Professional Athletic Training Programs Research Articles

Athletic Training Students’ Use of Evidence-Based Practice Professional Behaviors During Clinical Experiences: A Report From the Association for Athletic Training Education Research Network

With the incorporation of evidence-based practice (EBP) during patient care as a curricular content standard, professional programs must prepare athletic training students (ATSs) for the application of EBP during the delivery of patient care. We aimed to examine ATSs’ implementation of professional behaviors associated with EBP during patient encounters (PEs). Through a multisite panel design, we tracked numerous factors associated with PEs experienced by 363 ATSs of 12 professional athletic training programs. Generalized estimating equation models were used to analyze the likelihood that students included EBP behaviors during 30,522 PEs. Clinical site type (p < .001), student role (p < .001), and encounter length (p < .001) were associated with all three EBP professional behaviors while clinical site type (p < .001) was also associated with whether the ATS asked a question of a clinician, including their preceptor. Program administrators seeking to promote the greatest opportunities for ATSs to implement EBP during patient care should seek clinic-based or other nonacademic site types that promote longer PEs in which students can perform or assist their preceptor.

Interprofessional Collaborative Practice in Professional and Residency Athletic Training Programs: A Report from the Association of Athletic Training Education Research Network

Context Interprofessional collaborative practice (IPCP) is a required component of athletic training education, yet more needs to be learned about how professional and residency programs integrate IPCP into their curricula. Objective Identify current strategies used in the integration, assessment, and quality of IPCP clinical experiences in athletic training programs. Design Cross-sectional survey. Patients or Other Participants Forty-two of the 288 (14.6% response rate) invited individuals participated. All reported being faculty members affiliated with a professional or residency athletic training program. Data Collection and Analysis The IPCP implementation and assessment was e-mailed to all accredited professional and residency program directors to evaluate: (1) institutional or organizational support for and integration of IPCP; (2) faculty, learner, or preceptor preparation for IPCP engagement; and (3) tools for assessment and quality of IPCP experiences. Survey instrumentation was validated through peer and expert review. Descriptive statistics were calculated for quantitative data, and open coding was used to analyze open-ended questions. Results Respondents reported favorable support from their institution or organization (administrative, financial, and organizational structure) to integrate IPCP experiences. The most common methods for IPCP implementation included clinical simulations (n = 22, 22.9%), grand rounds (n = 13, 13.5%), morbidity and mortality conferences (n = 3, 3.1%), journal clubs (n = 6, 6.3%), direct patient care (n = 14, 14.9%), and intentional clinical education experiences (n = 28, 29.2%). Respondents reported formal IPCP training for faculty (n = 7, 16.7%) and learners (n = 23, 54.8%) but not for preceptors (n = 25, 73.5%). While programs assess their learners’ IPCP experiences (n = 25, 59.5%), the quality of those experiences is not formally captured (n = 19, 45.2%). Conclusion(s) Interprofessional collaborative practice experiences within athletic training education continue to evolve. As such, in this study, we highlight the need for formalized training in IPCP for faculty, learners, and preceptors. Additionally, program faculty should consider implementing quality assessments of IPCP experiences to assess the quality and degree to which learners experience interprofessional collaboration.

Exploring the Agreement Between Perceived Rankings and Outcome Data Rankings for Professional Athletic Training Programs

Context The U.S. News & World Report college ranking system is used to describe the best graduate programs in the country. Rankings of graduate programs are based solely on perceived ratings of quality by directors and/or deans. Athletic training is not listed by U.S. News & World Report; however, the Commission on Accreditation of Athletic Training Education (CAATE) reports key metrics such as the Board of Certification pass rate and program graduation rate, which could be helpful to create rankings. Objective To evaluate and rank CAATE-accredited professional athletic training (PAT) programs using 2 models: (1) perceived rating of academic quality by program directors (PDs) and (2) CAATE outcome data. Design Cross-sectional with survey and retrospective data. Setting Web-based survey. Patients or Other Participants One hundred fifty-five PDs and 230 CAATE-accredited PAT programs. Main Outcome Measure(s) The perceived rating survey for the PDs resembled the U.S. News & World Report system using a 5-point Likert scale to assess the academic quality of each program. For the CAATE outcome data, we used publicly available information for each PAT program on the CAATE website. We ranked all PAT programs using the data from each model. A Cohen κ was performed to explore the agreement between the PDs’ perceived ranking and the CAATE outcome data rankings. Results No agreement was found between the perceived peer assessment and CAATE outcome data rankings (κ = −0.003, P = .401). Conclusion Perception by PDs did not align with objective data reported by CAATE. The lack of agreement between the 2 ranking systems highlights concerns about using the U.S. News & World Report system for graduate health programs. We suggest exploring a more robust and comprehensive formula including overall pass rate and graduation rate to identify top-ranked programs in athletic training.

Athletic Training Students’ Mental Health Recognition and Referral Skills, Part 1: A Randomized Controlled Trial

Context The increased prevalence of mental health conditions and athletic training education’s heightened focus on behavioral and mental health necessitate an examination of teaching techniques for this material. This study explores the impact of virtual pedagogical strategies on athletic training students’ knowledge and confidence with mental health recognition and referral to help educators determine best practices for content delivery. Objective This study examined the effect of Mental Health First Aid (MHFA) training on students’ knowledge and confidence in mental health recognition and referral. The impact of group allocation (standardized patient [SP] encounters, case-based learning [CBL], and control) on these outcomes was also assessed. Design Randomized controllled trial portion from a sequential, explanatory mixed-methods design. Setting Online learning environment. Patients or Other Participants Convenience sample of 70 students (25 men, 44 women, 1 nonbinary; aged 23.38 ± 2.27 years) from Commission on Accreditation of Athletic Training Education-accredited graduate-level professional athletic training programs. Intervention(s) All participants completed MHFA training followed by either no intervention, an SP encounter, or CBL activity. Main Outcome Measure(s) Mental health recognition and referral skills as measured by an electronic knowledge assessment and self-reported confidence scale whose content validity were established by an expert panel. Results A mixed-model analysis of variance showed significant improvement from pretest to posttest for both knowledge and confidence [knowledge: F(1,67) = 70.31, P < .001; confidence: F(1,67) = 206.41, P < .001]. This relationship was similar among all 3 groups. No significant difference in knowledge or confidence was found between the control, SP, and CBL groups. Conclusions With the increased need to care for patients’ behavioral and mental health, professional athletic training programs and continuing education should consider incorporating MHFA training to improve content knowledge and confidence in skills. While no numerical difference between the groups was shown by this study, supplementation with simulation through CBL or SP encounters provides an opportunity for application specific to athletic training practice, which may help reinforce concepts and enhance clinical readiness.

Athletic Training Students’ Mental Health Recognition and Referral Skills, Part 2: Perceptions of Pedagogical Strategies

Context The increased prevalence of mental health conditions and the use of telehealth for patient care have exposed gaps in athletic training professional and continuing education. Here, we explore athletic training students’ perceptions of virtual pedagogical strategies for the delivery and application of concepts related to mental health recognition and referral, which may help educators determine best practices. Objective To examine students’ experiences and perceptions of Mental Health First Aid (MHFA) training, case-based learning, and standardized patient encounters. Design Qualitative portion of a sequential, explanatory mixed-methods design. Setting Individual interviews via video conference. Patients or Other Participants A convenience sample of graduate athletic training students from Commission on Accreditation of Athletic Training Education-accredited professional athletic training programs who participated in the MHFA training and secondary encounters were recruited. Twenty-two participants (11 from each intervention group; 45.5% male, 54.5% female; age = 24.59 ± 2.3) were interviewed. Data Collection and Analysis Interviews were recorded using Zoom and then transcribed. The Qualitative Analysis Guide of Leuven method was used to analyze the data to determine emergent themes. Strategies to enhance trustworthiness included an audit trail, member checks, and peer debriefing. Results Five higher order themes emerged from the interview data, as follows: (1) perceived value of MHFA training, (2) engaged learning and facilitated feedback, (3) capability, (4) comfort and confidence, and (5) authenticity. These themes were organized into the following 3 overarching dimensions: knowledge, skills, and pedagogy. Participants described how the opportunity to apply their knowledge and practice their skills with an athletic training-specific scenario helped them feel more equipped for future patient care. Conclusions Regardless of simulation strategy, the opportunity to practice influenced participants’ knowledge and feelings of confidence and capability. The MHFA training and simulated encounters were engaging techniques that incorporated feedback and provided elements of authentic patient interaction.

Interprofessional Interviewing in Intraprofessional Athletic Training Student Pairs: A Multi-Institutional Educational Technique

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.

Athletic Training Student Core Competency Professional Behavior Implementation Between Immersive and Non-immersive Clinical Experiences: A Report From the Association for Athletic Training Education (AATE) Research Network

Context The Commission on Accreditation of Athletic Training Education requires athletic training programs to emphasize the use of professional behaviors that are associated with 6 core competencies, 5 of which were measured in this study: patient-centered care, interprofessional education and collaborative practice (IPECP), evidence-based practice (EBP), health information technology (HIT), and quality improvement (QI). The purpose of this study was to examine the association between clinical experience type and student implementation of behaviors associated with the core competencies. Design Multisite, panel design. Setting Twelve professional athletic training programs (7 graduate, 5 undergraduate). Patients or Other Participants A total of 338 athletic training students logged patient encounters for 1 academic year in the E*Value system. Main Outcome Measure(s) Students reported clinical experience type (immersive versus nonimmersive) and implementation of behaviors associated with core competencies. Counts of professional behaviors were calculated, and differences in behavior implementation between immersive (ICEs) and non-immersive (N-ICEs) clinical experiences were assessed using a generalized estimating-equations approach for patient-centered care, IPECP, EBP, HIT, and QI behaviors (P < .05). Results Students implemented more behaviors associated with IPECP (P = .002), EBP (P = .002), and HIT (P = .042) during ICEs than N-ICEs. Students implemented the QI behavior more often during N-ICEs than during ICEs (P = .001). Patient-centered care behavior did not differ between clinical experience types. Conclusions Immersive clinical experiences facilitate increased implementation of behaviors associated with EBP, IPECP, and HIT, while N-ICEs offered increased opportunities for QI behaviors. Program administrators should consider placement of ICEs and N-ICEs in the curriculum that align with students’ capability to perform core competency behaviors. Preceptors of both ICEs and N-ICEs should be encouraged to provide students with opportunities to implement all core competencies during their clinical experience.

Implementation of Patient-Centered Care by Athletic Training Students during Clinical Experiences: A Report from the Association of Athletic Training Education Research Network.

Patient-centered care (PCC) is a core competency that should be required by all healthcare education programs, but little is known about its implementation in athletic training clinical experiences. Therefore, we examined characteristics of patient encounters documented by athletic training students implementing PCC behaviors. A multisite panel design was used to recruit 363 students from twelve professional athletic training programs (five undergraduate, seven graduate). Over 1.5 years, clinical experience patient encounter data were logged in E*Value Case Logs, including student role during the encounter, length of encounter, and clinical site. Generalized estimating equations models characterized the likelihood students included PCC behaviors in 30,522 encounters. Discussing patient goals was associated with student role (χ2(2) = 40.6, p < 0.001) and length of encounter (χ2(4) = 67.6, p < 0.001). Using patient-reported outcome measures was associated with student role (χ2(2) = 21.6, p < 0.001), length of encounter (χ2(4) = 34.5, p < 0.001), and clinical site (χ2(3) = 17.3, p = 0.001). Implementing clinician-rated outcome measures was affected by length of encounter (χ2(4) = 27.9, p < 0.001) and clinical site (χ2(3) = 8.6, p = 0.04). PCC behaviors were largely associated with student role and length of encounters; clinical site had less impact. Athletic training educators should emphasize progressive autonomous supervision with preceptors and encourage students to facilitate slightly longer patient visits, when possible, to incorporate more PCC behaviors.

Preparedness of Doctor of Athletic Training (DAT) Credentialed Athletic Trainers to Take Roles in Academia

Purpose: The athletic training education landscape is shifting, which has opened new avenues for postprofessional education. Previous literature has investigated stakeholder perceptions and attitudes towards hiring a DAT degree holder in academia. Yet, there is no research investigating the experiences of DAT degree holders in academic roles. The purpose of this study was to explore the preparation and experiences of DAT degree holders related to their roles in academia. Methods: We used a consensual qualitative research design to explore the lived experiences of DAT degree holders in academia through semi-structured web-based interviews. Twelve DAT degree holders with at least one-year post-graduation that have been in their current academic role for at least 6 months (5 male, 7 female) were interviewed. Participants engaged in semi-structured interviews that were audio-recorded and transcribed verbatim. We used a constant comparative analysis and multi-analyst triangulation to create a consensus codebook including domains and categories identified from the transcripts. Credibility and trustworthiness were established through member checking, multiple researcher triangulation, and auditing. Results: Three domains emerged from the experiences of DAT degree holders in their preparation within their program and their transition into education: 1) Common program preparation 2) Program variability and 3) Integration. Participants indicated they were commonly prepared in the areas of advanced clinical practice skills, clinically meaningful research, the value of service, and academic culture. However, there was variability in preparation regarding instructional design and program administration. Finally, participants spoke to receiving system acceptance through the perceived benefits of hybrid faculty as well as their increased translational teaching skills. Conclusions: DAT degree holders are prepared to assume academic roles based on the preparation received in their DAT program, despite not being formally prepared for teaching. Doctor of Athletic Training (DAT) degree holders are accepted by academia due to the perceived benefit of hybrid faculty and their ability to bridge the gap between didactic and clinical learning in professional athletic training programs

Student Educational Experiences Relative to Issues Impacting LGBTQPIA+ Patient Care

Context Athletic trainers have expressed a lack of knowledge and a desire to learn more about the issues impacting lesbian, gay, bisexual, transgender, queer/questioning, pansexual, intersex, asexual/aromantic/agender, two-spirit, and additional community/identity (LGBTQPIA+) patients, yet little is known about how students are prepared. Objective The purpose of this study was to explore educational experiences relative to LGBTQPIA+ patient care in Commission on Accreditation of Athletic Training Education–accredited, master's-level professional athletic training programs. Design Cross-sectional study. Setting Web-based survey. Participants Students (N = 333) who were currently enrolled in the last 1 to 2 semesters of their respective programs or had recently graduated from a master's-level professional athletic training program within the last year. Main Outcome Measure(s) The survey asked participants to characterize and evaluate the effectiveness of their learning experiences, then rank their confidence in addressing the needs of LGBTQPIA+ patients. We used additional open-ended responses to characterize effective instructional strategies. Data were analyzed using statistics of central tendency and open-ended responses were inductively coded. Results Participants reported that their learning experiences about LGBTQPIA+ patient needs were moderately effective for formal (38.2%), informal (42.2%), and clinical education (34.0%). Among the areas where participants reported wishing they had learned more were gender incongruence or dysphoria (39.6%), gender-affirming care (43.5%), and providing inclusive health care forms and documentation (38.4%). Participants reported about 15 ± 37 hours (range, 0–500 hours) of time dedicated to LGBTQPIA+ patient issues, although only 23.2% indicated that this was enough time. Participants indicated that they were quite confident in addressing the needs of LGBTQPIA+ patients (mode = 3 [quite confident], 33.0%); however, 53.7% of participants were only somewhat, slightly, or not at all confident. In the open-ended responses, participants indicated that informal and clinical education experiences providing authentic interactions with LGBTQPIA+ patients were most meaningful. Conclusions Professional athletic training programs should incorporate more educational experiences to better prepare students to meet the health care needs of LGBTQPIA+ patients. Participants in our study additionally indicated a strong desire to learn more about equitable patient care.

A Practical Approach to Health Literacy: A Primer for Athletic Training Educators

Context The Commission on Accreditation of Athletic Training Education has an educational standard to address the need for competence in health literacy. Objective The purpose of this paper is to introduce foundational health literacy knowledge and evidence-based tools to apply in athletic training and present examples of assignments to instruct and assess health literacy from a model professional athletic training program. Background Health literacy is “the degree to which individuals have the ability to find, understand, and use information and services to inform health-related decisions and actions for themselves and others.”1 Most patients will experience moments of poor health literacy; therefore, clinicians should use health literacy universal precautions to improve patient decisions and outcomes. These health decisions range from practicing health promotion behaviors, understanding when and how to use health services, and participating in shared decision-making about treatments or procedures. These same health decisions apply to athletic training patient populations. Athletic trainers (ATs) should demonstrate effective health literacy skills; therefore, professional athletic training programs must instruct athletic training students on essential concepts and tools. Description Examples of how one professional athletic training program instructs and assesses health literacy across the curriculum are discussed; including didactic lessons, rubric criteria development, a comprehensive health literacy project, and learning objectives for simulation-based experiences. Clinical Advantage Education drives clinical practice. Incorporating health literacy through didactic presentation and assessment of application may develop health literacy competence and prepare athletic training students to provide optimal care when transitioning to practice. Conclusion Health literacy universal precautions are recommended for all health care professionals to provide quality care. Introducing and assessing these concepts during education will prepare future ATs for successful integration of health literacy into clinical practice. Furthermore, these concepts and tools should be shared with preceptors to reinforce during student clinical experiences.

The Experiences of Professional Master's Athletic Training Students with Sexual Harassment During Clinical Education

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.

Incorporating Interfaith Concepts in Education on Patient-Centered Care

Context Many topics related to diversity, equity, and inclusion are receiving attention in the popular media and in literature. However, religious, spiritual, and secular identities and how these relate to culturally competent patient-centered care have received considerably less attention. Objective Encourage athletic training educators to enhance their curriculum related to providing culturally competent patient-centered care by including content on interfaith patient care and offer guidance on foundational concepts and practical strategies. This paper provides a framework for providing education on quality patient care with respect to patients' religious, spiritual, and secular identities: (1) create a foundation of understanding, (2) establish a rationale for content inclusion, and (3) provide practical strategies for teaching and the provision of quality patient-centered care with respect to religious, spiritual, and secular identities. Background Religious, spiritual, and secular identities are often an important part of a patient's self-concept, and thus need to be considered when providing culturally competent patient-centered care. The Board of Certification Standards of Professional Practice and the Commission on the Accreditation of Athletic Training Education standards for professional athletic training programs both address patient care with specific language related to cultural competence. Although athletic trainers recognize the importance of considering religious, spiritual, and secular identities of patients, many athletic trainers may not feel equipped to address these identities when providing culturally competent patient-centered care. Description Students should be better prepared to provide a more complete holistic approach to culturally competent patient-centered care. Educational Advantage A framework for addressing this content in an athletic training curriculum includes providing foundational concepts and a rationale for the inclusion of this content and then offering practical strategies for considering religious, spiritual, and secular identities in patient-centered care. Conclusion(s) Athletic training educational programs should include education on religious, spiritual, and secular identities for culturally competent patient-centered care.

Characteristics of Athletic Training Students' Patient Encounters During Immersive and Nonimmersive Clinical Experiences: A Report From the Association for Athletic Training Education Research Network

Context The 2020 Standards for the Accreditation of Professional Athletic Training Programs from the Commission on Accreditation of Athletic Training Education require programs to include at least one immersive clinical experience (ICE) in their clinical education curricula. Yet, it is unknown whether ICEs provide more opportunities and benefits than nonimmersive clinical experiences (N-ICEs). The purpose of this study was to compare characteristics of patient encounters (PEs) that occurred during ICEs and N-ICEs. Design Multisite panel design. Setting Twelve professional programs (5 undergraduate, 7 graduate). Patients or Other Participants Three hundred thirty-eight athletic training students logged PEs in the E*Value system. Main Outcome Measures For each PE, students reported clinical experience type (ICE, N-ICE), clinical site type, student role (observed, assisted, performed), diagnoses reported, and procedure(s) performed. Descriptive statistics were used to summarize PE characteristics. Generalized estimating equations were used to compare student role and clinical site type during PEs in ICEs and N-ICEs (P &amp;lt; .05). Results A total of 10 999 PEs occurred at ICEs and 18 228 PEs occurred at N-ICEs. Sixty-four percent of ICEs and 67.2% of N-ICEs occurred at collegiate settings. Students performed 70.6% of reported PEs during ICEs, and 72% of PEs at N-ICEs. Participants averaged 0.80 ± 0.64 diagnoses and 1.35 ± 1.12 procedures per PE during ICEs, compared with 0.82 ± 0.63 diagnoses and 1.33 ± 1.04 procedures per PE during N-ICEs. No significant differences between ICEs and N-ICEs were found in either student role (P = .50) or clinical site type (P = .71). Conclusion(s) Programs may intend to use ICEs later in their curricula to demonstrate progressive clinical autonomy; however, we found no statistically significant differences in student role for ICEs versus N-ICEs. The ICEs examined in this study may have been implemented without specific objectives, which may explain the lack of characteristic differences between the clinical experience types.

Program Administrators' Perceived Challenges Associated With Developing Preceptors

Context Understanding potential barriers that prevent program administrators from providing high-quality preceptor development opportunities will help inform strategies of preceptor development. Objective To explore the challenges program administrators encounter when developing preceptors for graduate, professional athletic training programs. Design Consensual qualitative research. Setting Individual semistructured phone interviews. Patients or Other Participants Eighteen program administrators (17 coordinators of clinical education, 1 program director; 5.92 ± 4.19 years of experience) participated in this study. Data saturation guided the number of participants. Data Collection and Analysis Semistructured interviews were recorded and transcribed verbatim. A 4-person research team used a consensus process to analyze data and identify emergent themes. A consensual codebook was created after researchers independently coded the data and discussed emergent themes. Credibility of the findings was established through multiple researchers, an external auditor, and member checks. Results Two themes emerged, delivery and content. How to deliver development posed a challenge, with work schedules and geographical spread inhibiting the ability to schedule one in-person group meeting. Lastly, participants struggled to balance their own workloads to overcome the challenges of curating and delivering multiple preceptor development opportunities in addition to their existing academic obligations. Identifying which content to include that was relevant and useful to a variety of preceptors regardless of setting or experience was also a challenge for our participants. Participants felt that some preceptors were reticent to learn about program policies, accreditation requirements, or newly included clinical skills, making large-group development opportunities more challenging. Conclusions Administrators may need multiple preceptor development options to accommodate the varying levels of experience, desired content, and geographical locations of preceptors; however, this subsequently increases workload challenges. Educating institutional administrators about the demands of developing preceptors may open dialogue regarding workload and provision of necessary resources associated with preceptor development.

Frequency of, Confidence in, and Educational Satisfaction With Mental Illness Recognition and Referral Among Certified Athletic Trainers.

Mental illness recognition and referral are required components of professional athletic training education. However, athletic trainers (ATs) often report feeling underprepared to assist patients with mental health emergencies. To determine ATs' frequency of and confidence in psychosocial skill use and their satisfaction with education related to mental illness recognition and referral. Cross-sectional study. Online survey. A total of 226 ATs (86 men, 140 women; age = 35.5 ± 9.9 years, years of practice = 11.9 ± 9.0). The independent variables were professional athletic training program, professional psychosocial courses, highest education level, psychosocial continuing education units, clinical practice setting, and years of experience. For each skill, individuals identified the average frequency with which the skill was performed each year, rated their confidence in performing the skill, and rated their satisfaction with professional education related to the skill. Anxiety was reported as the symptom most frequently recognized and referred. Most respondents felt moderately or extremely confident in managing patients with anxiety, panic attacks, depression, suicidal ideation, or eating disorders but less confident or unconfident in managing those with psychosis or substance use disorder. The majority of respondents felt dissatisfied or only slightly satisfied with their education related to mental health recognition and referral. Years of clinical practice and self-reported frequency of referral were significantly associated for managing patients with anxiety disorder (\(\def\upalpha{\unicode[Times]{x3B1}}\)\(\def\upbeta{\unicode[Times]{x3B2}}\)\(\def\upgamma{\unicode[Times]{x3B3}}\)\(\def\updelta{\unicode[Times]{x3B4}}\)\(\def\upvarepsilon{\unicode[Times]{x3B5}}\)\(\def\upzeta{\unicode[Times]{x3B6}}\)\(\def\upeta{\unicode[Times]{x3B7}}\)\(\def\uptheta{\unicode[Times]{x3B8}}\)\(\def\upiota{\unicode[Times]{x3B9}}\)\(\def\upkappa{\unicode[Times]{x3BA}}\)\(\def\uplambda{\unicode[Times]{x3BB}}\)\(\def\upmu{\unicode[Times]{x3BC}}\)\(\def\upnu{\unicode[Times]{x3BD}}\)\(\def\upxi{\unicode[Times]{x3BE}}\)\(\def\upomicron{\unicode[Times]{x3BF}}\)\(\def\uppi{\unicode[Times]{x3C0}}\)\(\def\uprho{\unicode[Times]{x3C1}}\)\(\def\upsigma{\unicode[Times]{x3C3}}\)\(\def\uptau{\unicode[Times]{x3C4}}\)\(\def\upupsilon{\unicode[Times]{x3C5}}\)\(\def\upphi{\unicode[Times]{x3C6}}\)\(\def\upchi{\unicode[Times]{x3C7}}\)\(\def\uppsy{\unicode[Times]{x3C8}}\)\(\def\upomega{\unicode[Times]{x3C9}}\)\(\def\bialpha{\boldsymbol{\alpha}}\)\(\def\bibeta{\boldsymbol{\beta}}\)\(\def\bigamma{\boldsymbol{\gamma}}\)\(\def\bidelta{\boldsymbol{\delta}}\)\(\def\bivarepsilon{\boldsymbol{\varepsilon}}\)\(\def\bizeta{\boldsymbol{\zeta}}\)\(\def\bieta{\boldsymbol{\eta}}\)\(\def\bitheta{\boldsymbol{\theta}}\)\(\def\biiota{\boldsymbol{\iota}}\)\(\def\bikappa{\boldsymbol{\kappa}}\)\(\def\bilambda{\boldsymbol{\lambda}}\)\(\def\bimu{\boldsymbol{\mu}}\)\(\def\binu{\boldsymbol{\nu}}\)\(\def\bixi{\boldsymbol{\xi}}\)\(\def\biomicron{\boldsymbol{\micron}}\)\(\def\bipi{\boldsymbol{\pi}}\)\(\def\birho{\boldsymbol{\rho}}\)\(\def\bisigma{\boldsymbol{\sigma}}\)\(\def\bitau{\boldsymbol{\tau}}\)\(\def\biupsilon{\boldsymbol{\upsilon}}\)\(\def\biphi{\boldsymbol{\phi}}\)\(\def\bichi{\boldsymbol{\chi}}\)\(\def\bipsy{\boldsymbol{\psy}}\)\(\def\biomega{\boldsymbol{\omega}}\)\(\def\bupalpha{\bf{\alpha}}\)\(\def\bupbeta{\bf{\beta}}\)\(\def\bupgamma{\bf{\gamma}}\)\(\def\bupdelta{\bf{\delta}}\)\(\def\bupvarepsilon{\bf{\varepsilon}}\)\(\def\bupzeta{\bf{\zeta}}\)\(\def\bupeta{\bf{\eta}}\)\(\def\buptheta{\bf{\theta}}\)\(\def\bupiota{\bf{\iota}}\)\(\def\bupkappa{\bf{\kappa}}\)\(\def\buplambda{\bf{\lambda}}\)\(\def\bupmu{\bf{\mu}}\)\(\def\bupnu{\bf{\nu}}\)\(\def\bupxi{\bf{\xi}}\)\(\def\bupomicron{\bf{\micron}}\)\(\def\buppi{\bf{\pi}}\)\(\def\buprho{\bf{\rho}}\)\(\def\bupsigma{\bf{\sigma}}\)\(\def\buptau{\bf{\tau}}\)\(\def\bupupsilon{\bf{\upsilon}}\)\(\def\bupphi{\bf{\phi}}\)\(\def\bupchi{\bf{\chi}}\)\(\def\buppsy{\bf{\psy}}\)\(\def\bupomega{\bf{\omega}}\)\(\def\bGamma{\bf{\Gamma}}\)\(\def\bDelta{\bf{\Delta}}\)\(\def\bTheta{\bf{\Theta}}\)\(\def\bLambda{\bf{\Lambda}}\)\(\def\bXi{\bf{\Xi}}\)\(\def\bPi{\bf{\Pi}}\)\(\def\bSigma{\bf{\Sigma}}\)\(\def\bPhi{\bf{\Phi}}\)\(\def\bPsi{\bf{\Psi}}\)\(\def\bOmega{\bf{\Omega}}\)\({\rm{\chi }}_{87}^2\) = 117.774, P = .016) and suicidal thoughts or actions (\({\rm{\chi }}_{87}^2\) = 179.436, P < .001). For confidence, significant positive associations were present between years of practice and self-reported recognition of patients with anxiety disorders (\({\rm{\chi }}_{145}^2\) = 195.201, P = .003) and referral for those with anxiety disorders (\({\rm{\chi }}_{145}^2\) = 15.655, P = .048) or panic attacks (\({\rm{\chi }}_{145}^2\) = 19.790, P = .011). Significant associations were also noted between the number of continuing education units and self-reported confidence in recognizing suicide (\({\rm{\chi }}_{15}^2\) = 26.650, P = .032), referring for suicidal concerns (\({\rm{\chi }}_{18}^2\) = 40.456, P = .002), recognizing substance use (\({\rm{\chi }}_{18}^2\) = 33.649, P = .014), and referring for substance use (\({\rm{\chi }}_{18}^2\) = 30.918, P = .029). No significant associations were related to satisfaction. The ATs with fewer years of clinical practice (ie, who had completed professional programs more recently) expressed higher confidence in mental health recognition and referral than those who had completed professional programs longer ago. We recommend that real-time interactions with individuals who have mental health concerns or emergencies be incorporated into professional education programs and that increased emphasis be placed on continuing education related to these topics.

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.

Characteristics of Patient Encounters for Athletic Training Students During Clinical Education: A Report From the Association for Athletic Training Education Research Network.

To enhance the quality of patient care, athletic training students (ATSs) should experience a wide variety of clinical practice settings, interact with diverse patient populations, and engage with patients who have a wide variety of conditions. It is unclear in what ways, if any, ATSs have diverse opportunities during clinical experiences. To describe the characteristics of patient encounters (PEs) ATSs engaged in during clinical experiences. Multisite panel design. Twelve professional athletic training programs (5 bachelor's, 7 master's). A total of 363 ATSs from the athletic training programs that used E*Value software to document PEs during clinical experiences. During each PE, ATSs were asked to log the clinical site at which the PE occurred (college or university, secondary school, clinic, or other), the procedures performed during the PE (eg, knee evaluation, lower leg flexibility or range of motion, cryotherapy), and the patient's diagnosis, with the International Classification of Diseases, Tenth Revision code (eg, S83.512A knee sprain, anterior cruciate ligament). A total of 30 630 PEs were entered by 338 ATSs across 278 unique clinical settings. More than 80% of PEs occurred in college or university and secondary school settings. More than half of the diagnoses were categorized as affecting the lower body region. Examination and evaluation procedures and application of therapeutic modality procedures each contributed approximately 27% of procedures. It was surprising that ATSs were not gaining experience in all clinical practice settings in which athletic trainers commonly practice. Our data suggest that students may be consigned to working with patients who have more frequently occurring injuries, which may not prepare them for the realities of autonomous clinical practice. These findings indicate that directed efforts are needed to ensure that ATSs are provided opportunities to engage with diverse patient populations who have a variety of conditions in an array of clinical site types during their clinical experiences.

Career Aspirations of Recent Graduates From Professional Master's-Level Athletic Training Programs

Context Transition to clinical practice is a topic receiving substantial attention. Many reports have focused on the educational program's role and have stopped short of identifying the impact of the initial year of employment on desire to persist and future career goals. Objective To examine the career aspirations of athletic trainers in their first year of employment who graduated from professional master's programs. Design Qualitative. Setting Nine professional master's athletic training programs, variety of employment settings. Patients or Other Participants Seven men and 7 women (age = 25.6 ± 3.7 years). Data Collection and Analysis A general inductive approach was used to analyze data from individual interviews conducted 6 and 12 months into the first year of clinical practice. Multiple-analyst triangulation and peer review ensured credibility. Results Graduates of professional master's programs in athletic training plan to stay in the profession. However, newly credentialed athletic trainers do not plan to remain with their initial employer beyond 2 years; 11 of 14 participants (79%) stated their first job was transitional. The first year of employment did not change participants' perceptions, as the graduates knew upon taking their first job that it would be temporary. Though participants planned to change jobs, most (79%) planned to continue to engage in clinical practice as athletic trainers. Conclusions Understanding newly credentialed athletic trainers' perceptions of the impact of the first year of employment can provide educators and employers important insight to assist in retention and persistence of young professionals. Graduates regard their first years of employment as impermanent. However, the majority do not wish to leave clinical practice. Participants viewed their first job as a way to gain valuable experience that did not dissuade them from continuing in the field. Recent graduates demonstrated ambitions to experience different work settings and higher-level positions with greater responsibilities.

Optimism, But Not Locus of Control, Moderates Burnout in Professional Master's Athletic Training Students

Context Burnout is a common concern in the field of athletic training that may affect athletic training students. They may experience burnout because of stressors related to their clinical education responsibilities and course load. Various buffers have been suggested to reduce burnout in other health care settings; however, there is a limited body of research examining the effect of locus of control and optimism as buffers against burnout in athletic training populations. Objective To investigate whether a perceived internal locus of control and/or optimism can provide a buffer against burnout in athletic training students. Design and Setting A cross-sectional observational research design via Qualtrics survey. Patients or Other Participants A total of 48 professional master's athletic training students enrolled in Commission on Accrediting Athletic Training Education–accredited programs. Data Collection and Analysis Participants were sent a survey link that included demographic questions, the Copenhagen Burnout Inventory, Life Orientation Test–Revised, and the Rotter Internal/External Locus of Control Scale. Three multiple regression analyses were conducted to examine the relationships of personal burnout, work-related burnout, and client-related burnout with optimism and locus of control. A Pearson correlation was conducted on the significant findings to determine the strength of relationship among variables. Main Outcome Measure(s) Copenhagen Burnout Inventory, Life Orientation Test–Revised, Rotter Internal/External Locus of Control Scale. Results Significant relationships were identified between optimism and personal burnout (t = −3.30, P = .002) and between optimism and work-related burnout. (t = −2.48, P = .02). No significant relationships were identified between locus of control and any of the burnout-related variables (P &amp;gt; .05). Conclusion Optimism could be an effective buffer against student burnout in professional master's athletic training programs. Athletic training programs should implement various strategies to promote student optimism including proper social support strategies, time management, and stress management to help reduce the onset of burnout in students.