scholarly journals Educational Technique: Using a Phased Approach to Integrate Diagnostic Ultrasound into Athletic Training Education

2018 ◽  
Vol 13 (4) ◽  
pp. 372-376
Author(s):  
Kellie C. Huxel Bliven ◽  
Barton E. Anderson ◽  
Saskia D. Richter ◽  
Inder Raj S. Makin

Context: The use of point-of-care diagnostic ultrasound is increasing in health care, specifically among sports medicine clinicians as an adjunct to the physical exam. Given the role of athletic trainers in interdisciplinary sports medicine teams, athletic training educational programs should consider integrating this noninvasive imaging modality into curricula. Objective: To provide a framework for integrating diagnostic ultrasound imaging content into existing athletic training curricula. Background: A phased approach to incorporating ultrasound imaging into existing courses with minimal disruption is important for adoption. Foundational knowledge for skill performance begins with early exposure to ultrasound concepts and is followed by phased integration of hands-on ultrasound imaging into athletic training courses. Description: Content delivery considerations, such as online modules and technology needs, to enhance hands-on learning is discussed. Examples of integrating diagnostic ultrasound imaging throughout the curriculum, including anatomy, clinical assessment, and manual therapy courses, are provided. Clinical Advantage(s): Integrating ultrasound throughout curricula teaches students how to use and interpret ultrasound images as an adjunct to physical exam, enhancing the athletic trainer's value on a health care team and improving clinical practice. Ultrasound imaging can also be used as a valuable feedback mechanism during the performance of hands-on athletic training skills, including special tissue tests and manual therapy techniques. Conclusion(s): Following initial exposure to ultrasound imaging, the inclusion of diagnostic ultrasound instruction in athletic training curricula can expose students to ultrasound imaging, basic concepts, transducer characteristics, and image interpretation, which is a valuable adjunct to clinical practice.

2018 ◽  
Vol 13 (4) ◽  
pp. 367-371 ◽  
Author(s):  
Kellie C. Huxel Bliven ◽  
Barton E. Anderson ◽  
Inder Raj S. Makin

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


2018 ◽  
Vol 13 (4) ◽  
pp. 309-323 ◽  
Author(s):  
Cailee E. Welch Bacon ◽  
Bonnie L. Van Lunen ◽  
Dorice A. Hankemeier

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.


2017 ◽  
Vol 12 (3) ◽  
pp. 188-194
Author(s):  
Forrest Q. Pecha ◽  
Lucas A. Bahnmaier ◽  
Jefferson J. Wetherington ◽  
Alejandro A. Homaechevarria ◽  
Jon Schott

Context: Postprofessional residency (PPR) programs continue to gain popularity as athletic training education prepares for a paradigm shift. The Commission on Accreditation of Athletic Training Education has established didactic and clinical infrastructure for PPRs seeking accreditation. Accredited programs provide athletic trainers (ATs) with an advanced level of knowledge in a focused area of clinical practice. Objective: A case study report to introduce a novel PPR general medical rotation to illustrate the skills and knowledge of ATs, evaluate the impact of the athletic training residents in the rural family practice (FP) setting, and to discuss how employing an AT in this setting aligns with the triple aim of the Affordable Care Act (ACA). Background: Currently, there is very little literature regarding PPRs. Additionally, very little research exists describing how ATs function within the ACA model of health care delivery. Description: The PPR developed a rotation for a rural FP outpatient clinic. Athletic training residents completed 3-week rotations in this setting working with multiple providers. Learning objectives were created to emphasize the evaluation, diagnosis, and management of general medical conditions. Objectives were assessed at the conclusion of the rotation. Finally, data were collected to evaluate the impact of athletic training residents in the ACA model of health care delivery. Clinical Advantage(s): The athletic training residents improved their clinical evaluation and diagnosis skills in a FP clinic through this educational opportunity. This rotation cultivated and fostered interdisciplinary education and interprofessional collaboration. Finally, the observational findings of this rotation revealed the impact of ATs appear to align with the objectives of the ACA health care model, supporting the use of ATs in this role. Conclusion(s): This rotation highlights an area of clinical practice future ATs could pursue. Accredited PPR programs must consider the evolution in health care delivery and the shift in athletic training education standards to develop strong PP programs.


Author(s):  
Jessica Barrett ◽  
Stephanie Singe ◽  
Aynsley Diamond

Background: Institutions of higher education suffer from a shortage of appropriately prepared faculty members in athletic training and physical therapy programs. Both professional programs have recently undergone curricular reform and degree change. We sought gain an understanding of the preparation mechanisms experienced by athletic training and physical therapy practitioners for their junior faculty positions. Method: Twenty-six athletic trainers and physical therapists participated in this phenomenological study. Data from one-on-one phone interviews were analyzed following the inductive process of interpretive phenomenological analysis. Content experts, pilot interviews, multiple analysts and member checking ensured trustworthiness. Results: Findings indicate two primary mechanisms prepared the practitioners to become junior faculty members: doctoral degree programs and clinical practice. Doctoral degree programs did not provide experiences for all future faculty roles. Hands-on patient care practice provided participants the context for their teaching and confidence in knowledge aptitude. Conclusion: Doctoral institutions should provide a variety of hands on active learning experiences to doctoral students. Future faculty members can maximize the amount of time they provide clinical care to patients, following the attainment of their professional credential. Clinical competence and proficiency will serve as the foundational basis for their future teaching endeavors and may increase credibility and respect.


2020 ◽  
Vol 15 (4) ◽  
pp. 321-330
Author(s):  
Rhianna Freiburger ◽  
Kelsey J. Picha ◽  
Cailee E. Welch Bacon ◽  
Alison R. Snyder Valier

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.


2020 ◽  
Vol 55 (3) ◽  
pp. 217-228 ◽  
Author(s):  
Kenneth C. Lam ◽  
Cailee E. Welch Bacon ◽  
Eric L. Sauers ◽  
R. Curtis Bay

Context Recently, calls to conduct comparative effectiveness research (CER) in athletic training to better support patient care decisions have been circulated. Traditional research methods (eg, randomized controlled trials [RCTs], observational studies) may be ill suited for CER. Thus, innovative research methods are needed to support CER efforts. Objectives To discuss the limitations of traditional research designs in CER studies, describe a novel methodologic approach called the point-of-care clinical trial (POC-CT), and highlight components of the POC-CT (eg, incorporation of an electronic medical record [EMR], Bayesian adaptive feature) that allow investigators to conduct scientifically rigorous studies at the point of care. Description Practical concerns (eg, high costs and limited generalizability of RCTs, the inability to control for bias in observational studies) may stall CER efforts in athletic training. In short, the aim of the POC-CT is to embed a randomized pragmatic trial into routine care; thus, patients are randomized to minimize potential bias, but the study is conducted at the point of care to limit cost and improve the generalizability of the findings. Furthermore, the POC-CT uses an EMR to replace much of the infrastructure associated with a traditional RCT (eg, research team, patient and clinician reminders) and a Bayesian adaptive feature to help limit the number of patients needed for the study. Together, the EMR and Bayesian adaptive feature can improve the overall feasibility of the study and preserve the typical clinical experiences of the patient and clinician. Clinical Advantages The POC-CT includes the basic tenets of practice-based research because studies are conducted at the point of care, in real-life settings, and during routine clinical practice. If implemented effectively, the POC-CT can be seamlessly integrated into daily clinical practice, allowing investigators to establish patient-reported evidence that may be quickly applied to patient care decisions. This design appears to be a promising approach for CER investigations and may help establish a “learning health care system” in the sports medicine community.


2011 ◽  
Vol 6 (2) ◽  
pp. 121-123
Author(s):  
Jennifer Doherty-Restrepo

Evidence-based practice collectively involves research evidence, clinician expertise, and patient preference while making health care decisions. Due to health care reform legislation, there is greater emphasis on evidence-based practice as a means for improving the quality, and lowering the cost, of health care. Principles of evidence-based practice must be integrated into athletic training curricula for students to develop the skill set of accessing, understanding, and evaluating research to appropriately apply evidence–based procedures in clinical practice. We will provide brief synopses of current research related to teaching evidence-based practice and discuss possible applications to athletic training.


2018 ◽  
Vol 13 (1) ◽  
pp. 49-56
Author(s):  
Dorice A. Hankemeier ◽  
Jessica L. Kirby

Context: Knowledge and understanding of how to evaluate and implement clinical prediction rules (CPRs) is necessary for athletic trainers, but there is a lack of information on how to best teach students about CPRs. Objective: To provide an overview of the derivation, validation, and analysis of the different types of CPRs and to provide examples and strategies on how to best implement CPRs throughout didactic and clinical athletic training curricula. Background: Clinical prediction rules are used in a variety of health care professions to aid in providing patient-centered care in diagnosis or intervention. Previous research has identified that many athletic trainers have a limited knowledge of CPRs and often do not implement them in clinical practice even if they do know about them. Using these evidence-based decision-making tools can help improve patient outcomes while also decreasing unnecessary medical costs. Description: This article discusses the derivation and validation of CPRs as well as how to implement the concepts of CPRs in multiple courses to allow students numerous opportunities to understand how CPRs can be beneficial. Clinical Advantage(s): Teaching students how to critically analyze CPRs and understand the derivation process of CPRs will develop students' decision-making skills and encourage students to be evidence-based clinicians. In addition, the teaching strategies described here aim to create dialogue between students and preceptors regarding evidence-based practice concepts. Conclusion(s): Athletic trainers must be able to function in the larger health care environment, and understanding how to correctly evaluate and apply CPRs will be helpful. Teaching students a variety of CPRs and how to evaluate their impact on clinical practice will prepare students to step into this role when they become independent clinicians.


2021 ◽  
Vol 16 (3) ◽  
pp. 178-187
Author(s):  
Lindsey E. Eberman

Context Athletic training residency programs are proliferating rapidly, yet only 1 accredited residency is housed outside of physician-practice or clinic settings. Objective The focus of this article was to explore the structural and cultural factors that support a residency program in a college/university athletic training facility. Design Qualitative ethnographic study. Setting Boston University Commission on Accreditation of Athletic Training Education–accredited residency program. Patients or Other Participants The unit includes 16 full-time athletic trainers (2 of whom are residents, 6 of whom are residency faculty/preceptors) and 3 fellowship-trained primary care sports medicine physicians. Data Collection and Analysis I made observations, engaged in discussions, and conducted interviews for 34 days (159.5 hours) over 4 months. Data analysis involved examining transcriptions, field notes, and observational summaries of dialogue and behaviors, reactions, and my own interpretations. I used an inductive coding process to develop meaningful concepts, grouping them together to classify the data and identify themes and subthemes characterizing the structures of the culture. Results I identified 3 themes: resident preparation and expectations, residency experience, and environment. In the first theme, I identified that the residents came into the residency having some deficiencies and incongruent expectations of the program. In the second theme, I observed the residents gained depth of knowledge, skills, and abilities in their focused area of practice, and they improved self-reflective practices through their exposure to clinical specialists and the varied pedagogical approaches within the program. The environment included both benefits and challenges in having a residency. Engagement in interprofessional and collaborative practice and a culture of teaching and learning supported the residency environment. Conclusions Athletic health care administrators must clearly communicate expectations when recruiting candidates, consider the training and commitment of their staff, and ensure culture of health care education within their unit before developing a residency, regardless of setting.


2019 ◽  
Vol 14 (3) ◽  
pp. 208-214
Author(s):  
Julie M. Cavallario ◽  
Bonnie L. Van Lunen ◽  
Sarah A. Manspeaker

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.


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