Postprofessional Athletic Training Research Articles

Factors Influencing Athletic Trainers Pursuing Residency Training

Context Residency training in athletic training is an educational priority for specialist development; however, little is known about what motivates athletic trainers (ATs) to pursue this training. Objective To identify the motivating factors that influence ATs to pursue postprofessional athletic training residencies. Design Qualitative study. Setting Individual telephone interviews. Patients or Other Participants Twelve postprofessional athletic training residency candidates (8 females, 4 males; age = 26 ± 3 years; years of experience as a practicing AT = 4 ± 3 years) participated. Data Collection and Analysis Each teleconference interview was transcribed verbatim. All information was retrieved, coded, and categorized under domains, subdomains, and categories. Three members of the research team coded and compared transcripts using multiple-analyst triangulation and peer review to confirm their findings. An external auditor was used to verify the accuracy of the codebook. Results We identified 4 emergent domains: (1) support to pursue, (2) personal influencers, (3) professional influencers, and (4) future recruitment considerations. Web resources, direct residency contacts, and mentors with knowledge of residencies provided potential residents with information about residency programs. Personal influencers included financial considerations, work/life balance, and increased respect. Professional influencers included practice setting, working in teams, developing a specialization, and self-improvement. Professional influencers also included a subdomain, by which potential residents acknowledged what is gained from postprofessional learning in terms of advanced practice clinical, scholarship, and leadership skill development. Participants suggested residencies should use social media and conference presentations to clarify the central message around the purpose of residencies and specialization. Conclusions The purpose of this study was to identify the motivating factors that influence ATs to pursue residency training. Participants applied to residencies for several different reasons, but all wanted to advance their practice and improve their ability to perform their job functions through both additional clinical and didactic education.

Perspectives of a Mental Health Emergency Standardized Patient Encounter: A Follow-Up Interview of Athletic Trainers

Context Athletic trainers should be able to recognize, refer, and provide support to patients with mental health challenges such as anxiety, depression, and suicidal ideation. However, clinicians may not have the opportunity to identify the signs and symptoms in an authentic scenario until a patient presents in their facility. Therefore, supplemental clinical education via standardized patient (SP) encounters may allow for an opportunity to practice mental health care in a safe manner. However, data to support if a SP encounter has a lasting effect on one's clinical practice are lacking. Objective To reflect on a SP encounter focused on a mental health emergency (suicidal ideation) and the influence, if any, the encounter had on one's clinical practice 1.5 to 3 years following the encounter. Design Consensual qualitative research tradition. Setting One-on-one interview. Patients or Other Participants Twelve graduates from the same postprofessional athletic training program (men = 6, women = 6) participated in this study. Main Outcome Measure(s) Participants completed a one-on-one interview guided by a 7-question, semistructured interview protocol. A 3-person coding team identified domains and categories. Results Two domains emerged from the study: (1) learning experience and (2) patient approach. The learning environment created an emotionally realistic space with reassurance and collaborative learning. Specifically, the participants were able to transform their practice from errors made during the SP encounter. The SP encounter had positive, long-term effects on their clinical care including improvements in empathy, active listening, and emergency planning. Conclusions Like other research about the longitudinal effects of SP encounters, participants applied the learning outcomes from the encounter in their clinical practice 1.5 to 3 years later. We suggest mental health SP encounters be used to prepare athletic trainers, regardless of experience, for emergency mental health crises.

Integration and Outcomes of a Hybrid Simulation for Simple Laceration Suturing

Context Emergency and immediate care skills are often difficult to practice in real time during clinical education. One immediate care skill requiring advanced training that may not be implemented during clinical education is wound closure via suturing. Simple laceration management with sutures can be advantageous skill for athletic training students to learn and practice; however, deliberate practice with feedback in a realistic manner is necessitated. Objective To describe the use of hybrid simulation to practice suturing in professional and postprofessional athletic training programs. Background The practice of immediate and emergency skills is predominately classroom based and removes the patient experience. Simulation-based learning has provided athletic training educators an opportunity for skill practice with patient simulators and standardized patients to fill the gap. Description The hybrid simulation incorporates the use of a standardized live patient actor with an attached part-task–training simulated arm for suturing in a safe and realistic manner. Clinical Advantage(s) Incorporating a hybrid simulation encounter for practice of suturing skills requires multitasking and delivery of patient-centered care and promotes proper skill execution while receiving questions and direct feedback from the standardized patient. Conclusion(s) Suturing should be taught and assessed in a tiered format using part-task trainers such as pig skin and artificial skin pads. After skill development, a hybrid simulation as a summative assessment allows for the educator to evaluate the learners' interpersonal communication and technical skills in a safe manner.

Translation of Standardized Patient Encounter Performance and Reflection to Clinical Practice

Context Standardized patient (SP) encounters have been incorporated into many healthcare education programs, including professional athletic training programs, yet there is little exploration about the use of SP encounters in postprofessional programs and continuing education opportunities. Objective To explore athletic trainers' translation of skills and reflections in clinical practice after an SP encounter and debriefing session. Design Qualitative action research. Setting One-on-one interview. Patients or Other Participants Fifteen learners from the same postprofessional athletic training degree program (males = 3, females = 12; age = 25 ± 5 years; certified experience = 3 ± 3 years) without previous SP experience participated in this study. All learners had to be employed full or part-time in a clinical setting. Main Outcome Measure(s) Sixty days after an SP encounter related to patient-centered care during an orthopedic evaluation and subsequent debriefing session, participants completed an online, audio-only interview after a 10-question, semistructured interview protocol. A 3-person primary coding team identified domains and categories using the consensual qualitative research tradition. Results Three main domains emerged from the study: (1) limitations of a novice SP experience, (2) practice transformation, and (3) promoting self-reflection. Participants reported that the initial SP encounter in their postprofessional education was a new experience through which they were able to implement new skills learned in their previous courses. Translation of newly learned ideas or ways of thinking to clinical practice varied among clinicians and their job settings. Collaborative thinking and self-reflection were key components. Participants were able to identify with their classmates' struggles and triumphs and to take away new learning experiences. Conclusions SP encounters are a useful instructional and assessment technique for athletic trainers in a postprofessional athletic training degree program to promote self-reflection and to translate newly learned skills to their clinical practice, while nerves and anxiety influenced the learners' ability to suspend reality.

Postprofessional Athletic Training Students' Perceptions Concerning the Health Care Competencies

Context: Over a decade ago, the Institute of Medicine indicated that all health care professionals should be educated in several health care competency areas (quality improvement, health care informatics, interprofessional education and collaborative practice, evidence-based practice, and patient-centered care). Despite this initiative, athletic training has only recently incorporated these competencies throughout education. Objective: To assess postprofessional athletic training students' perceived abilities and importance regarding 6 core competencies. Design: Cross-sectional. Setting: Self-reported paper survey. Patients or Other Participants: A total of 221 from a convenience sample of 258 postprofessional athletic training students (85.7%) completed the survey (82 males, 138 females; age = 23.29 ± 2.05 years). Main Outcome Measure(s): The survey consisted of several concept statements for each competency, and perceptions were collected via Likert-scale items (range 1–4). Composite perceived ability and importance Likert-scale scores were achieved by tabulating all values and then averaging the scores back to the Likert scale. Higher scores indicated that participants perceived themselves to have greater ability and that the concepts were more important for implementation in clinical practice. Results: Overall, postprofessional athletic training students perceived they were able to implement the concepts of the competencies into their daily practice and perceived all of the competencies to be moderately to extremely important for implementation. However, while participants globally perceived they were able to implement the competencies, they disagreed or strongly disagreed they were able to implement some concepts, particularly within health care informatics and patient-centered care, as a part of their clinical practice. Conclusions: Postprofessional athletic training students recognize the importance of the core competencies and perceive they are able to implement these competencies throughout clinical practice. However, as postprofessional athletic training students continue to advance their skills as clinicians, the benefits of health care informatics and incorporating real-time electronic patient data to support their clinical decisions should be emphasized.

Newly Credentialed Athletic Trainers' Perceptions of Professional Preparation for Their Role as Collegiate Graduate Assistants

Context: The professional preparation of newly credentialed athletic trainers (ATs) has been passionately debated. Understanding how newly credentialed ATs feel they are prepared will help enhance professional preparation. Objective: Explore newly credentialed ATs' perceptions of their professional preparation for their role. Design: Phenomenological qualitative. Setting: Phone interviews with graduate assistant ATs in the collegiate setting. Patients or Other Participants: Nineteen collegiate graduate assistants (15 female, 4 male; average age = 23 ± 0.15 years; National Collegiate Athletic Association Division I: 13, II: 3, III: 2, National Association of Intercollegiate Athletics: 2; postprofessional athletic training program: 6). Main Outcome Measure(s): Participants were recruited via an e-mail from the National Athletic Trainers' Association database sent to all certified students. Data were collected via phone interviews, which were recorded and transcribed verbatim. Interviews were conducted until data saturation occurred. Data were analyzed through phenomenological reduction, with data coded for common themes and subthemes. Credibility was established via member checks and peer debriefing. Results: Two themes emerged: facilitators and barriers. Overall, participants felt academically prepared for their role, but preparedness was often dependent on the facilitators of academic rigor, hands-on opportunities in clinical education, and their preceptor. Barriers included a lack of rigor in the academic setting, lack of active opportunities in clinical education, the culture of clinical experiences, and incongruence. Incongruence existed when students were exposed to all the competencies during didactic education, but never gained experience with some skills (eg, rehabilitation, documentation, communication) if situations never arose or they were not actively involved clinically. Conclusions: Athletic training students are being exposed to a variety of learning experiences academically, but often do not gain clinical experience if situations do not arise or preceptors do not allow active participation. To ensure new ATs are prepared, academic programs need to ensure rigor and place students with preceptors who provide active learning opportunities.

Curation of a Simulation Experience by the Clinical Scholar: An Educational Technique in Postprofessional Athletic Training

Context: Postprofessional athletic training programs continue to prepare advanced-practice leaders in the profession. As part of being leaders and clinical scholars within the field, it is important that students pursing postprofessional graduate education be exposed to curriculum and instructional theory, practice, and strategies. Objective: To describe an education technique focused on the curation of a simulation assignment as part of a postprofessional athletic training course as a means to develop an appreciation of instructional strategies as a clinical scholar. Background: The postprofessional athletic training student (PP-ATS) may be working as a full-time clinician, graduate assistant, or novice educator, or as an intern within an athletic training clinic. Regardless of employment status, PP-ATSs engage with several key stakeholders, ranging from parents and legal guardians to coaching staff and professional athletic training students. The PP-ATS may be tasked to provide education to these stakeholders in the form of patient participation status to a coach, describing the pathogenesis of a condition to a patient, and rationale for care to professional athletic training students. Description: The PP-ATSs were placed in learning communities of 3 to 5 students. The learning communities were tasked with the development of high- and low-fidelity simulations for learners (the other PP-ATSs in the course) to engage in during an intensive and focused learning session, facilitation of the experience, and a debrief encounter. Clinical Advantage(s): A 2-fold benefit exists. First, PP-ATSs are engaged in the design and development of a simulation experience as an instructional intervention. Second, simulation learners are gainfully engaged in low-stakes patient encounters that promote professional growth. Conclusion(s): Developing and implementing learner-curated simulation experiences exposes PP-ATSs to an innovative instructional strategy in athletic training.

Development of an Instrument to Assess Athletic Trainers' Attitudes Toward Transgender Patients

The unique contexts in which athletic trainers (ATs) work require specific tools in order to understand their attitudes toward diverse patient populations, including sexual and gender minorities. To develop and validate the Attitudes Toward Transgender Patients (ATTP) instrument for ATs. Cross-sectional study. Semistructured interviews, paper-based questionnaire, and electronic questionnaire. Six ATs completed semistructured interviews to develop themes regarding transgender patients. Additionally, 39 students in professional and postprofessional athletic training programs answered questionnaires designed to elicit statements regarding transgender patients. For item reduction, a sample of 3000 ATs were e-mailed (response rate = 17%), and for validation, another sample of 3000 ATs were e-mailed (response rate = 13%). Athletic trainers' e-mail addresses were obtained from the National Athletic Trainers' Association. The 3 phases were (1) exploratory interviews, (2) construct validity and item reduction, and (3) criterion validity. Items were created based on interviews and questionnaires. Principal axis factoring was used for item reduction, and Pearson correlations were used for validation. Thirty-six statements pertaining to transgender patients were developed from the interview and questionnaire data. After item reduction, 10 items remained to form the ATTP (α = .834). For validation, the ATTP and Transphobia Scale were significantly correlated ( r = .723; P < .001). The ability to assess attitudes toward transgender patients will allow clinicians to identify needed areas of focus for training and education. The ATTP assesses affective and cognitive attitudes and behavioral intentions toward transgender patients in common clinical settings.

Graduate-Assistant Athletic Trainers' Perceptions of Professional Socialization in the Collegiate Setting: Part I.

Many newly credentialed athletic trainers (ATs) pursue graduate assistantships, which allow them to gain experience while being supervised by an experienced AT. The graduate-assistant (GA) ATs' perception of their socialization process into the collegiate setting is unknown. To explore the professional socialization of GAs in the collegiate setting. Qualitative study. Phone interviews. A total of 19 collegiate GAs (15 women, 4 men; average age = 23 ± 0.15 years; National Collegiate Athletic Association Division I = 13, II = 3, III = 2; National Association of Intercollegiate Athletics = 2; postprofessional athletic training program = 6) participated. Data were collected via phone interviews and transcribed verbatim. Interviews were conducted until data saturation occurred. Data were analyzed through phenomenologic reduction. Trustworthiness was established via member checks and peer review. Four themes emerged: (1) role identity, (2) initial entry into role, (3) maturation, and (4) success. Before beginning their role, participants envisioned the assistantship as a way to gain independent experience while being mentored. They perceived themselves as the primary care providers for their athletic teams. Those who were immediately immersed into clinical practice adapted to their role quickly despite experiencing stress initially. Participants felt that a formal orientation process and a policies and procedures manual would have alleviated some of the initial stress. The GAs matured as they practiced clinically and developed confidence as they gained experience. Personal attributes, experience, and peer and supervisor support contributed to perceived success as GAs. Factors that hindered perceived success were lack of confidence, an unsupportive environment, and long hours. When looking for graduate assistantships, ATs should seek a position that allows them to practice independently and provides didactic educational opportunities while aligning with their athletic training philosophies.

Graduate-Assistant Athletic Trainers' Perceptions of the Supervisor's Role in Professional Socialization: Part II.

Many new athletic trainers (ATs) obtain graduate-assistant (GA) positions to gain more experience and professional development while being mentored by a veteran AT; however, GA ATs' perceptions of the supervisor's role in professional development are unknown. To explore the supervisor's role in the professional development of GAs in the collegiate setting. Qualitative study. Phone interviews. A total of 19 collegiate GAs (15 women, 4 men; average age = 23 ± 0.15 years; National Collegiate Athletic Association Division I = 13, II = 3, III = 2; National Association of Intercollegiate Athletics = 2; postprofessional athletic training program = 5). Data were collected via phone interviews and transcribed verbatim. Interviews were conducted until data saturation occurred. Data were analyzed through phenomenologic reduction. Trustworthiness was established via member checks and peer review. Three themes emerged: (1) GAs' expectations of supervisors, (2) professional development, and (3) mentoring and support. Participants expected their supervisors to provide mentorship, support, and feedback to help them improve their athletic training skills, but they also realized supervisors were busy with patient care responsibilities. Most participants felt their supervisors were available, but others believed their supervisors were too busy to provide support and feedback. Participants felt their supervisors provided professional development by teaching them new skills and socializing them into the profession. Furthermore, they thought their supervisors provided mentorship professionally, personally, and clinically. Supervisors supported the participants by standing behind them in clinical decisions and having open-door policies. The graduate assistantship allows new ATs to gain experience while pursuing professional development, mentorship, and support from a supervisor. The extent of development is highly dependent on the supervisor, but most supervisors mentor GAs. When looking for graduate assistantships, future GAs should seek positions in which supervisors actively provide mentoring and professional development.

Orientation Tactics Utilized in Postprofessional Athletic Training Programs

Context: Some newly credentialed athletic trainers pursue a postprofessional degree with a curriculum that specifically advances their athletic training practice. Orientation sessions are a tactic used to assist these students' transition into these new roles of graduate student and independent clinician, yet the structure of these sessions is unknown. Objective: Understand how postprofessional athletic training programs' orientation session structure integrates new students. Design: Qualitative. Setting: Semistructured phone interviews. Patients or Other Participants: Nineteen program directors (10 men, 9 women) from 13 Commission on Accreditation of Athletic Training Education–accredited and 6 unaccredited postprofessional athletic training programs. Main Outcome Measure(s): Phone interviews were digitally recorded and transcribed verbatim. Data analysis used the principles of conventional content analysis. Credibility was maintained using peer review, member checks, and researcher triangulation. Results: Orientation sessions were used to familiarize students with policies, procedures, and expectations regarding their roles as student and clinician. These sessions occurred before role engagement, and were described by the themes type and time. Type referred to whether the orientation session was blended or individual. Blended sessions discussed information pertaining both to the academic program, such as course registration and research expectations, and to the clinical information affecting the graduate assistantship. Individual orientation sessions, on the other hand, discussed only academic program information or clinical information, not both. Time referred to the frequency of the orientation sessions. One-time orientation sessions occurred over the course of 1 day or 1 week, after which no additional orientation activities occurred. Conversely, ongoing orientation occurred throughout the semester. Conclusions: Postprofessional athletic training programs used different orientation methods to help newly credentialed athletic trainers transition into graduate students and practicing clinicians.

Self-Funding a Postprofessional Athletic Training Residency

Context: Postprofessional athletic training residencies (PP-ATRs) are formal educational programs that provide advanced professional preparation for an athletic trainer. These programs are intended to provide clinical and didactic education in a focused area of clinical practice. Identifying and procuring funding to support athletic training residencies can be extremely difficult. Objective: To provide a basic understanding of the foundational requirements of a PP-ATR and to explain some of the basic principles behind funding a PP-ATR. Conclusion(s): Orthopaedic and physical therapy residencies have been able to demonstrate supporting the costs of those residencies through billable patient visits and/or improving clinic efficiency. As they progress through training, athletic training residents are able to increase patient volumes by 3-4 patients in a physician practice setting. In addition, the resident also indirectly generates revenue for the practice, thus offsetting the cost of the residency.

Exploring the Transition to Practice for the Newly Credentialed Athletic Trainer: A Programmatic View.

Some newly credentialed athletic trainers (ATs) pursue a postprofessional degree with a curriculum that specifically advances their athletic training practice. It is unknown how those postprofessional programs assist in their transition to practice. To gain an understanding of initiatives used by postprofessional athletic training programs to facilitate role transition from student to professional during their graduate degree programs. Qualitative study. Semistructured telephone interviews. A total of 19 program directors (10 men, 9 women) from 13 Commission on Accreditation of Athletic Training Education-accredited and 6 unaccredited postprofessional athletic training programs. Telephone interviews were recorded digitally and transcribed verbatim. For data analysis, we used the principles of general inductive approach. Credibility was maintained using peer review, member checks, and researcher triangulation. Three facilitators of transition to practice emerged: orientation sessions, mentoring, and assistantship. Participants used orientation sessions ranging from a few hours to more than 1 week to provide and discuss program polices and expectations and to outline roles and responsibilities. Faculty, preceptors, and mentors were integrated into the orientation for the academic and clinical portions of the program. All participants described a mentoring process in which students were assigned by the program or informally developed. Mentors included the assigned preceptor, a staff AT, or peer students in the program. The clinical assistantship provided exposure to the daily aspects of being an AT. Barriers to transition to practice included previous educational experiences and time management. Participants reported that students with more diverse didactic and clinical education experiences had easier transitions. The ability to manage time also emerged as a challenge. Postprofessional athletic training programs used a formal orientation session as an initial means to help the newly credentialed AT transition into the role. Mentoring provided both more informal and ongoing support during the transition.

The professional socialization of the graduate assistant athletic trainer.

The graduate assistant athletic trainer (AT) position often serves as one's first experience working independently as an AT and is also an important aspect of the professional socialization process. The socialization experiences of graduate assistant ATs have yet to be fully explored. To understand the socialization process for graduate assistant ATs during their graduate experience. Qualitative study. We conducted phone interviews with all participants. A total of 25 graduate assistant ATs (20 women, 5 men) studying in 1 of 3 academic tracks: (1) accredited postprofessional athletic training program (n = 8), (2) postprofessional athletic training program (n = 11), or (3) a nonathletic training degree program (n = 6). The average age was 25 ± 5 years, and the median age was 24 years. Participants were certified by the Board of Certification for an average of 2 ± 0.4 years. We analyzed the data using a general inductive approach. Peer review, field notes, and intercoder reliability established trustworthiness. Data saturation guided participant recruitment. The ability to gain clinical independence as a practitioner was an important socialization process. Having the chance to develop a relationship with a mentor, who provided support, guidance, and more of a hierarchical relationship, was an important socializing agent for the graduate assistant AT. Participants used the orientation session as a means to understand the expectations and role of the graduate-assistant position. Academic coursework was a way to achieve better inductance into the role via the opportunity to apply classroom skills during their clinical practice. Socializing the graduate assistant blends formal and informal processes. Transition to practice is a critical aspect of the profession; thus, supporting autonomous practice with directed mentoring can promote professional maturity.

Career commitment of postprofessional athletic training program graduates.

Choosing to pursue an advanced degree in athletic training appears to indicate professional commitment and passion for the profession. Currently, there is a paucity of information regarding why some athletic trainers pursue enrollment in a postprofessional athletic training program (PPATP), indicating commitment to the profession, but later depart for another primary role outside of athletic training. To understand why athletic trainers invested in advanced training via a PPATP but then decided to leave the profession. Qualitative study. Online data collection. Twelve graduates (8 women [67%], 4 men [33%], age = 31.58 ± 3.06 years) from PPATPs who no longer had primary employment as an athletic trainer. Recruits responded to an e-mail invitation to participate by completing a confidential online questionnaire. We analyzed data using a general inductive approach and secured trustworthiness using multiple-analyst triangulation, peer review, and member checks. Two higher-order themes emerged regarding the career commitment of former athletic trainers who were PPATP graduates: (1) departure from an athletic training career and (2) partial continuance in athletic training. Two second-order themes emerged from the reasons for departure: (1) decreased recognition of value and (2) work-life imbalance. Finally, we identified 2 third-order themes from the participants' reasons for departure because of a perceived lack of value: (1) low salary and (2) long, inconsistent hours worked. Most of our participants intended to stay in the profession when they chose to attend a PPATP. However, during role inductance in either the clinical experience of the PPATP they attended or early in their careers, they began to have thoughts of leaving mainly because of inadequate financial compensation, challenging work schedules, or both.

Perceptions of Support Networks During the Graduate-Assistant Athletic Trainer Experience.

The graduate-assistant position can be a highly influential experience because it is often the first time novice athletic trainers (ATs) are practicing autonomously. To gain an understanding of how graduate-assistant ATs (GAATs) perceive professional socialization and mentorship during their assistantships. Semistructured phone interviews. Graduate-assistant ATs in various clinical settings. Twenty-five GAATs (20 women, 5 men) studying in 1 of 3 academic tracks (postprofessional athletic training = 8, athletic training-based curriculum = 11, non-athletic training-based curriculum = 6). Median age was 24 years. Phone interviews were digitally recorded and transcribed verbatim. Data analysis used principles of the general inductive approach. Credibility was maintained using peer review, field notes, and intercoder reliability. Participants identified peer support throughout their experiences, in both academic and clinical settings. The GAATs frequently relied on other GAATs for support due to shared experiences and understanding of workloads. Participants described difficulty receiving supervisor support from full-time staff ATs due to the supervisors' workload and time constraints, limiting their availability for mentoring. Guidance from academic support personnel occurred only in athletic training-centered academic programs. Communication emerged as helpful for incoming GAATs; the previous GAATs provided formal mentorship via job descriptions highlighting role responsibilities and expectations. Differences between assistantship types were noted only in terms of receiving balanced mentorship between the academic and clinical staffs, such that students studying in postprofessional athletic training programs perceived more balanced support. Our results confirm the literature regarding the GAAT's pursuit of continued formal mentoring. The GAATs perceived less support from full-time AT staff members due to limited availability. Therefore, GAATs leaned on their peers for support during the graduate experience.

Use of Evidence-Based Practice Among Athletic Training Educators, Clinicians, and Students, Part 2: Attitudes, Beliefs, Accessibility, and Barriers

Successful implementation of evidence-based practice (EBP) within athletic training is contingent upon understanding the attitudes and beliefs and perceived barriers toward EBP as well as the accessibility to EBP resources of athletic training educators, clinicians, and students. To assess the attitudes, beliefs, and perceived barriers toward EBP and accessibility to EBP resources among athletic training educators, clinicians, and students. Cross-sectional study. Online survey instrument. A total of 1209 athletic trainers participated: professional athletic training education program directors (n = 132), clinical preceptors (n = 266), clinicians (n = 716), postprofessional athletic training educators (n = 24) and postprofessional students (n = 71). Likert-scale items (1 = strongly disagree, 4 = strongly agree) assessed attitudes and beliefs and perceived barriers, whereas multipart questions assessed accessibility to resources. Kruskal-Wallis H tests (P ≤ .05) and Mann-Whitney U tests with a Bonferroni adjustment (P ≤ .01) were used to determine differences among groups. Athletic trainers agreed (3.27 ± 0.39 out of 4.0) that EBP has various benefits to clinical practice and disagreed (2.23 ± 0.42 out of 4.0) that negative perceptions are associated with EBP. Benefits to practice scores (P = .002) and negative perception scores (P < .001) differed among groups. With respect to perceived barriers, athletic trainers disagreed that personal skills and attributes (2.29 ± 0.52 out of 4.0) as well as support and accessibility to resources (2.40 ± 0.40 out of 4.0) were barriers to EBP implementation. Differences were found among groups for personal skills and attributes scores (P < .001) and support and accessibility to resources scores (P < .001). Time (76.6%) and availability of EBP mentors (69.6%) were the 2 most prevalent barriers reported. Of the resources assessed, participants were most unfamiliar with clinical prediction rules (37.6%) and Cochrane databases (52.5%); direct access to these 2 resources varied among participants. Athletic trainers had positive attitudes toward the implementation of EBP within didactic education and clinical practice. However, accessibility and resource use remained low for some EBP-related resources. Although the perceived barriers to implementation are minimal, effective integration of EBP within athletic training will present challenges until these barriers dissolve.

Use of Evidence-Based Practice Among Athletic Training Educators, Clinicians, and Students, Part 1: Perceived Importance, Knowledge, and Confidence

Although evidence-based practice (EBP) has become more prevalent, athletic trainers' perceptions of importance and knowledge of these concepts and their confidence in EBP are largely unknown. To assess perceived importance and knowledge of and confidence in EBP concepts in athletic trainers in various roles and with different degree levels. Cross-sectional study. Online survey instrument. The survey was sent to 6702 athletic training educators, clinicians, and postprofessional students. A total of 1209 completed the survey, for a response rate of 18.04%. Demographic information and perceived importance and knowledge of and confidence in the steps of EBP were obtained. One-way analysis of variance, a Kruskal-Wallis test, and an independent-samples t test were used to determine differences in scores among the demographic variables. Athletic trainers demonstrated low knowledge scores (64.2% ± 1.29%) and mild to moderate confidence (2.71 ± 0.55 out of 4.0). They valued EBP as moderately to extremely important (3.49 ± 0.41 out of 4.0). Perceived importance scores differed among roles (clinicians unaffiliated with an education program scored lower than postprofessional educators, P = .001) and highest educational degree attained (athletic trainers with terminal degrees scored higher than those with bachelor's or master's degrees, P < .001). Postprofessional athletic training students demonstrated the highest total EBP knowledge scores (4.65 ± 0.91), whereas clinicians demonstrated the lowest scores (3.62 ± 1.35). Individuals with terminal degrees had higher (P < .001) total knowledge scores (4.31 ± 1.24) than those with bachelor's (3.78 ± 1.2) or master's degrees (3.76 ± 1.35). Postprofessional educators demonstrated greater confidence in knowledge scores (3.36 ± 0.40 out of 4.0) than did those in all other athletic training roles (P < .001). Overall knowledge of the basic EBP steps remained low across the various athletic trainers' roles. The higher level of importance indicated that athletic trainers valued EBP, but this value was not reflected in the knowledge of EBP concepts. Individuals with a terminal degree possessed higher knowledge scores than those with other educational preparations; however, EBP knowledge needs to increase across all demographics of the profession.

Clinical Preceptors' Perspectives on Clinical Education in Post-Professional Athletic Training Education Programs

Context: Clinical education is the interaction between a clinical preceptor and student within the clinical setting to help the student progress as a clinician. Post-professional athletic training clinical education is especially important to improve these students' clinical knowledge and skills. However, little research has been conducted to assess the pedagogical principles for clinical education at this level or what factors are necessary to enhance the clinical skills and decision-making abilities of post-professional students. Therefore, exploring the perspectives of clinical preceptors involved in post-professional education will help educators understand what strategies are necessary to improve post-professional athletic training education programs (PPATEPs). Objective: To qualitatively investigate clinical preceptors' perspectives and experiences regarding clinical education within PPATEPs. Design: Consensual qualitative research (CQR) with an emergent design. Setting: Telephone interviews were conducted with all participants. Patients or Other Participants: Eleven collegiate post-professional clinical preceptors (7 males, 4 females; average age = 38±7.3 years; average years as an athletic trainer = 15±6.6 years) who were affiliated with a PPATEP were interviewed, representing 11 out of 16 PPATEPs. Data Collection and Analysis: Interview transcripts were coded for themes and categories. Triangulation included a consensus process by the research team and member checking to verify the data. Results: Data analysis yielded four themes relating to clinical education in PPATEPs: importance of clinical education, clinical preceptor responsibilities, clinical preceptor qualities, and barriers to clinical education. Participants indicated that clinical education was important for students to develop clinical skills and give them opportunities to make patient care decisions, and that several fundamental responsibilities and qualities contribute to being an effective clinical preceptor at the post-professional level. Conclusions: Post-professional clinical preceptors recognized that an appropriate balance between autonomy and guided practice in clinical experiences fostered an effective learning environment which allowed post-professional students to improve their clinical and decision-making skills beyond their entry-level skill set. Preceptors should also demonstrate attributes of a clinician, educator, and communicator to be an effective mentor.

National Athletic Trainers' Association-Accredited Postprofessional Athletic Training Education: Attractors and Career Intentions

Anecdotally, we know that students select graduate programs based on location, finances, and future career goals. Empirically, however, we lack information on what attracts a student to these programs. To gain an appreciation for the selection process of graduate study. Qualitative study. Postprofessional programs in athletic training (PPATs) accredited by the National Athletic Trainers' Association. A total of 19 first-year PPAT students participated, representing 13 of the 16 accredited PPAT programs. All interviews were conducted via phone and transcribed verbatim. Analysis of the interview data followed the procedures as outlined by a grounded theory approach. Trustworthiness was secured by (1) participant checks, (2) participant verification, and (3) multiple analyst triangulations. Athletic training students select PPAT programs for 4 major reasons: reputation of the program or faculty (or both), career intentions, professional socialization, and mentorship from undergraduate faculty or clinical instructors (or both). Participants discussed long-term professional goals as the driving force behind wanting an advanced degree in athletic training. Faculty and clinical instructor recommendations and the program's prestige helped guide the decisions. Participants also expressed the need to gain more experience, which promoted autonomy, and support while gaining that work experience. Final selection of the PPAT program was based on academic offerings, the assistantship offered (including financial support), advanced knowledge of athletic training concepts and principles, and apprenticeship opportunities. Students who attend PPAT programs are attracted to advancing their entry-level knowledge, are committed to their professional development as athletic trainers, and view the profession of athletic training as a life-long career. The combination of balanced academics, clinical experiences, and additional professional socialization and mentorship from the PPAT program experience will help them to secure their desired career positions.