. Objective Describe the Commission on Accreditation of Athletic Training Education (CAATE) accredited PM ATPs including athletic training student retention rates and career placement rates as well as strengths and areas for improvement. Design Mixed-method study. Setting Professional master's ATPs. Patients or Other Participants We surveyed directors of all accredited PM ATPs and obtained responses from 15 out of the 25 directors (60.0%). Main Outcome Measure(s) We sent a link to an electronic survey to all directors. The survey asked background questions about the ATP, the institution, and the director. Using data saturation as a guide, we also performed follow-up telephone interviews with 8 directors to expand upon the data gathered in the survey, specifically related to aspects of their PM ATPs. We analyzed the data using grounded theory and maintained trustworthiness through multiple analyst triangulation, member checks, and a peer review. Results Our findings indicate an 88.7% retention rate and an 88.5% career placement rate for PM athletic training students. The directors responded very positively about their ATPs, particularly didactic education. The participants also felt they provide a positive environment which fosters student learning, excellent clinical education opportunities, and unique experiences beyond those typically offered at the undergraduate level. Many directors also noted they wanted to make personnel modifications to strengthen their ATPs. Conclusions We were able to provide descriptive information on PM ATPs. The participants described the didactic and clinical education experiences, social experiences, and overall ATP atmosphere as overwhelmingly positive. The small class sizes and involvement from faculty, staff, and preceptors helped create an environment, which fosters athletic training student learning.

Context The Commission on Accreditation of Athletic Training Education 2020 Standards for Professional Programs highlight the need to further incorporate interprofessional education components into the curricula for athletic training programs. Interprofessional education can be a challenging component to integrate into the curriculum on an ongoing and routine basis, especially when access, quantity, and quality of interprofessional education resources are limited at individual universities. Objective To promote professional socialization between athletic training students of different universities while also promoting teamwork and collaboration values and skills through the use of shared interprofessional resources. Background This educational technique was developed as a means to address the lack of access to interprofessional resources faced by 3 professional athletic training programs in order to help meet compliance with 2020 Commission on Accreditation of Athletic Training Education standards 8, 57, and 79. Description Athletic training students from 3 professional athletic training programs were paired with one athletic training student from another institution to research a nonorthopaedic, general medical condition. They were assigned a 3-part project: (1) review the existing literature for peer-reviewed articles on their assigned pathology, (2) interview a non–athletic trainer health care provider who has worked with the pathology, and (3) create an education infographic of the information to use as an educational tool for patients. The project helped to promote collaborative and team-based skills critical to interprofessional and intraprofessional success as a health care provider. Clinical Advantage(s) Students learned with, from, and about how non–athletic trainer health care professionals manage their assigned nonorthopaedic, general medical pathologies in clinical practice. Conclusion(s) This collaborative project allowed athletic training students to develop intraprofessional and interprofessional skills by working with both athletic training students and non–athletic training health care professionals. Informative feedback on how the students perceived their interactions was received at the conclusion of the assignments.