scholarly journals Postprofessional Athletic Training Students' Perceptions Concerning the Health Care Competencies

2018 ◽  
Vol 13 (4) ◽  
pp. 309-323 ◽  
Author(s):  
Cailee E. Welch Bacon ◽  
Bonnie L. Van Lunen ◽  
Dorice A. Hankemeier
Keyword(s):  
Health Care ◽  
Clinical Practice ◽  
Athletic Training ◽  
Core Competencies ◽  
Likert Scale ◽  
Athletic Training Students ◽  
Patient Centered ◽  
Health Care Informatics ◽  
Centered Care ◽  
Care Informatics

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.

scholarly journals Effect of Procedure Type on Core Competency Implementation by Athletic Training Students

2019 ◽  
Vol 14 (3) ◽  
pp. 208-214
Author(s):  
Julie M. Cavallario ◽  
Bonnie L. Van Lunen ◽  
Sarah A. Manspeaker
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Training Program ◽  
Athletic Training ◽  
Manual Therapy ◽  
Regression Models ◽  
Core Competencies ◽  
Athletic Training Students ◽  
Health Care Informatics ◽  
Care Informatics

Context Core competencies (CCs) are now a required component of educational content in all types of Commission on Accreditation of Athletic Training Education-accredited athletic training programs. There is limited evidence demonstrating which procedures included during patient encounters (PEs) occurring in clinical education allow for implementation of CCs. Objective To determine the relationship between procedures performed by athletic training students during PEs on CC implementation. Design Panel design. Setting Undergraduate, professional athletic training program, National Collegiate Athletic Association Division I institution. Patients or Other Participants We purposefully recruited 1 athletic training program that used E*Value (Medhub) software; 40 participants (31 female, 9 male) enrolled in the professional phase (12 first year, 14 second year, 14 third year) participated. Interventions Participants viewed a 20 minute recorded CC education module followed by educational handouts, which were available online for reference throughout the semester. E*Value was used to track procedures (prevention, evaluation, manual therapy, rehabilitation, treatment, diagnostic, surgical, or other) performed during PEs and an added block of questions indicating which, if any, of the CCs were implemented during the PE. Main Outcome Measure(s) Independent variables included procedures performed during PEs and whether any of the 6 CCs were implemented (yes/no). Binary logistic regression models determined how the type of procedure performed related to the implementation of each CC. Results Regression models were significant for 5 of the 6 CCs: patient-centered care (PCC; {\rm{\chi }}_7^2 = 62.949, P < .001), interprofessional education and collaborative practice (IPECP; {\rm{\chi }}_6^2 = 41.172, P < .001), health care informatics ({\rm{\chi }}_7^2 = 186.487, P < .001), evidence-based practice (EBP) ({\rm{\chi }}_8^2 = 54.712, P < .001), and quality improvement ({\rm{\chi }}_7^2 = 67.967, P < .001). Participants including evaluation procedures during PE were 3.6 and 1.3 times more likely to implement PCC and IPECP, respectively. Participants including a diagnostic procedure were 4.2 and 2.9 times more likely to implement EBP and IPECP, respectively, and 0.2 times less likely to implement health care informatics. Participants incorporating a manual therapy procedure were 2.6, 1.7, and 2.1 times more likely to implement PCC, EBP, and quality improvement, respectively. Conclusions Athletic training program administrators should identify clinical sites that allow for PEs and procedural opportunities that align with priorities for greater CC implementation.

scholarly journals Program Directors' and Athletic Training Students' Educational Experiences Regarding Patient-Centered Care and Transgender Patient Care

2021 ◽  
Vol 16 (3) ◽  
pp. 219-234
Author(s):  
Gillian T. Shaughnessy ◽  
Ashley K. Crossway ◽  
Lindsey E. Eberman ◽  
Sean M. Rogers ◽  
Zachary K. Winkelmann
Keyword(s):  
Health Care ◽  
Patient Care ◽  
Athletic Training ◽  
Clinical Education ◽  
Training Programs ◽  
Educational Experiences ◽  
Athletic Training Students ◽  
Patient Centered ◽  
Centered Care ◽  
Transgender Patient

Context The United States transgender patient population often suffers from insufficient health care and faces barriers to obtaining health care. Understanding the current classroom education provided in professional athletic training programs related to patient-centered and transgender patient care is necessary to foster improvements to the education of future health care providers. Objective To explore the education, comfort, and experience of professional athletic training students and program directors (PDs) on patient-centered care (PCC) and transgender patient care. Design Cross-sectional survey. Setting Online survey. Patients or Other Participants A total of 74 PDs of Commission on Accreditation of Athletic Training Education-accredited professional athletic training programs (age = 46 ± 9 years) and 452 athletic training students (age = 23 ± 3 years) responded to the survey. Data Collection and Analysis Two surveys were created from literature and were reviewed by a committee of content experts. Participants were sent links to their respective survey in March 2020. Surveys contained questions on demographic information, PCC, and transgender patient care. Data were analyzed descriptively with follow-up χ2 analyses comparing athletic training students' comfort and competence between those who learned and did not learn about transgender patient care. Results Most PDs reportedly felt comfortable (98.6%, n = 73) and competent (94.6%, n = 70) teaching PCC. Half (50% n = 37/74) of PDs include transgender health care in their program's curriculum but lacked competence (37.8%, n = 28) in teaching. All students felt comfortable (100%, n = 452) and competent (98.7%, n = 446) practicing PCC, but only 12.4% (n = 54) reported practicing it during clinical education. Less than half (43.1%, n = 195/452) of students learned about transgender patient care, yet most (78.3%, n = 354) felt comfortable but lacked competence (41.8% n = 189). Conclusions Few students reportedly practice PCC during clinical education. Both groups perceived deficiencies in competence related to transgender patient care. We suggest PDs teach transgender health care in their curriculum and seek professional development to create meaningful educational experiences.

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

2020 ◽  
Vol 15 (4) ◽  
pp. 321-330
Author(s):  
Rhianna Freiburger ◽  
Kelsey J. Picha ◽  
Cailee E. Welch Bacon ◽  
Alison R. Snyder Valier
Keyword(s):  
Health Care ◽  
Clinical Practice ◽  
Social Determinants Of Health ◽  
Athletic Training ◽  
Social Determinants ◽  
Health Care Services ◽  
Athletic Trainers ◽  
Athletic Training Education ◽  
Determinants Of Health ◽  
Patient Centered

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.

scholarly journals Time's Up! Needed Cultural Changes in Athletic Training Education and Clinical Practice

2021 ◽  
Vol 16 (1) ◽  
pp. 87-93
Author(s):  
Destinee Grove ◽  
Jamie Mansell ◽  
Dani Moffit
Keyword(s):  
Clinical Practice ◽  
Cultural Competence ◽  
Athletic Training ◽  
Athletic Trainers ◽  
Holistic Approach ◽  
Athletic Training Education ◽  
Culturally Competent ◽  
Patient Centered ◽  
Cultural Changes ◽  
Centered Care

Context Culturally competent care has been on the radar of peer health care professions for many years. The unique patient populations that athletic trainers work with lend us to be at the forefront of delivering truly patient-centered care. However, we have not yet appropriately incorporated this tenet of evidence-based practice. Objective To convey the importance of culturally inclusive care and education to athletic training clinical practice and educational programs. We also present a novel way to intertwine inclusivity in the classroom and the clinic in a way that is accessible at any point in one's cultural competence journey. Background Historically, cultural competence in athletic training education has focused on ethnicity and race. The students we teach and the patients we treat share a variety of cultures that are often forgotten yet need to be included for a more holistic approach. Recommendation(s) Athletic trainers and athletic training educators need to continue the journey toward delivering culturally inclusive care. This journey also needs to extend to the classroom, from the delivery methods of teaching to the way we interact with our students. Teaching priorities should include a focus on the cultures around and within our profession.

scholarly journals Using Disablement Models and Clinical Outcomes Assessment to Enable Evidence-Based Athletic Training Practice, Part I: Disablement Models

2008 ◽  
Vol 43 (4) ◽  
pp. 428-436 ◽  
Author(s):  
Alison R. Snyder ◽  
John T. Parsons ◽  
Tamara C. Valovich McLeod ◽  
R. Curtis Bay ◽  
Lori A. Michener ◽  
...  
Keyword(s):  
Health Care ◽  
Clinical Practice ◽  
Clinical Outcomes ◽  
Athletic Training ◽  
Outcomes Assessment ◽  
Evidence Based ◽  
Patient Centered ◽  
Clinical Outcomes Assessment ◽  
Training Practice

Abstract Objective: To present and discuss disablement models and the benefits of using these models as a framework to assess clinical outcomes in athletic training. Background: Conceptual schemes that form the basic architecture for clinical practice, scholarly activities, and health care policy, disablement models have been in use by health care professions since the 1960s. Disablement models are also the foundation for clinical outcomes assessment. Clinical outcomes assessment serves as the measurement tool for patient-oriented evidence and is a necessary component for evidence-based practice. Description: Disablement models provide benefits to health professions through organization of clinical practice and research activities; creation of a common language among health care professionals; facilitation of the delivery of patient-centered, whole-person health care; and justification of interventions based on a comprehensive assessment of the effect of illness or injury on a person's overall health-related quality of life. Currently, the predominant conceptual frameworks of disability in health care are those of the National Center for Medical Rehabilitation Research and the World Health Organization. Disablement models need to be understood, used, and studied by certified athletic trainers to promote patient-centered care and clinical outcomes assessment for the development of evidence-based practice in athletic training. Clinical and Research Advantages: For clinicians and researchers to determine effective athletic training treatments, prevention programs, and practices, they must understand what is important to patients by collecting patient-oriented evidence. Patient-oriented evidence is the most essential form of outcomes evidence and necessitates an appreciation of all dimensions of health, as outlined by disablement models. The use of disablement models will allow the athletic training profession to communicate, measure, and prioritize the health care needs of patients, which will facilitate organized efforts aimed at assessing the quality of athletic training services and practices and ultimately promote successful evidence-based athletic training practice.

scholarly journals Translation of Standardized Patient Encounter Performance and Reflection to Clinical Practice

2019 ◽  
Vol 14 (2) ◽  
pp. 117-127
Author(s):  
Kristen N. Sims-Koenig ◽  
Stacy E. Walker ◽  
Zachary K. Winkelmann ◽  
Joshua M. Bush ◽  
Lindsey E. Eberman
Keyword(s):  
Clinical Practice ◽  
Athletic Training ◽  
Athletic Trainers ◽  
Degree Program ◽  
Standardized Patient ◽  
Semistructured Interview ◽  
Patient Centered ◽  
Self Reflection ◽  
Centered Care ◽  
Part Time

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.

Arteriovenous fistula cannulation in hemodialysis: A vascular access clinical practice guidelines narrative review

2021 ◽  
pp. 112972982110069
Author(s):  
Rui Pinto ◽  
Clemente Sousa ◽  
Anabela Salgueiro ◽  
Isabel Fernandes
Keyword(s):  
Clinical Practice ◽  
Arteriovenous Fistula ◽  
Vascular Access ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Good Evidence ◽  
Preparation Technique ◽  
Patient Centered ◽  
The Past ◽  
Centered Care

The cannulation of an arteriovenous fistula (AVF) by the hemodialysis (HD) nurse is challenging. Despite it being the focus of extensive research, it is still one of the majors causes of damage making it prone to failure. A considerable number of Clinical Practice Guidelines (CPGs) for the management of vascular access (VA) have been published worldwide over the past two decades. This review aimed to assess all information available in the selected CPG regarding AVF cannulation for HD providing a comprehensive analysis in order to interpret possible future cannulation approaches. A total of seven CPGs were described in a coding table separated in seven subthemes: Initiation of cannulation, preparation, technique, needle selection, surveillance, pain, and education. Our analysis outlines current CPGs for HD VA cannulation with lack of good evidence support for the majority of the recommendations, showing that, there is an urgent need for international collaboration and coordination to ensure relevant and high-quality evidence. Future CPGs must consider recommendations with better grading of evidence aiming patient-centered care and nurse decision models that can potentially represent better AVF cannulation outcomes.

Consent, Refusal, and Waivers in Patient-Centered Dysphagia Care: Using Law, Ethics, and Evidence to Guide Clinical Practice

2016 ◽  
Vol 25 (4) ◽  
pp. 453-469 ◽  
Author(s):  
Jennifer Horner ◽  
Maria Modayil ◽  
Laura Roche Chapman ◽  
An Dinh
Keyword(s):  
Health Care ◽  
Public Policy ◽  
Clinical Practice ◽  
Health Care Providers ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Care Providers ◽  
Patient Centered ◽  
Legal Advice ◽  
Medical Context

PurposeWhen patients refuse medical or rehabilitation procedures, waivers of liability have been used to bar future lawsuits. The purpose of this tutorial is to review the myriad issues surrounding consent, refusal, and waivers. The larger goal is to invigorate clinical practice by providing clinicians with knowledge of ethics and law. This tutorial is for educational purposes only and does not constitute legal advice.MethodThe authors use a hypothetical case of a “noncompliant” individual under the care of an interdisciplinary neurorehabilitation team to illuminate the ethical and legal features of the patient–practitioner relationship; the elements of clinical decision-making capacity; the duty of disclosure and the right of informed consent or informed refusal; and the relationship among noncompliance, defensive practices, and iatrogenic harm. We explore the legal question of whether waivers of liability in the medical context are enforceable or unenforceable as a matter of public policy.ConclusionsSpeech-language pathologists, among other health care providers, have fiduciary and other ethical and legal obligations to patients. Because waivers try to shift liability for substandard care from health care providers to patients, courts usually find waivers of liability in the medical context unenforceable as a matter of public policy.

scholarly journals Concordance and Patient-Centered Care in Medicaid Enrollees’ Care Experience With Providers

2021 ◽  
Vol 8 ◽  
pp. 237437352110340
Author(s):  
Iwimbong Kum Ghabowen ◽  
Neeraj Bhandari
Keyword(s):  
Health Care ◽  
Health Care Access ◽  
Patient Centered Care ◽  
Care Utilization ◽  
Federal State ◽  
Patient Centered ◽  
Care Experience ◽  
Centered Care ◽  
State And Local ◽  
Privately Insured

Patient-centered care is at the nexus of several overlapping institutional reforms to improve health care system performance. However, we know little regarding Medicaid patients’ experience with their doctors along several key dimensions of patient-centered care, and how their experience compares with Medicare and privately insured patients. We studied 4 outcomes using the 2017 National Health Interview Survey: patient–provider concordance on racial/sexual/cultural identity, respectful provider attitude, solicitation of patient opinion/beliefs during the care encounter, and patient-centered communication (PCC). The primary independent variable was Medicaid enrollee status. We dichotomized responses and ran multivariate logistic regressions for each type of care experience outcome, controlling for sociodemographic factors, health care access, and health care utilization of respondents. Compared to Medicare and privately insured enrollees, Medicaid enrollees reported much lower odds of seeing providers who treated them with respect (OR = 1.91, P < .001; OR = 1.62, P < .01) and who offered PCC (OR = 1.35, P < .05; OR = 1.35, P < .01), but similar odds of seeing concordant providers (OR = 0.78, P = .96; OR = 0.96, P = .72). Importantly, Medicaid enrollees reported higher odds of seeing providers who solicited their opinion/beliefs/preferences than their Medicare or privately insured counterparts (OR = 0.82, P < .05; OR = 0.87 P < .10). Medicaid enrollees report less patient-centered experiences in some important facets of their provider interaction than their Medicare or privately insured counterparts. Federal, state, and local policies and practices directed at improving these facets of patient–provider interaction are needed and should be aimed squarely at Medicaid providers, especially those working in geographic areas and settings with a disproportionate number of racial, gender, cultural, and linguistic minorities.

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