Athletic Training Education Programs Research Articles

Attitudes Toward Implicit Bias Among Athletic Trainers.

Implicit biases are attitudes, emotions, or stereotypes that occur in an unconscious manner and have the potential to negatively affect behaviors, actions, and decisions. Recent studies have suggested that even when certain factors are controlled for, health care workers do not provide equitable care to patients from different demographics. When patients are not receiving equitable health care, there is a potential for disparities in patient-related outcomes. The purpose of this study was to determine attitudes toward implicit bias among athletic trainers. A secondary purpose of this study was to assess differences and correlations between attitudes toward implicit bias and demographic factors including age, years of experience, gender identity, sexual orientation, and race. Participants were recruited for this study by emailing athletic trainers from publicly available staff directories at institutions of higher education and high schools, and athletic training education program directors. The survey consisted of questions gathering demographic information and questions taken from the Attitudes Toward Implicit Bias Instrument. A total of 218 athletic trainers (age = 38 [11]y, years of certified experience = 14 [11]y) opened and completed the survey. On average, participants scored 71.0 [11.2] on the Attitudes Toward Implicit Bias Instrument. This mean score indicated that the average participant felt that implicit bias had the potential to negatively impact patient care and needed to be addressed through education. There was a significant, negligible negative correlation between age and attitudes toward implicit bias (r[216] = -.157, P = .02). Examining implicit bias among athletic trainers warrants further research to understand how implicit bias can negatively affect access to equitable health care opportunities. The development of high-quality interventions for identifying and addressing implicit bias is crucial to ensuring optimal patient outcomes in athletic training and all medical settings.

Development and Validation of the Athletic Training Student—Soft Skills Assessment Instrument

Context Education of athletic training students should include the acquisition of soft skills. Evaluation of soft skills is important but challenging. Multisource performance reviews can provide students with feedback from different viewpoints, which can be used to promote self-awareness and encourage reflection. Objective To develop and validate a new multisource soft skills assessment tool for master’s level professional athletic training students. Design Cross-sectional study. Setting Web-based questionnaires. Patients or Other Participants Nineteen participants evaluated the instrument for face and content validity. These participants included 5 athletic training educators, 7 athletic training preceptors, and 7 students currently enrolled in a graduate-level, Commission on Accreditation of Athletic Training Education-accredited athletic training education program. Participants in the first pilot test included 22 students, 22 preceptors, and 3 instructors. Participants in the second pilot test included 28 students, 32 preceptors, and 3 instructors. Data Collection and Analysis A 3-stage process was used to develop and validate the instrument. The process included a literature review and formation of 65 survey items organized into 11 themes. Questions were reviewed by students, preceptors, and instructors. Responses were analyzed using content validity ratio to help identify items needing revision, deletion, or substitution. All open responses were considered. Based on results, 1 question was removed, and 2 questions were updated to improve clarity. The updated Athletic Training Student—Soft Skills Assessment instrument includes 64 questions. In the final stage, reliability analysis was conducted on 2 samples. Internal consistency was examined with Cronbach α and interitem correlations. Results Using a rigorous content validation approach provided evidence that the instrument was comprehensive, clear, and complete enough to establish the tool’s credibility in the preliminary stages. Conclusion(s) The outcome of this study is a multisource soft skills assessment tool that can provide students with formative feedback.

Student Perceptions of Soft Skills Multisource Feedback in a Professional-Level Athletic Training Program

Purpose: A new multi-source soft skills assessment tool and process was used in an entry-level masters of science in athletic training education program. The goal was to provide students with individualized feedback related to soft skills that would serve to facilitate improvement and growth. The feedback process included self-reflection, goal-setting, and follow-ups. This study aims to examine athletic training student’s perceptions of a new, multisource soft-skills assessment process and the feedback they received. Methods: A convenience sample of 27 students enrolled in a graduate-level, CAATE-accredited athletic training education program participated in the study. At the beginning of a semester participants received an individualized multi-source soft skills feedback report based on data collected the previous semester using the Athletic Training Student - Soft Skills Assessment (ATS-SSA) instrument which includes 11 soft skill themes. Participants completed 1 survey designed to assess initial impressions of the feedback and 2 assignments focused on reflection and goal setting. One week before the end of the term, students completed a second survey to assess final impressions. Surveys included Likert scale and open response questions. Results: The process and feedback were viewed favorably. Feedback was considered fair, useful, and easy to understand. Participants recognized benefits from receiving multi-source feedback from credible evaluators. The majority of participants indicated a willingness to invest in efforts to improve. Conclusions: Preliminary findings suggest that the ATS-SSA Instrument and associated feedback process can provide worthwhile and beneficial feedback to athletic training students.

Cannabis Content in Athletic Training and Physical Therapy Curriculums in the United States

Background: Cannabis is the most commonly used illicit drug in the U.S. and its use is becoming more popular with the legalization of medical marijuana. Currently, 36/50 states and the District of Columbia have legalized marijuana for medical purposes. These changes have allowed for more cannabis-related research to be conducted. It is unknown how health professional education programs such as physical therapy and athletic training have integrated cannabis-related curriculum into their students’ training. This study aimed to identify how physical therapy and athletic training education programs are approaching teaching students about cannabis-related topics. Methods: There were 111 individuals from 40 states who responded to the survey (Males=53; Female=58), including 88 athletic training and 23 physical therapy faculty. Methods: An email was sent to all program directors of athletic training and physical therapy programs in the US with a Qualtrics survey link for faculty to complete. The 23-item questionnaire included closed-ended questions on demographics, where they sought cannabis-related information, and whether program curriculum includes cannabis-related topics. Frequencies were computed for sources of cannabis-related information and whether program curriculum includes cannabis-related topics. Results: Sixty (53.5%) participants stated they have not received information or completed any training related to cannabis. Of those receiving information or completing training (n=51), the most common sources of information were live lectures (n=23), peer-reviewed manuscripts (n=24), and social media/news (n=21). Also, 43 (38%) participants noted teaching cannabis-related topics in their curriculum. However, 33 participants reported either not completing training related to cannabis or being self-educated through the current literature. Conclusions: These results suggest program faculty may benefit from formal cannabis education in an effort to adequately integrate the content into curriculums.

Celebrating the Culture of Interprofessional Collaboration in Athletic Training

Celebrating the Culture of Interprofessional Collaboration in Athletic Training

Using Graphic Novels to Teach Diversity, Equity, Inclusion, and Social Justice: An Educational Technique

ContextThe Commission on Accreditation of Athletic Training Education Professional and Residency and Fellowship Standards indicate athletic training students, residents, and fellows must be trained in diversity, equity, inclusion, and social justice (DEI&SJ). Diversity, equity, inclusion, and social justice is a broad, complicated subject. Stereotyping and bias training are 2 topics within DEI&SJ that are important for providing culturally competent health care.ObjectiveTo detail a strategy for implementing concepts of DEI&SJ into athletic training education programs.BackgroundAs part of the health care team, athletic trainers are at the forefront of access to the medical system. Athletic trainers need to be prepared to service a growing diverse population.DescriptionThis learning activity enables athletic training educators to creatively engage students in discussion using graphic novels. This article describes the preparation and delivery methods for using graphic novels to teach stereotyping and bias concepts.Clinical Advantage(s)Integrating graphic novels into a classroom activity allows students the opportunity for open communication with classmates. Interpreting graphic novels may increase patient-centered care by increasing empathy in athletic training students.Conclusion(s)The inclusion of graphic novels into athletic training education using interpretation and open discussion techniques can expose students to complicated topics related to DEI&SJ.

Racial Microaggressions During Clinical Education Experiences of Professional Master's Athletic Training Students

Context Racial microaggressions can be comments or actions that are often unconsciously or unintentionally directed toward members of marginalized groups. Athletic trainers have been found to be prone to organizational conflict and harassment; however, no studies have investigated whether racial microaggressions occur during athletic training student (ATS) clinical education experiences. Objective To examine the existence of racial microaggressions directed toward ATSs during clinical education, specifically identifying the resources that existed for students who perceived they were encountering racial microaggressions. Design Qualitative study. Setting Commission on Accreditation of Athletic Training Education–accredited professional master's programs. Patients or Other Participants One hundred fifteen second-year master's students (80 female, 33 male, 1 nonbinary/third gender, 1 wished to not disclose; age = 23.67 ± 3.41 years). Data Collection and Analysis We created a questionnaire based on the purpose of the study and the current literature that we validated via peer and expert review before initiation of the study. We used peer review and multiple-analyst triangulation to provide credibility and analyzed the data with a phenomenological qualitative approach. Results Three main themes emerged: (1) participants experienced forms of microaggression including, but not limited to, microassaults, microinsults, microinvalidations, and stereotypes; (2) participants experienced a lack of action after racial microaggressions; and (3) participants experienced a period of career reconsideration during which they questioned entering the profession because of feeling uncomfortable and discriminated against. Conclusions To reduce the number of racial microaggressions that students face, athletic training education program administrators and preceptors should be educated on racial microaggressions, validate athletic training student emotions, encourage brave spaces where students can openly communicate about what is transpiring at clinical sites, safely identify aggressors, and remove students from harmful environments.

Using the Unfolding Case Study to Improve Clinical Reasoning

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 where providing clinical experiences became impossible. Yet, students still needed to exercise clinical judgement 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 involves using a case study over time where the student receives information, evaluates the information, makes a clinical decision in response to the information, and receives further information and feedback based on their decision. This repeats until the student reaches the conclusion of the case. Clinical Advantages: Students found this assignment to be beneficial as 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 allows for critical feedback to be given to the students at multiple points. Conclusions: The unfolding case study can be an effective substitute for a clinical experience in extreme situations. The unfolding case study allows students to exercise clinical judgement in a safe environment.

Athletic Training Educators' ConferenceApril 29–May 1, 2021

Athletic Training Educators' ConferenceApril 29–May 1, 2021

Integrating Safe Space Ally Training Into the Athletic Training Curriculum

Context It has become increasingly important that athletic trainers (ATs) understand and promote diversity, inclusion, and cultural competency. One technique athletic training educators can use to promote cultural competency for those in the lesbian, gay, bisexual, transgender, queer, intersex, and asexual (LGBTQIA+) community is by attending a safe space ally training (SST) program to integrate the concepts of SST programing into their curriculum. Objective To provide athletic training educators with techniques to integrate inclusion and cultural competence regarding the LGBTQIA+ community into the athletic training curriculum using SST content. Our goal is that athletic training educators will train future ATs as well as embrace individual professional development. Background The National Athletic Trainers' Association (NATA) LGBTQ+ Advisory Committee (AC) has created an SST workshop for athletic trainers. Educators can promote cultural competency throughout the curriculum using evidence-based training programs such as the NATA LGBTQ+ AC SST. Description The emphasis of SST is to improve cultural competence regarding sexual minorities to improve inclusivity in all athletic training settings. It is critical that athletic training education programs prepare graduates to be competent, compassionate, patient-centered and professional ATs who are ready to function as health care professionals for all patients. Clinical Advantage(s) A goal of cultural competency is to create an inclusive environment within all athletic training settings, whether it be in a classroom, a clinic, or a nontraditional work setting. Health disparities and health care inequities must be appreciated by every AT to deliver compassionate and competent care for all in marginalized populations. Educators can make a difference in the future of athletic training by increasing the cultural competency of their students. Conclusion(s) Patient-centered care, knowledge of the care of those in diverse and minority populations, and ethical behavior can be enhanced through SST programs.

Athletic Training Education: Educating the Future Athletic Training Professionals

Athletic Training Education: Educating the Future Athletic Training Professionals

Self-Confidence and Perceptions of Athletic Training Students Following Simulated Experiences: A Mixed-Methods Pilot Study

Purpose: Athletic training clinical education provides students with a variety of real-life patient encounters under the supervision of a credentialed athletic trainer. However, clinical education experiences may not allow for all students to practice more invasive or less common skills such as rectal thermometry. The purpose of this study was two-fold: 1) determine the effect of a series of low to high-fidelity simulated rectal thermometry experiences on athletic training students’ self-confidence scores; and 2) through a phenomenological qualitative approach, explore athletic training students’ perceptions following the simulated rectal thermometry experiences. Method: This study used a quasi-experimental, mixed methods, one-group repeated measures design. Participants were nine first year professional Master of Athletic Training students who completed four simulated experiences on the skill of rectal thermometry. The outcome measures were The Athletic Trainer’s Self-Confidence Scale (ATSCS) and qualitative semi-structured open-ended interviews. Results: Friedman’s ANOVA revealed a statistically significant improvement from the participant’s baseline ATSCS scores to the last post-test scores. We identified three major themes following qualitative interviews: 1) Perception changes before and after participation; 2) Benefits of a series of four simulations; 3) Explanations for the improvements in confidence and competence. Conclusions: A series of simulated learning activities using high-fidelity and standardized patient interactions can help improve athletic training students’ self-confidence. Though future research is needed, athletic training education programs should consider implementing simulated experiences to equip athletic training students to transition to practice.

Cultural Competence in Athletic Training Education Programs: A Critically Appraised Topic

Clinical Question: Do cultural-competence-based educational interventions improve the cultural competence of athletic training students, based on the constructs of the Campinha-Bacote model? Clinical Bottom Line: Athletic training programs can improve athletic training students’ cultural awareness, knowledge, skill, encounters, and desire by incorporating cultural-competence-based independent readings, lecture presentations, in-class discussions, and self-awareness activities.

Responding in Crisis: Considerations for Administrators and Faculty

Responding in Crisis: Considerations for Administrators and Faculty

Educational Technique: Incorporating Social Determinants of Health Into Athletic Training Education

Context Social determinants of health (SDH) are reportedly more important in determining a patient's health status than the actual health care services provided. Given their role and unique clinical practice environment, athletic trainers will encounter patients who are influenced by SDH. It is important to educate future generations of athletic trainers on the importance of SDH to promote positive patient outcomes. Objective To detail a strategy for implementing concepts of SDH into athletic training education programs. Background A purposeful educational strategy that incorporates didactic concepts and clinical practice application of SDH for athletic training students is important to produce a deeper understanding of the role these factors play in populational health. Description Delivery methods such as presentation modules and learning activities are presented. Clinical Advantage(s) Integrating SDH through a tailored activity exposes students to the concepts of SDH and promotes observation and use in clinical practice. Awareness and recognition of how SDH support delivery of patient-centered care may promote patient and population health outcomes. Conclusion(s) The inclusion of SDH into athletic training education using lecture, observational learning, and reflective techniques can expose students to SDH in clinical practice and promote whole-person health care.

A Study on the Improvement Guide for Sports injury Management System: An Analysis of Survey on the Management, Satisfaction of Facilities and Job Satisfaction of Athletic Trainers

PURPOSE: The purpose of this study was to investigate athletes’ satisfaction of sports injury management system and athletic trainers’ job satisfaction.METHODS: Total of 183 athletes and 30 athletic trainers responded to the survey. The surveys consisted 25 questions for health care satisfaction from athletes. From factor analysis, there were four subfactors 1) Satisfaction with trainer quality, 2) Activity on the role of the trainer, 3) Satisfaction with injury management system service, 4) The necessity of an athletic trainer) from 25 questions. The survey for athletic trainers consisted to 19 questions and there were five subfactors 1) Relationship and communication, 2) Treatment as an athletic trainer 3) Expectation for working environment change, 4) Proud for the job, 5) Anxiety and inequality in the work environment). One-way analysis of variance was utilized to compare the differences among subfactors in each category. Independent t-test was used to compare the satisfaction with or without athletic trainers.RESULTS: 1) Athletes’ satisfaction: there was a significant difference between the satisfaction with or without athletic trainers in subfactor 2 and 3 (p<.01). The satisfaction of injury management system exhibited that subfactor 2 and 3 showed a significance difference by age (p<.05) and subfactor 1, 2, and 3 (p<.01) showed a significant difference by event participations of athletic trainers. 2) Athletic trainers’ satisfaction: There was a significant difference on subfactor 3 (p<.05) between age 20-26 years old. In addition, there was a significant difference on sub factor 3 (p<.05) by type of sports and on subfactor 2 (p<.05) by career span.CONCLUSIONS: A systematic athletic training education program and the vocational welfare environment of athletic trainer will be necessary for providing a better health care services to athletes.

Faculty Perceptions of Readiness to Implement Interprofessional Education in Athletic Training

PURPOSE As the athletic training profession advances, master’s degree accreditation standards aim to position athletic trainers as key players on interprofessional healthcare teams. Interprofessional education standards were recently introduced to academic leaders as key elements in the professional healthcare education of athletic trainers. While the current standards reflect essential skills for entry-level clinicians, faculty instructing these elements may require additional development. METHODS The objective of this study was to explore athletic training educators’ perceptions of interprofessional education and to examine perceived barriers related to the implementation of IPE in athletic training curricula. An electronic survey was administered to a stratified, random sample of 1000 athletic training education program faculty from the National Athletic Trainer’s Association (NATA) member database. Participating faculty completed the Interdisciplinary Education Perception Scale (IEPS) and a set of additional Likert-scale questions regarding barriers to implementation of IPE in athletic training education. RESULTS The results indicated that differences exist in faculty readiness to implement IPE based on faculty rank or role, years of teaching experience, prior experience and skill level using IPE, and geographical location of the athletic training program within the institution. CONCLUSION The results indicated that differences exist in faculty readiness to implement IPE based on faculty rank or role, years of teaching experience, prior experience and skill level using IPE, and geographical location of the athletic training program within the institution. Together, the findings suggest that IPE integration should include initiatives that provide administrative support, delineate leadership roles, offer formal IP development, and aim to create closer physical proximity among healthcare disciplines on campuses.

Organizational Socialization: Experiences of Junior Faculty in Athletic Training Education Programs

Background: New faculty members become oriented to their new positions through numerous methods, such as institutional mechanisms as well as networking with various individuals. The process of acculturation is often complex, and best understood from a socialization framework. Role transition for the faculty member is often accomplished through professional socialization, or the experiences prior to beginning a faculty position. However, role transition also continues once the newly minted doctoral student is catapulted into employment. This dynamic, on-going process is often seen as organizational socialization. Objective: We sought to understand how Athletic Training faculty members navigate role transition, from doctoral student to faculty member during the pre-tenure years. Procedures: 19 junior Athletic Training faculty members completed semi-structured interviews to discuss their role transition and inductance into higher education. Data were analyzed following a general inductive approach. Credibility was secured through triangulation, peer review, and interpretative member checks. Results: We found that several organizational mechanisms were in place to support this time of role transition: 1) interviews, 2) orientation, 3) professional development activities, and 4) role consistency. Also, internal motivation and individual inquisitiveness supported this transition, as the junior faculty often solicited feedback or advice from others in their department to evaluate what was expected of them and how to succeed while performing their roles.

Commentary: Integrating Diagnostic Ultrasound into Athletic Training Education Programs

Context: The use of point-of-care ultrasound (POCUS) is increasingly becoming a standard of care for sports medicine and orthopedic physicians. As such, there will be increased demand for athletic trainers to have knowledge and skills in diagnostic ultrasound. Objective: To provide key considerations for integration of diagnostic ultrasound into athletic training education and address challenges and barriers to such integration. Background: Advancements in designing portable, user-friendly ultrasound units have enabled clinicians to perform POCUS as an adjunct to the physical exam, resulting in improved patient care. Increased demands for POCUS across medicine have prompted medical schools to integrate diagnostic ultrasound throughout the curriculum, providing athletic training education programs a framework to consider within their curriculum. Synthesis: Integrating diagnostic ultrasound throughout the curriculum provides focused experiences to prepare, conduct, and link imaging to clinical and physical exam skills. Diagnostic ultrasound has a role in visualizing structures in an anatomy course, as an adjunct to physical exam in medical conditions, orthopedic exam, and diagnosis courses, and as a visual feedback tool in rehabilitation courses, thus enabling it to be integrated throughout existing curriculum. Barriers to diagnostic ultrasound include cost, time, and faculty expertise. Results: Cost sharing or use of ultrasound simulators can overcome cost barriers. Use of online educational modules to deliver content virtually is effective and allows face-to-face time to be spent in hands-on experiential learning. Finally, developing interprofessional partnerships to “teach the teacher” is an effective model in teaching faculty about diagnostic ultrasound. Recommendation(s): Educational programs should consider ways to overcome barriers and integrate diagnostic ultrasound into curriculum equipping future athletic trainers with knowledge and skills for POCUS, thus increasing their effectiveness on a health care team. Conclusion(s): Proactive integration of diagnostic ultrasound into athletic training education will equip graduates to add value to a health care team.

Mini-Editorial Compilation for Special Section

Mini-Editorial Compilation for Special Section